Dataset Information

Recruitment and Retention of Parents of Adolescents in a Text Messaging Trial (MyTeen): Secondary Analysis From a Randomized Controlled Trial.

ABSTRACT:

Background

Parenting programs are well established as an effective strategy for enhancing both parenting skills and the well-being of the child. However, recruitment for family programs in clinical and nonclinical settings remains low.

Objective

This study aims to describe the recruitment and retention methods used in a text messaging program (MyTeen) trial for parents of adolescents (10-15 years) and identify key lessons learned. We aim to provide insights and direction for researchers who seek to recruit parents and build on the limited literature on recruitment and retention strategies for parenting program trials.

Methods

A recruitment plan was developed, monitored, and modified as needed throughout the course of the project. Strategies to facilitate recruitment were identified (eg, program content and recruitment material, staff characteristics, and study procedures). Traditional and web-based recruitment strategies were used.

Results

Over a 5-month period, 319 parents or caregivers expressed interest in our study, of which 221 agreed to participate in the study, exceeding our recruitment target of 214 participants. Attrition was low at the 1-month (4.5% overall; intervention group: n=5, 4.6%; control group: n=5, 4.5%) and 3-month follow-ups (9% overall; intervention group: n=10, 9.2%; control group: n=10, 8.9%).

Conclusions

The use of web-based recruitment strategies appeared to be most effective for recruiting and retaining parents in a text-messaging program trial. However, we encountered recruitment challenges (ie, underrepresentation of ethnic minority groups and fathers) similar to those reported in the literature. Therefore, efforts to engage ethnic minorities and fathers are needed.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12618000117213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374307.

SUBMITTER: Chu JTW

PROVIDER: S-EPMC8726057 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundTransgender women in the United States experience numerous risk factors for HIV acquisition and transmission, including increased rates of homelessness, alcohol and drug use, sex work, and nonprescribed hormone and soft tissue-filler injections. In addition, transgender women face discrimination and social/economic marginalization more intense and deleterious than that experienced by lesbian, gay, or bisexual individuals, further worsening health outcomes. Although little research has been done specifically with young transgender women aged 35 years and younger, existing evidence suggests even further elevated rates of homelessness, substance use, and engagement in HIV transmission risk behaviors relative to their older transgender women and nontransgender young adult counterparts. Young transgender women living with HIV experience a range of barriers that challenge their ability to be successfully linked and retained in HIV care.ObjectiveThe aim of this randomized controlled trial, Text Me, Girl!, is to assess the impact of a 90-day, theory-based, transgender-specific, text-messaging intervention designed to improve HIV-related health outcomes along the HIV care continuum among young (aged 18-34 years) transgender women (N=130) living with HIV/AIDS.MethodsParticipants were randomized into either Group A (immediate text message intervention delivery; n=61) or Group B (delayed text message intervention delivery whereby participants were delivered the text-messaging intervention after a 90-day delay period; n=69). Over the course of the 90-day intervention, participants received 270 theory-based text messages that were targeted, tailored, and personalized specifically for young transgender women living with HIV. Participants received 3 messages per day in real time within a 10-hour gradual and automated delivery system. The text-message content was scripted along the HIV care continuum and based on social support theory, social cognitive theory, and health belief model. The desired outcome of Text Me, Girl! was virological suppression.ResultsRecruitment began on November 18, 2016, and the first participant was enrolled on December 16, 2016; enrollment closed on May 31, 2018. Intervention delivery ended on November 30, 2018, and follow-up evaluations will conclude on August 31, 2019. Primary outcome analyses will begin immediately following the conclusion of the follow-up evaluations.ConclusionsText messaging is a communication platform well suited for engaging young transgender women in HIV care because it is easily accessible and widely used, as well as private, portable, and inexpensive. Text Me, Girl! aimed to improve HIV care continuum outcomes among young transgender women by providing culturally responsive text messages to promote linkage, retention, and adherence, with the ultimate goal of achieving viral suppression. The Text Me, Girl! text message library is readily scalable and can be adapted for other hard-to-reach populations.International registered report identifier (irrid)DERR1-10.2196/12837.

