Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 20, 2023
Date Accepted: Jun 9, 2023
A text-message based type 2 diabetes prevention program for Hispanic adolescents with obesity: a qualitative co-design process
ABSTRACT
Background:
Text-message based interventions are a promising approach for reaching and engaging youth in health promotion and disease prevention opportunities. Including youth in the development of text content can lead to messaging that is more acceptable and relevant; however, few studies include youth as co-collaborators.
Objective:
This study used a co-design process to develop evidence-based text messages grounded in the Self-Determination Theory that promote healthy physical activity (PA) and sleep behaviors among Hispanic youth with obesity.
Methods:
Participating youth (N=20) completed in-depth interviews to identify barriers and facilitators of PA and sleep, desired behavior change techniques, and preferences for autonomy, competence, and relatedness support in line with the self-determination theory. Information gleaned from interviews was used to develop an initial bank of text messages (n=116), which was evaluated by research experts (N=6) and youth (N=5).
Results:
According to experts, all texts were age and culturally appropriate (100%), yet some (18%) did not adequately address youth-identified barriers and facilitators to PA and sleep and others (26%) were not theoretically adherent. Youth reported that texts were easy to understand (100%), provided the support needed for behavior change (89%), and that the language used was mostly acceptable (72%).
Conclusions:
Using expert and youth feedback a revised bank of 125 unique text messages was developed and will be further evaluated in a forthcoming randomized pilot study to assess the feasibility, acceptability, and preliminary efficacy of the messages. The co-design process used in this study provides a framework for future research aimed at developing text-message based strategies among high-risk adolescents.
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