Physical Activity and Social Support Prompting Via Phone Messaging

Study Overview
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Brief Summary
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The objective of this study was to investigate the feasibility, perceived usefulness, and potential effectiveness of a short text or voice message intervention to activate 1) physical activity behavior change among low-income, urban, Latino patients in diabetes management and 2) supportive behaviors by family members or close friends.

Detailed Description
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Despite the promise of phone-based interventions to effectively support diabetes self-management (DSM), little is known about their impact on the outcomes of highly vulnerable populations such as low-income, inner-city, racial/ethnic minorities. And while phone-based interventions have generally been successful at reaching and engaging adults with diabetes, they have failed to do the same with family members/friends (FF) whom are a promising source of ongoing support for DSM. The objective of this study was to investigate the feasibility, perceived usefulness, and potential effectiveness of a short text or voice message (ST/VM) intervention to activate 1) physical activity (PA) behavior change among low-income, urban, Latino patients in diabetes management and 2) supportive behaviors by FF. The investigators conducted a 12-week pilot study in which participants were randomized into one of three study arms: control, phone messaging (PM), and phone messaging plus social support from FF (PM+FF). Participants were recruited in person from a diabetes management program at a safety-net ambulatory care clinic. All participants were given a pedometer and walking log for self-monitoring. Participants in the PM and PM+FF arms received ST/VMs as reminders to review daily step goals and to self-monitor; explaining the benefits of regular PA, importance of regular PA to daily life, and ways to overcome commonly identified barriers to PA; asking participants to report on PA performance; providing feedback based on responses. Participants in the PM+FF identified a FF to receive ST/VMs with suggested behaviors that are perceived as supportive by individuals making PA behavior changes. Participants received semi-structured assessments in person at baseline, 6 weeks, and 12 weeks. Participants were asked about the extent to which the program enhanced the participant's ability to make PA behavior changes. The primary outcome measures were daily step counts and perceived FF social support.

Official Title
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Phone Messaging for Physical Activity and Social Support Prompting Among Low-Income Latino Patients: A Randomized Pilot Study

Conditions
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Physical Activity

Intervention / Treatment
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* Behavioral: Pedometers and Walking Logs
* Behavioral: Phone Messaging
* Behavioral: Family/Friend Support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age greater than or equal to 18 years Diagnosis of type 2 diabetes No medical conditions restricting patient from beginning a walking program Preferred language of English or Spanish, self-identifies as a Hispanic Ability to walk without the use of assistive devices such as canes or walkers Available to attend three interviews at the clinic Does not plan to move away from the region or be out of the country during the next three months Has a working phone where they can receive regular short text or voice messages for three months Exclusion Criteria: Pregnant or breastfeeding women

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Control<br>Pedometers and walking logs | Behavioral: Pedometers and Walking Logs<br>* Participants were recommended to use the pedometer and walking log to self-monitor how many steps participants walked each day. Participants were recommended to gradually increase daily steps over the course of 12 weeks until reaching 10,000 steps per day. Participants were also recommended to walk at a brisk pace for 3000 of these steps, which roughly translates to 30 minutes per day.<br>|
| Experimental: Phone Messaging<br>Phone Messaging | Behavioral: Pedometers and Walking Logs<br>* Participants were recommended to use the pedometer and walking log to self-monitor how many steps participants walked each day. Participants were recommended to gradually increase daily steps over the course of 12 weeks until reaching 10,000 steps per day. Participants were also recommended to walk at a brisk pace for 3000 of these steps, which roughly translates to 30 minutes per day.<br>Behavioral: Phone Messaging<br>* Participants received short text or voice messages (depending on participant preference) as reminders to review daily step goals and to self-monitor; explaining the benefits of regular physical activity, importance of regular physical activity to daily life, and ways to overcome commonly identified barriers to physical activity; asking participants to report on their physical activity performance; providing feedback based on responses.<br>|
| Experimental: Phone Messaging + Family/Friend Support<br>Phone Messaging + Family/Friend Support | Behavioral: Pedometers and Walking Logs<br>* Participants were recommended to use the pedometer and walking log to self-monitor how many steps participants walked each day. Participants were recommended to gradually increase daily steps over the course of 12 weeks until reaching 10,000 steps per day. Participants were also recommended to walk at a brisk pace for 3000 of these steps, which roughly translates to 30 minutes per day.<br>Behavioral: Phone Messaging<br>* Participants received short text or voice messages (depending on participant preference) as reminders to review daily step goals and to self-monitor; explaining the benefits of regular physical activity, importance of regular physical activity to daily life, and ways to overcome commonly identified barriers to physical activity; asking participants to report on their physical activity performance; providing feedback based on responses.<br>Behavioral: Family/Friend Support<br>* Participants identified a family member or close friend (FF) to receive short text or voice messages (depending on FF preference) with suggested behaviors that are perceived as supportive by individuals making physical activity behavior changes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in average daily steps assessed by pedometers | Change in average daily steps assessed using pedometer 7-day data storage | Baseline, 6 weeks, 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in body mass index | Change in Body Mass Index, which was calculated as weight (in kilograms) over height squared (in centimeters) | Baseline, 6 weeks, 12 weeks | 
| Change in exercise self-efficacy assessed using the Exercise Self-Efficacy Scale | Change in exercise self-efficacy assessed using the Exercise Self-Efficacy Scale | Baseline, 6 weeks, 12 weeks | 
| Change in barriers self-efficacy assessed using the Barriers Self-Efficacy Scale | Change in barriers self-efficacy assessed using the Barriers Self-Efficacy Scale | Baseline, 6 weeks, 12 weeks | 
| Change in perceived family/friend social support assessed using the Social Support and Exercise Survey | Change in perceived family/friend social support assessed using the Social Support and Exercise Survey | Baseline, 6 weeks, 12 weeks |