Motive8! Feasibility of a Text Messaging Intervention to Promote Physical Activity in Knee Osteoarthritis

Holly Blake

doi:10.23937/2469-5718/1510027

Abstract

Aim: To develop and test the feasibility of using a SMS text messaging intervention to promote physical activity in patients with knee OA. Methods: 27 people (6 male, 21 female; aged 25-81 years) with knee osteoarthritis received 4 text messages per week, for 6 weeks. Telephone surveys were conducted at baseline and 6 weeks to measure physical activity levels and beliefs, including self-efficacy for exercise, barriers and benefits of exercise, social support and pain. Participants completed physical activity diaries. Process evaluation included participant perceptions of the intervention and 'real-time' data on intervention fidelity (automated collection of delivery and response data) and participant engagement (text response). Results: 648 messages were sent, 100% were accurately delivered. From baseline to 6 weeks, physical activity, self-efficacy for exercise, perceived benefits of exercise and social support significantly increased; reductions were observed in barriers to exercise and pain. Participants engaged with the intervention; 100% read the messages, 89% responded to texts requesting replies, 64% completed physical activity diaries with low attenuation (1.8% drop) by six weeks. Participants perceived messaging to be enjoyable (96%), personally relevant (85%), of appropriate frequency (100%) and duration (88%). Mobile phones, email and web were perceived to be most acceptable for health promotion compared with other forms of technology. Conclusions: People with knee osteoarthritis can engage meaningfully with an interactive mobile phone messaging intervention over a six-week period. Health communications promoting physical activity demonstrate potential for behaviour change and positive implications for perceptions of exercise and pain; this needs to be tested in a randomised trial. Data collected in 'real-time' can be used for process evaluation to demonstrate participant engagement and intervention fidelity.

Highlights

Regular physical activity is essential for lifelong health and reducing the risk of chronic disease and all-cause mortality [1]
Obesity and overweight are common in knee OA [8], but excess weight is associated with increased OA pain and lowered effectiveness of OA pain management [9,10]
This was a cohort feasibility study in which physical activitypromoting messages were developed in collaboration with service users, and delivered to a group of people living with knee OA over a six-week period

Summary

Introduction

Regular physical activity is essential for lifelong health and reducing the risk of chronic disease and all-cause mortality [1]. Many people in the general population do not achieve government recommended levels for daily physical activity [2] and rates tend to be significantly lower with advancing age[2,3]. Sixty per cent of adults with arthritis do not adhere to physical activity guidelines sedentary lifestyles are predictors of poor function in the osteoarthritis population [4,5]. Aerobic physical activity and strengthening exercises (combined with weight loss, if overweight) are first-line concerns in the management of OA [7]. Physical activity can facilitate weight control, and has been associated with reductions in OA pain and improved quality of life [11,12]

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