JMIR Publications

ABSTRACT

Background:

Type 2 diabetes mellitus (T2DM) is a major challenge for Dutch public health authorities and regular physical activity (PA) is a key factor in the management of this disease. Forty percent of people with T2DM are physically inactive and fail to meet the Dutch Recommendations on PA. Web-based tailored interventions are a promising approach to help this population successfully adopt regular PA. Spoken animation seems effective regardless of the characteristics of the user, such as gender, education level, lifestyle or health literacy and may be a relevant strategy to communicate complex health information. In order to enhance health communication, the application of behavioral change techniques (BCTs) is also recommended but its appreciation by users is rarely evaluated.

Objective:

(1) to evaluate pretesting communication elements and user-appreciation, and (2) to evaluate the applied BCTs of designed spoken animated video messages in a tailored self-management program for people with diabetes type 2.

Methods:

(Semi)-structured interviews were conducted with 15 patients with T2DM. Based on the pre-testing key communication elements of Salazar’s model, participants were asked about the spoken animated video messages’ attractiveness, comprehensibility, acceptance, believability, involvement and relevance, and to what extent the video messages motivated them to become more physically active. Furthermore, participants’ intention to use the spoken animated video messages and recommend them to others was assessed. In order to evaluate participants’ appreciation of the different applied BCTs a Post- Hoc analysis of the qualitative data was conducted. Data analysis was executed using the MaXQDA program. Transcripts were coded by two coders using iterative qualitative content analysis methods in order to uncover key health communication issues.

Results:

The positive appreciation of the comprehensibility, believability and personalization was underpinned with participants’ statements on BCTs and other communication elements. The reinforcement and feedback of participants’ answers were positively evaluated as was the simplicity and concreteness of the spoken animated video messages. The majority of participants indicated reasons for not feeling motivated to increase their level of PA including, being already sufficiently physically active and the presence of other impeding health factors.

Conclusions:

Spoken animated video messages should be simple, short, concrete, without the use of medical terminology. Including positive reinforcement, feedback of participants’ answers, providing examples that match user characteristics and the possibility to identify with the animation figures will enhance involvement in the health message. In order to connect more with patient’s needs and thereby increase the perceived relevance and the motivation to use an animated video program it is suggested to offer the program soon after people are diagnosed with diabetes mellitus. Piloting of BCTs is recommended in order to identify potential resistance.