A Study for Testing Text Messaging and Newsletter as a Strategy for Interrupting Sedentary Behavior
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis
Study type: Interventional

Summary: 
      The study will examine the possibility of reducing sedentary behavior (SB) in African
      Americans with MS. SB consists of any waking activities that are done lying or sitting and do
      not demand significant physical effort (e.g., watching television, using the computer). SB is
      a major public health issue because it is associated with mortality and higher probabilities
      of presenting with health conditions and morbidity. There is indication that SB is related to
      physical disability, which is the inability of performing daily activities independently.
      This outcome is of high concern for persons with MS, especially those from underserved
      groups, such as African Americans. Thus, reducing the amount of time that people with MS
      spend in SB is important, but it is hard to find ways of doing so in large groups of people
      with MS. One possibility is to use text-messages to inform people about the necessity and
      benefits of interrupting SB by standing up, walking, or doing another activity. Text-messages
      are an ideal way to prompt behavior change because almost everyone owns a
      cellphone/smartphone in today's world. Considering this potential, the investigators will be
      studying whether or not it is possible to have a small group of African Americans with MS
      spend less time in SB by sending informative text-messages prompting individuals to stand-up
      and move around. This study will be used to inform the development of a much larger study
      that will aim to reduce SB in a very large sample of persons with MS.
    

Detailed description: 
      The investigators are conducting a pilot study to examine the feasibility and efficacy of a
      technology-based behavior change intervention for reducing SB in African Americans with MS
      located in the United States. The intervention combines text message- and print-based
      approaches for behavior change based on Social Cognitive Theory (SCT). SCT-based content will
      be the active component for changing SB, while cellphone text messages and print newsletter
      will be the delivery mechanism. The use of cellphone to deliver the intervention content is
      based, in part, on the fact that cellphone is an ordinary form of communication in today's
      world, providing an optimal medium for reaching large groups of people remotely. The study
      will yield major advancement in identifying the feasibility and efficacy of interrupting and
      reducing SB via a technology-based intervention in African Americans with MS, a segment of
      the MS population that has been underrepresented in MS therapeutic management studies. If
      successful, this research will lay the foundation for applying the current strategy in
      large-scale interventions including African Americans and possibly other minority groups with
      MS.

      The intervention will be 12 weeks and divided into two parts. Part 1: Weeks 1-6 will focus on
      interrupting long periods of SB. At the beginning of the first week, participants will
      receive a packet containing print material providing lay information on what constitutes SB
      and examples of such behavior, highlighting the importance of interrupting prolonged periods
      of SB and the associated health benefits. The aim of the packet is to provide the basis to
      introduce the key element (i.e., SCT-based instructional cellphone text-messages) of the
      intervention. This will occur during the following six weeks, wherein participants will
      receive two text-messages/day (i.e., morning and afternoon) on the importance and health
      benefits of interrupting SB hourly. The text-messages will prompt individuals to interrupt SB
      by standing still, standing while performing tasks, or walking around. The text-messages will
      include further tips and strategies for interrupting SB. The investigators have previously
      developed a computerized messaging system that will be used to send the text-messages twice a
      day in the proposed intervention. The investigators will supplement the text messaging by
      sending bi-weekly SCT-based newsletters to participants that highlight ways of overcoming
      difficulties in effectively interrupting SB. The SCT content for the messages and newsletter
      has been created in previous research and will be revised for the proposed intervention. Part
      2: Weeks 7-12 will focus on replacing SB with light PA. On the first day of week 7,
      participants will receive a second packet of print material explaining the concept of light
      PA and emphasizing the importance of moving more daily. The print material will highlight the
      benefits of replacing SB with light PA and will contain instructions for goal setting (i.e.,
      target number of steps/day) and self-monitoring of daily PA, including receive a pedometer
      and a log for recording total steps/day. Similar to part 1, the key element for intervention
      delivery will be the SCT-based instructional cellphone text-messages, which participants will
      receive during the second six-week intervention period. More specifically, they will receive
      two text-messages/day on the importance and health benefits of replacing SB with light PA.
      The text-messages will recommend participants to watch for prolonged periods of SB and try
      and substitute these for light PA, such as light intensity walking and light-intensity focal
      exercise (e.g., stationary walk, marching). The text-messages will also remind participants
      to use the pedometer to set incremental personal goals for steps/day and to gauge the
      replacement of SB with light PA by watching the pedometer readings. The investigators further
      will include tips and strategies for replacing SB with light PA based on common daily
      activities. Bi-weekly SCT-based newsletters will be used to supplement the stimulus from the
      text-messages, by reinforcing the importance of sitting less and moving more.
    

Intervention name(s): Social Cognitive Theory based text messages
Intervention type(s): Behavioral
Intervention description(s): Participants receive daily text messages and bi-weekly newsletters with information about reducing sitting behavior and increasing physical activity.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: sedentary behavior; physical activity