JMIR Publications

ABSTRACT

Background:

Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities; however, few digital prevention interventions have been developed for Hispanic limiting our knowledge of these strategies among this population.

Objective:

Our study qualitatively assessed the feasibility and acceptability of Fit24, a 12-week goal-setting intervention that uses a Fitbit and theoretically-grounded Short Message Service (SMS) text messages to promote physical activity and sleep among Hispanic adolescents (14-16 years) with obesity.

Methods:

After completing the intervention, a subsample of youth (N=15) participated in an in-depth interview. Themes were categorized into dimensions on participant perspectives using the Practical, Robust Implementation and Sustainability Model (PRISM) framework.

Results:

Participants shared positive perceptions of wearing the Fitbit and receiving SMS text messages. Youth were highly engaged in monitoring their behaviors and perceived increased activity and sleep. Almost all youth organically received social support from a peer or family member and suggested the use of a group chat or team challenge for integrating peers into future interventions. However, most youth also expressed the need to take personal responsibility for their own behavior change. Barriers that impacted the feasibility of the study including the skin-irritating material on the Fitbit watch band and environmental barriers (e.g. lack of resources, school schedules), that limited participation in activity suggestions. Additionally, sync issues with the Fitbit limited the transmission of data leading to inaccurate feedback.

Conclusions:

Fit24 is a promising approach for engaging Hispanic youth in a diabetes prevention program. Strategies are needed to address technical issues with the Fitbit and environmental issues such as message timing. While integrating peer social support may be desired by some, peer support strategies should be mindful of youth’s desire to foster personal motivation for behavior change. Findings from this study will inform future diabetes prevention trials of Fit24 and other digital health interventions for high-risk pediatric populations.