Project description:BACKGROUND:Up to one-third of adolescents and young adults (11-21 years old) with chronic kidney disease exhibit suboptimal rates of adherence to renal-protective antihypertensive medications. Mobile health interventions may promote higher adherence to these medicines in these individuals, but empirical research is needed to inform best practices for applying these modalities. OBJECTIVE:In this multiphase investigation, we developed and tested a theoretically informed text messaging intervention based on the COM-B model, a well-established health intervention framework stating that capability, opportunity, and motivation interactively modify health behaviors, to improve participants' antihypertensive medication adherence in a pilot randomized controlled trial. Qualitative data on user experiences were obtained. METHODS:In phase 1, intervention messages (Reminder+COM-B Message) were developed via stakeholder engagement of participants and pediatric nephrologists. In phase 2, the Reminder+COM-B Message intervention was tested against a Reminder-only Message active control condition in an 8-week pilot randomized controlled trial. The primary outcome was daily electronically monitored antihypertensive medication adherence and secondary outcomes included pre-post participant surveys of adherence self-efficacy, adherence barriers, outcome expectancies for taking medicine, and motivation for and importance of taking medicine. In phase 3, qualitative interviews related to user experiences were conducted with participants in the Reminder+COM-B Message intervention group. RESULTS:Following phase 1, 34 participants (mean age 16.59 years, 41% female, 38% African American/Black, 35% hypertension diagnosis) completed the phase 2 pilot randomized controlled trial (n=18 in the Reminder+COM-B Message intervention group, n=16 in the Reminder-only Message active control group). All participants in the Reminder+COM-B Message intervention group completed a phase 3 qualitative interview. Overall, study procedures were feasible and the Reminder+COM-B Message intervention was acceptable to the participants (eg, 15/18 participants reported reading the majority of messages sent to them, 0/18 reported that the messages reduced their desire to take medicine). Prerandomization, there were no significant group differences in the rate of change in daily adherence over time. However, postrandomization, there was a significant group by time interaction (B=.01, P=.04) in which daily adherence decreased significantly over time in the Reminder-only Message active control group but remained stable in the Reminder+COM-B Message intervention group. There were no significant differences between groups in pre-post changes in survey responses. Qualitative interviews revealed participants' perceptions of how the Reminder+COM-B Message intervention changed adherence behavior and highlighted several areas for improving the intervention (eg, adapt messaging timing, intensity, and content to match daily adherence, send praise when medicine is taken). CONCLUSIONS:The Reminder+COM-B Message intervention was feasible and acceptable to adolescents/young adults and demonstrated potential to promote participants' daily medication adherence beyond simple reminders. Further research is needed to determine the Reminder+COM-B Message intervention's mechanisms of adherence behavior change and to incorporate qualitative participant feedback into a modified version of this intervention to enhance its acceptability. TRIAL REGISTRATION:ClinicalTrials.gov NCT03651596; https://clinicaltrials.gov/ct2/show/NCT03651596.

Project description:BackgroundDespite promising data in Western countries, there is a dearth of research into the efficacy of text messaging-based smoking cessation programs in other settings, including the Middle East, where smoking prevalence rates are higher.ObjectiveThis paper reports cessation rates observed in SMS Turkey, a text messaging-based smoking cessation program for adult smokers in Ankara, Turkey.MethodsThis study was a small-scale, parallel-group randomized controlled trial (RCT) conducted in Ankara, Turkey. Participants were adult daily smokers who were seriously thinking about quitting in the next 15 days and living in Ankara, Turkey. The text messaging intervention, SMS Turkey, provided 6 weeks of daily messages aimed at giving participants skills to help them quit smoking. Messages were sent in an automated fashion, except 2 days and 7 days after the initial quit day. On days 2 and 7, the research assistant manually assigned participants to content "paths" based on whether they were still not smoking or had relapsed. The control arm received a brochure that provided similar information about smoking cessation. The main outcome measure was self-reported 3-month sustained abstinence, verified by carbon monoxide (CO) readings. Neither participants nor researchers were blinded to arm assignment.ResultsThe 151 participants were randomly assigned to 1 of 2 groups: 76 to the SMS Turkey intervention group and 75 to the brochure control group. Using intention to treat, all 151 participants were included in analyses. Three-month cessation trends were not significantly higher in the intervention group: 11% intervention vs 5% control had quit (χ(2)(1)=1.4, P=.24; R(2)=2.0, 95% CI 0.62-6.3). When the sample was stratified by sex, female intervention participants (14%, n=5) were significantly more likely to have quit at 3 months than female control participants (0%, n=0; χ(2)(1)=3.7, P=.05). Among light smokers (ie, those smoking less than 20 cigarettes per day), intervention participants (17%, n=5) also were significantly more likely to have quit compared to control participants (0%, n=0; χ(2)(1)=5.3, P=.02). We noted no difference in cessation rates for males or heavy smokers. Participants experienced significant technology problems during the study. Some participants received duplicate text messages at least once during the trial; others failed to receive some program messages. Neither receiving duplicate messages (χ(2)(1)=0.12, P=.73), or missing 5 or more program messages (χ(2)(1)=0.75, P=.39) negatively affected quitting rates.ConclusionsAlthough the study was not powered to detect statistically significant differences, as the primary aim was to provide estimates of effect size that could be used to better inform a power analysis for a larger trial, findings provide optimism that SMS Turkey may be able to affect quitting rates in environments with high smoking prevalence, such as Ankara, Turkey. The SMS Turkey software program did not work as well as it did 2 years previous. The system will need to be updated to maintain software compatibility with ongoing technology evolution.Trial registrationClinicaltrials.gov NCT00912795 http://clinicaltrials.gov/ct2/show/NCT00912795 (Archived by WebCite® at http://www.webcitation.org/6Ch1cIA8l).

