Evaluate Health Coaching Support in Technology-based Interventions for Goal Setting (PEC 15-470)
Phase: NA
Conditions: Chronic Disease Prevention
Sponsor: VA Office of Research and Development

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Health Coaching Support in Technology-based Interventions  
for Meeting Health Goals 
NCT Number: NCT04021472 
Project ID: PEX 19-002 
April 2nd, 2024 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Background 
Overweight/obesity is strongly linked to mortality from multiple chronic diseases. For health 
disparity-facing populations, including racial/ethnic minority and low-income communities, 
interventions promoting goal setting and behavioral change for nutrition, physical activity, and weight 
are a national health priority.  There has been a rapid expansion in the use of digital technologies for 
delivering health interventions, but there is a need for more study of the potential use of these 
technologies among Veterans. This evaluation entails testing an automated SMS texting protocol 
intended to offer Veterans encouragement, tips, and other actionable information to assist in the 
pursuit of physical activity and healthy eating goals.  
 
Research Design/Methods 
We completed the development of materials and procedures to support a local, one-site 
evaluation focused on use of VA’s SMS automated texting system. The texting protocol offered Veterans 
encouragement, tips, and other actionable information over the course of an 8-week period to assist in 
the pursuit of physical activity and healthy eating goals. 
To test materials and procedures, we recruited one Veteran from a single VA medical center. A 
research assistant called the Veteran to administer a series of baseline survey measures. As part of this 
baseline data collection, the research assistant also led the Veteran through a process of identifying and 
setting a goal related to either diet or physical activity. This was achieved by first providing a brief lesson 
about SMART goals (Specific, Measurable, Achievable, Realistic, and Time-bound) and then asking the 
Veteran to state their goal. If the goal was too general, the research assistant worked with the Veteran 
to further revise the goal into a SMART goal. This process resulted in the Veteran articulating a goal that 
they wanted to pursue over the course of their participation. At the conclusion of the baseline data 
collection, the research assistant then enrolled the Veteran in the 8-week texting protocol through the 
automated texting system’s portal and mailed a welcome letter and FAQ sheet to the Veteran as well as 
a reminder of the goal that was set. The text messages that comprised the protocol were designed 
based on principles of behavioral change and were intended to motivate, support, and spur action 
toward the goals that were self-identified at baseline. Messages included standardized elements to 
encourage behavior change, like self-monitoring, instructions on how to perform specific behaviors, 
action planning, social support, feedback on goals, and problem-solving tips. In addition, we included a 
selection of light-hearted messages to enhance engagement with the texting protocol and assessment 
messages to gauge perceptions of the program. The automated texting system delivered messages daily 
over the course of the 8-week protocol period.  
At the conclusion of the 8-week texting protocol, the research assistant again called the Veteran 
to administer a series of follow-up survey measures and to gather open-ended feedback through semi-
structured interview questions about their experiences with the text messages. At the conclusion of 
follow-up data collection, the Veteran was mailed a thank you letter and a gift card as remuneration.  
 
Results/Conclusions 
We finalized a set of measures and materials, including baseline and follow-up surveys and a 
semi-structured interview guide, and an 8-week automated SMS texting protocol founded on 
established principles of behavior change. We enrolled one Veteran to pilot our materials and 
procedures with the intention of subsequently enrolling 40 Veterans (N) in a larger evaluation after any 
necessary revisions to the materials and procedures were made; however, these enrollment plans were 
halted because of COVID-19 risks and precautions.  
 The Veteran with whom we piloted our materials and procedures was 81 years old, male, single 
(never been married), white, had completed college /professional training, was not using SNAP 
(Supplemental Nutrition Assistance Program) at the time of participation, and self-reported having high 

blood pressure and treating it with medication. The Veteran set a goal to lose a specific, realistic amount 
of weight during the course of the program. 
We examined scores of psychosocial factors before and after completion of the texting protocol. 
This Veteran increased confidence to eat healthfully in a variety of situations (4.1 to 6.4; scale of 0: not 
at all confident to 10: very confident) and be physically active in a variety of situations (3.5 to 6.0 on a 
scale of 0: not at all confident to 10: very confident); lowered perception of goal difficulty (4 to 3; scale 
of 1: low difficulty to 5: high difficulty); and slightly lowered health confidence (1 to 1.75; scale of 1: high 
health confidence to 4: low health confidence). 
In terms of perceptions of the texting protocol, this Veteran reported that the number of text 
messages they received was just right, the texts were very useful in helping meet their health goal and 
would be very likely to recommend this program to others. The Veteran did not have changes to the 
program to recommend. 
Overall, some positive effects were reported by the Veteran and perceptions of the program 
were positive. These development activities are now complete and preparations for a full evaluation 
may commence at a later date.