Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 7, 2023
Open Peer Review Period: Jan 7, 2023 - Mar 4, 2023
Date Accepted: Jun 16, 2023
(closed for review but you can still tweet)
Development of a Text Message Platform to Enhance a Youth Diabetes Prevention Program: An observational process study.
ABSTRACT
Background:
About 1 in 5 adolescents in the United States has prediabetes, and racial/ethnic minoritized youth are disproportionately impacted. Unfortunately, there are few effective youth diabetes prevention programs, and in-person interventions are challenging due to barriers in access and engagement.
Objective:
We collaborated with our youth action board and a technology partner (mPulse Mobile) to develop a novel Short Message Service (SMS) based text-messaging tool to provide additional support and motivation to prediabetic youth participating in a virtual diabetes prevention workshop in East Harlem, NY.
Methods:
The technology subcommittee of our Community Action Board (comprised of youth/young adults) used results from focus groups we had previously conducted with youth from our community to develop text message content. There are five message types focused on healthy eating and active living: goal setting, behavior tracking, individually tailored guidance, motivational messages, and photo diary. We conducted a pilot of the 12-week texting program with 13 prediabetic teens.
Results:
Adolescents (ages 15-21, 77% female, 77% Hispanic/Latinx, 23% Black) received an average of two automated messages per day. The system correctly sent messages as intended 84% of the time. Level of engagement with the texting program ranged from 1 to 5 based on how frequently participants responded to interactive (2-way) messages. Highly responsive participants (46%) responded more than 75% of the time to interactive messages sent over 12 weeks, and 69% of participants were still engaged with the program at week 12. During a focus group conducted after program completion, teens remarked that the message frequency was appropriate, and those who had participated in our in-person workshops reflected that the messages were reminiscent of the workshop content. Participants rated goal setting, behavior tracking, and tailored messages most highly and informed planned adaptations to the platform. Participants described the program as: “Interactive, helpful, informative, enjoyable, very convenient, reliable, motivational, thoughtful, productive, and reflective.”
Conclusions:
We partnered with youth in the initial content development and pilot testing of a novel text-messaging platform to support diabetes prevention. This study is also unique in its triple partnership between academia, technology experts, and youth to develop an mHealth platform to address diabetes-related disparities.
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