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Simple and rationale-providing SMS reminders to promote accelerometer use: a within-trial randomised trial comparing persuasive messages.

ABSTRACT: BACKGROUND:Literature on persuasion suggests compliance increases when requests are accompanied with a reason (i.e. the "because-heuristic"). The reliability of outcomes in physical activity research is dependent on sufficient accelerometer wear-time. This study tested whether SMS reminders-especially those that provided a rationale-are associated with increased accelerometer wear-time. METHODS:We conducted a within-trial partially randomised controlled trial during baseline data collection in a school-based physical activity intervention trial. Of 375 participants (mean age?=?18.1), 280 (75%) opted to receive daily SMS reminders to wear their accelerometers. These 280 participants were then randomised to receive either succinct reminders or reminders including a rationale. Data was analyzed across groups using both frequentist and Bayesian methods. RESULTS:No differences in total accelerometer wear minutes were detected between the succinct reminder group (Mdn?=?4909, IQR?=?3429-5857) and the rationale group (Mdn?=?4808, IQR?=?3571-5743); W?=?8860, p?=?0.65, CI95?=?-?280.90-447.20. Similarly, we found no differences in wear time between participants receiving SMS reminders (Mdn?=?4859, IQR?=?3527-5808) and those not receiving them (Mdn?=?5067, IQR?=?3201-5885); W?=?10,642.5, p?=?0.77, CI95?=?-?424.20-305.30. Bayesian ANOVA favored a model of equal weartime means, over one of unequal means, by a Bayes Factor of 12.05. Accumulated days of valid accelerometer wear data did not differ either. Equivalence testing indicated rejection of effects more extreme than a Cohen's d (standardised mean difference) of ±~0.3. CONCLUSIONS:This study casts doubt on the effectiveness of using the because-heuristic via SMS messaging, to promote accelerometer wear time among youth. The because-heuristic might be limited to face-to-face communication and situations where no intention for or commitment to the behavior has yet been made. Other explanations for null effects include non-reading of messages, and reminder messages undermining the self-reminding strategies which would occur naturally in the absence of reminders. TRIAL REGISTRATION:DRKS DRKS00007721 . Registered 14.04.2015. Retrospectively registered.

SUBMITTER: Heino MTJ

PROVIDER: S-EPMC6286544 | biostudies-other | 2018 Dec

REPOSITORIES: biostudies-other

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Simple and rationale-providing SMS reminders to promote accelerometer use: a within-trial randomised trial comparing persuasive messages.

Heino Matti T J MTJ Knittle Keegan K Haukkala Ari A Vasankari Tommi T Hankonen Nelli N

BMC public health 20181207 1

<h4>Background</h4>Literature on persuasion suggests compliance increases when requests are accompanied with a reason (i.e. the "because-heuristic"). The reliability of outcomes in physical activity research is dependent on sufficient accelerometer wear-time. This study tested whether SMS reminders-especially those that provided a rationale-are associated with increased accelerometer wear-time.<h4>Methods</h4>We conducted a within-trial partially randomised controlled trial during baseline data ...[more]

PMID: 30526616

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Project description:In Cameroon, the National Tuberculosis Control Program that applies selective directly observed treatments faces difficulties in its implementation for a lack of resources, leading to only 65% of patients with sputum smear-positive pulmonary tuberculosis being cured after 6 months of treatment. This study aimed to evaluate the effectiveness of daily Short Message Service reminders to increase adherence and the proportion of adult tuberculosis patients cured after 6 months of treatment.A simple blinded, randomised controlled, multicentre study carried out in 12 Treatment and Diagnostic Centres of Yaoundé. The patients included were randomly assigned to two groups: patients in the intervention group received daily SMS reminders in addition to the usual treatment; those in the control group received the usual treatment only. The primary outcomes were the number and proportion of treatment success at 5 months, and the number and proportion of patients cured at 6 months. Data analysis was by intention to treat.Two hundred and seventy-nine participants were randomized into intervention group (n?=?137) and control group (n?=?142). At five months, there were 111 treatment success (81%) in the intervention group and 106 (74.6%) in the control group (OR?=?1.45 [0.81, 2.56]; p?=?0.203). At 6 months, there were 87 patients cured (63.5%) in the intervention group and 88 (62%) in the control group (OR?=?1.06 [0.65, 1.73]; p?=?0.791). The number of drop-outs at 6 months was 47 (34.3%) in intervention group, and 46 (32.4%) in the control group. 48.9% (23/47) and 39.1% (18/46) of these drop-outs were sputum-negative at 5 months. At three different appointments, there were no significant differences between the two groups in any secondary outcomes. Very high and similar satisfaction was found for general management of patients in both groups: 99.5 and 99.2% (p?=?0.41).Our study suggests that SMS reminders do not increase treatment success and cure proportions. However, the low proportion of patients cured at 6 month may be an underestimation due to a high dropout rate between the fifth and the sixth months of treatment. Future trials should focus on reducing the dropout rate.The trial was registered on the Pan-African Clinical Trials Registry ( PACTR201307000583416 of 22 July 2013) and the protocol was published.

Project description:BackgroundPretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages.MethodsSix candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score.ResultsExplanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score.ConclusionThe 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience.Trial registrationNot applicable; this is not a report of intervention trial.

Project description:Effective use of proven treatments for high blood pressure, a preventable health risk, is challenging for many patients. Prompts via mobile phone SMS-text messaging may improve adherence to clinic visits and treatment, though more research is needed on impact and patient perceptions of such support interventions, especially in low-resource settings.An individually-randomised controlled trial in a primary care clinic in Cape Town (2012-14), tested the effect of an adherence support intervention delivered via SMS-texts, on blood pressure control and adherence to medication, for hypertensive patients. (ClinicalTrials.gov NCT02019823). We report on a qualitative evaluation that explored the trial participants' experiences and responses to the SMS-text messages, and identified barriers and facilitators to delivering adherence support via patients' own mobile phones. Two focus groups and fifteen individual interviews were conducted. We used comparative and thematic analysis approaches to identify themes and triangulated our analysis amongst three researchers.Most participants were comfortable with the technology of using SMS-text messages. Messages were experienced as acceptable, relevant and useful to a broad range of participants. The SMS-content, the respectful tone and the delivery (timing of reminders and frequency) and the relational aspect of trial participation (feeling cared for) were all highly valued. A subgroup who benefitted the most, were those who had been struggling with adherence due to high levels of personal stress. The intervention appeared to coincide with their readiness for change, and provided practical and emotional support for improving adherence behaviour. Change may have been facilitated through increased acknowledgement of their health status and attitudinal change towards greater self-responsibility. Complex interaction of psycho-social stressors and health service problems were reported as broader challenges to adherence behaviours.Adherence support for treatment of raised blood pressure, delivered via SMS-text message on the patient's own phone, was found to be acceptable, relevant and helpful, even for those who already had their own reminder systems in place. Our findings begin to identify for whom and what core elements of the SMS-text message intervention appear to work best in a low-resource operational setting, issues that future research should explore in greater depth.

Dataset Information

Simple and rationale-providing SMS reminders to promote accelerometer use: a within-trial randomised trial comparing persuasive messages.

Publications

Simple and rationale-providing SMS reminders to promote accelerometer use: a within-trial randomised trial comparing persuasive messages.

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