Feasibility of promoting physical activity using mHEALTH technology in rural women: the step-2-it study

Cara Locklin,Rebecca Lyons,Kristine Zimmermann,Ben S Gerber,Manorama M Khare

doi:10.1186/s12905-021-01561-5

Abstract

BackgroundRural women are more likely to be obese and have a higher risk for chronic disease than their non-rural counterparts. Inadequate physical activity (PA) at least in part contributes to this increased risk. Rural women face personal, social and environmental barriers to PA engagement. Interventions promoting walking among rural women have demonstrated success; however, few of these studies use text messaging to promote PA.MethodsStep-2-It was a pilot study to assess the feasibility, acceptability, and effectiveness of text-messaging combined with a pedometer to promote PA, specifically walking among English-speaking women, aged 40 and older, living in a rural, northwest Illinois county. Enrolled participants completed baseline assessments, received pedometers and two types of automated text messages: motivational messages to encourage walking, and accountability messages to report pedometer steps. Participants engaged in 3, 6, 9, and 12-week follow-ups to download pedometer data, and completed post-intervention assessments at 12 weeks.ResultsOf the 44 enrolled participants, 35 participants (79.5%) completed the intervention. Among completers, the proportion meeting PA guidelines increased from 31.4% (11/35) at baseline to 48.6% (17/35) at post-intervention, those with no PA decreased from 20% (7/35) to 17.1% (6/35). During weeks 1-12, when participants received motivational text messages, average participant daily step count was 5926 ± 3590, and remained stable during the intervention. Pedometer readings were highly correlated with self-reported steps (r = 0.9703; p < 0.001).ConclusionStep-2-It was a feasible and acceptable walking intervention for older rural women. Technology, including text messaging, should be investigated further as an enhancement to interventions for rural women.Trial Registration on Clinicaltrials.gov: NCT04812756, registered on March 22, 2021

Highlights

Rural women are more likely to be obese and have a higher risk for chronic disease than their non-rural counterparts
Mobile health technology and physical activity (PA) trackers are two technologies that can be used to promote walking in rural women
Cell phone use in the US is nearly universal, 97% of urban adults and 95% of rural adults are cell-phone users [19]. Mobile health (mHealth) interventions using text messaging have been used to address a variety of health concerns [20,21,22,23,24,25,26], including PA promotion [27,28,29]

Summary

Introduction

Rural women are more likely to be obese and have a higher risk for chronic disease than their non-rural counterparts. Interventions promoting walking among rural women have demonstrated success; few of these studies use text messaging to promote PA. Rural women are significantly more likely to be obese than non-rural women [1], which is associated at least in part to inadequate physical activity (PA) [2,3,4,5,6]. Mobile health (mHealth) technology and PA trackers are two technologies that can be used to promote walking in rural women. Mobile health or mHealth when used to promote walking in rural women can broaden the reach of these interventions and gives the ability to communicate with women in real-time

Methods

Results

Discussion

Conclusion