Project description:BackgroundSmoking rates are significantly higher among young people experiencing homelessness than in the general population. Despite a willingness to quit, homeless youth have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. Homeless youth generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive.ObjectiveThis study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI) as an adjunct to group-based cessation counseling and provision of nicotine patches to help homeless youth quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention.MethodsHomeless youth smokers aged 18 to 25 years who were interested in quitting (n=77) were recruited from drop-in centers serving homeless youth in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches, with 52% (40/77) randomly assigned to receive 6 weeks of text messages to provide additional support for their quit attempt. Participants received text messages on their own phone rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow-up survey data as well as back-end data from the messaging platform to gauge the acceptability and feasibility of the TMI among the 40 participants who received it.ResultsParticipants had widespread (smart)phone ownership-16.4% (36/219) were ineligible for study participation because they did not have a phone that could receive text messages. Participants experienced interruptions in their phone use (eg, 44% [16/36] changed phone numbers during the follow-up period) but reported being able to receive the majority of messages. These survey results were corroborated by back-end data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Qualitative feedback indicated that participants enjoyed the group counseling session that preceded the TMI and suggested including more such group elements into the intervention.ConclusionsThe TMI was well accepted and feasible to support smoking cessation among homeless youth. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support homeless youth, a population urgently in need of effective smoking cessation interventions.Trial registrationClinicalTrials.gov NCT03874585; https://clinicaltrials.gov/ct2/show/NCT03874585.International registered report identifier (irrid)RR2-10.1186/s13722-020-00187-6.

Project description:ImportanceMyopia in school-aged children is a public health issue worldwide; consequently, effective interventions to prevent onset and progression are required.ObjectiveTo investigate whether SMS text messages to parents increase light exposure and time outdoors in school-aged children and provide effective myopia control.Design, setting, and participantsThis randomized clinical trial was conducted in China from May 2017 to May 2018, with participants observed for 3 years. Of 528 965 primary school-aged children from Anyang, 3113 were randomly selected. Of these, 268 grade 2 schoolchildren were selected and randomly assigned to SMS and control groups. Data were analyzed from June to December 2021.InterventionsParents of children in the SMS group were sent text messages twice daily for 1 year to take their children outdoors. All children wore portable light meters to record light exposure on 3 randomly selected days (2 weekdays and 1 weekend day) before and after the intervention.Main outcomes and measuresThe co-primary outcomes were change in axial length (axial elongation) and change in spherical equivalent refraction (myopic shift) from baseline as measured at the end of the intervention and 3 years later. A secondary outcome was myopia prevalence.ResultsOf 268 grade 2 schoolchildren, 121 (45.1%) were girls, and the mean (SD) age was 8.4 (0.3) years. Compared with the control group, the SMS intervention group demonstrated greater light exposure and higher time outdoors during weekends, and the intervention had significant effect on axial elongation (coefficient, 0.09; 95% CI, 0.02-0.17; P = .01). Axial elongation was lower in the SMS group than in the control group during the intervention (0.27 mm [95% CI, 0.24-0.30] vs 0.31 mm [95% CI, 0.29-0.34]; P = .03) and at year 2 (0.39 mm [95% CI, 0.35-0.42] vs 0.46 mm [95% CI, 0.42-0.50]; P = .009) and year 3 (0.30 mm [95% CI, 0.27-0.33] vs 0.35 mm [95% CI, 0.33-0.37]; P = .005) after the intervention. Myopic shift was lower in the SMS group than in the control group at year 2 (-0.69 diopters [D] [95% CI, -0.78 to -0.60] vs -0.82 D [95% CI, -0.91 to -0.73]; P = .04) and year 3 (-0.47 D [95% CI, -0.54 to -0.39] vs -0.60 D [95% CI, -0.67 to -0.53]; P = .01) after the intervention, as was myopia prevalence (year 2: 38.3% [51 of 133] vs 51.1% [68 of 133]; year 3: 46.6% [62 of 133] vs 65.4% [87 of 133]).Conclusions and relevanceIn this randomized clinical trial, SMS text messages to parents resulted in lower axial elongation and myopia progression in schoolchildren over 3 years, possibly through increased outdoor time and light exposure, showing promise for reducing myopia prevalence.Trial registrationChinese Clinical Trial Registry Identifier: ChiCTR-IOC-17010525.

