(002) Predictors of Completion and Response to a Text Message Intervention to Promote Well-Being and Cardiac Health Behaviors

Trainee Involvement: No

Background/Significance: Adherence to physical activity and a healthy diet are associated with improved cardiovascular health outcomes (Garcia 2016); however, many individuals at risk for cardiovascular disease struggle to adhere to these health behaviors (Lanier 2016). Text message interventions (TMIs) have the potential to improve adherence (Smith 2019) but may not be equally effective for all individuals. Identifying participant and intervention characteristics associated with improvements in health behavior adherence and psychological well-being has the potential to identify individuals most likely to respond to TMIs and/or ways to tailor TMIs to maximize its impact in diverse populations. Accordingly, we aim to identify demographic, clinical, and intervention-related predictors of response to an adaptive TMI designed to promote well-being and adherence to cardiac health behaviors.

Methods: We will analyze data from a randomized, controlled trial (Nf60) of a TMI to promote well-being and health behavior adherence in individuals with two or more cardiac risk conditions (i.e., hypertension, type 2 diabetes, and hyperlipidemia). Predictors will include demographic (e.g., age, gender, race/ethnicity), clinical (e.g., medical diagnoses, psychological factors), and intervention characteristics (e.g., types of text messages received, number of messages receiving a response). Outcomes of interest will include participant engagement (i.e., number of text message responses), changes in health behavior adherence (i.e., changes in physical activity and dietary adherence over time), and changes in psychological and functional outcomes (e.g., positive affect, quality of life). To assess these relationships, we will perform repeated measures regression analyses, with a categorical effect of time and an unstructured covariance matrix.

Results: Recruitment for this trial is complete, but data collection and analysis are ongoing (expected completion: June 2023). We anticipate finding significant relationships between demographic, clinical, and intervention characteristics and both engagement in and response to the TMI.

Discussion: The results of this trial will provide information about the most effective components of the intervention and will identify areas for further intervention improvement/refinement. Additionally, these results will help to identify characteristics of patients who respond well to this intervention.

Conclusion/Implications: We will identify sociodemographic, clinical, and intervention characteristics associated with engagement in and response to a health behavior intervention delivered via adaptive text messaging. This information ultimately can help to create an effective, easily accessible, and flexible intervention that has the potential to improve both adherence and mental and physical health in clinical care.

References:

García MC, Bastian B, Rossen LM, et al. Potentially preventable deaths among the five leading causes of death — United States, 2010 and 2014. MMWR Morb Mortal Wkly Rep. 2016;65:1245-1255.

Lanier JB, Bury DC, Richardson SW. Diet and physical activity for cardiovascular disease prevention. American family physician. 2016;93(11):919-924.

Smith DM, Duque L, Huffman JC, Healy BC, Celano CM. Text Message Interventions for Physical Activity: A Systematic Review and Meta-Analysis. Am J Prev Med. Nov 20 2019; doi:10.1016/j.amepre.2019.08.014