Project description:Excessive drinking among university students is a global challenge, leading to significant health risks. However, heavy drinking among students is widely accepted and socially normalized. Mobile phone interventions have attempted to reach students who engage in excessive drinking. A growing number of studies suggest that text message-based interventions could potentially reach many students and, if effective, such an intervention might help reduce heavy drinking in the student community.The objective of this study was to test the effectiveness of a behavior change theory-based 6-week text message intervention among university students.This study was a two-arm, randomized controlled trial with an intervention group receiving a 6-week text message intervention and a control group that was referred to treatment as usual at the local student health care center. Outcome measures were collected at baseline and at 3 months after the initial invitation to participate in the intervention. The primary outcome was total weekly alcohol consumption. Secondary outcomes were frequency of heavy episodic drinking, highest estimated blood alcohol concentration, and number of negative consequences attributable to excessive drinking.A total of 896 students were randomized to either the intervention or control group. The primary outcome analysis included 92.0% of the participants in the intervention group and 90.1% of the control group. At follow-up, total weekly alcohol consumption decreased in both groups, but no significant between-group difference was seen. Data on the secondary outcomes included 49.1% of the participants in the intervention group and 41.3% of the control group. No significant between-group difference was seen for any of the secondary outcomes.The present study was under-powered, which could partly explain the lack of significance. However, the intervention, although theory-based, needs to be re-assessed and refined to better support the target group. Apart from establishing which content forms an effective intervention, the optimal length of an alcohol intervention targeting students also needs to be addressed in future studies.International Standard Randomised Controlled Trial Number ISRCTN95054707; http://www.isrctn.com/ISRCTN95054707 (Archived by WebCite at http://www.webcitation.org/70Ax4vXhd).

Project description:BackgroundText message (ie, short message service, SMS) smoking cessation interventions have demonstrated efficacy in high-income countries but are less well studied in low- and middle-income countries, including Vietnam.ObjectiveThe goal of the research is to assess the feasibility, acceptability, and preliminary efficacy of a fully automated bidirectional SMS cessation intervention adapted for Vietnamese smokers.MethodsThe study was conducted in 3 phases. In phase 1, we adapted the SMS library from US-based SMS cessation programs (ie, SmokefreeTXT and Text2Quit). The adaptation process consisted of 7 focus groups with 58 smokers to provide data on culturally relevant patterns of tobacco use and assess message preferences. In phase 2, we conducted a single-arm pilot test of the SMS intervention with 40 smokers followed by in-depth interviews with 10 participants to inform additional changes to the SMS library. In phase 3, we conducted a 2-arm pilot randomized controlled trial (RCT) with 100 smokers. Participants received either the SMS program (intervention; n=50) or weekly text assessment on smoking status (control; n=50). The 6-week SMS program consisted of a 2-week prequit period and a 4-week postquit period. Participants received 2 to 4 automated messages per day. The main outcomes were engagement and acceptability which were assessed at 6 weeks (end of intervention). We assessed biochemically confirmed smoking abstinence at 6 weeks and 12 weeks. Postintervention in-depth interviews explored user experiences among a random sample of 16 participants in the intervention arm.ResultsParticipants in both arms reported high levels of engagement and acceptability. Participants reported using the program for an average of 36.4 (SD 3.4) days for the intervention arm and 36.0 (SD 3.9) days for the control arm. Four of the 50 participants in the intervention arm (8%) reset the quit date and 19 (38%) texted the keyword TIPS. The majority of participants in both arms reported that they always or usually read the text messages. Compared to the control arm, a higher proportion of participants in the intervention arm reported being satisfied with the program (98% [49/50] vs 82% [41/50]). Biochemically verified abstinence was higher in the intervention arm at 6 weeks (20% [10/50] vs 2% [1/50]; P=.01), but the effect was not significant at 12 weeks (12% [6/50] vs 6% [3/50]; P=.49). In-depth interviews conducted after the RCT suggested additional modifications to enhance the program including tailoring the timing of messages, adding more opportunities to interact with the program, and placing a greater emphasis on messages that described the harms of smoking.ConclusionsThe study supported the feasibility and acceptability of an SMS program adapted for Vietnamese smokers. Future studies need to assess whether, with additional modifications, the program is associated with prolonged abstinence.Trial registrationClinicalTrials.gov NCT03219541; https://clinicaltrials.gov/ct2/show/NCT03219541.

Project description:BackgroundRapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential.MethodsThis mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA).ResultsParticipants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2[1] =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power.ConclusionsText messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.