Accepted for/Published in: JMIR Formative Research
Date Submitted: May 3, 2024
Date Accepted: Aug 20, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Design of a Temporally Augmented Text Messaging Bot to Improve Adolescents’ Physical Activity and Engagement: A Proof-of-Concept Study
ABSTRACT
Background:
Digital interventions hold promise for improving physical activity in adolescents. However, a lack of empirical decision points (e.g., timing of intervention prompts) is an evidence gap in the optimization of digital physical activity interventions.
Objective:
The study examined the feasibility, acceptability, technical/functional reliability of and participant engagement with a digital intervention that aligned its decision points to occur during times when adolescents typically exercise. This study also explored the impact of the intervention on adolescents’ moderate-to-vigorous physical activity (MVPA) levels. Consistent with the ORBIT model, the primary goal of the study was to identify opportunities to refine the intervention for preparation for future trials.
Methods:
Ten adolescents completed a seven-day baseline monitoring period and TAGS (Temporally Augmented Goal Setting), a digital physical activity intervention that included a mid-day self-monitoring message that occurred when adolescents typically start to exercise (3pm). Participants wore an accelerometer to measure their MVPA during the intervention. Participants completed questionnaires about the acceptability of the platform. Rates of recruitment and attrition (feasibility), user and technological errors (reliability), and engagement were calculated. The investigation team performed multilevel models to explore the effect of TAGS on MVPA levels from pre-intervention to intervention. Additionally, as exploratory analyses, participants were matched to adolescents who previously completed a similar intervention (NUDGE: Network Underwritten Dynamic Goals Engine), without the mid-day self-monitoring message, to explore differences in MVPA between interventions.
Results:
The TAGS intervention was mostly feasible, acceptable, and technically/functionally reliable. Adolescents showed adequate levels of engagement. Pre-intervention to intervention changes in MVPA were small (approximately a two-minute change). Exploratory analyses revealed no greater benefit of TAGS on MVPA compared to NUDGE.
Conclusions:
TAGS shows promise for future trials with additional refinements given its feasibility, acceptability, technical/functional reliability, participants’ rates of engagement, and the relative MVPA improvements. Opportunities to strengthen TAGS include reducing the burden of wearing devices and incorporating of other strategies at the 3pm decision point. Further optimization of TAGS will inform the design of a just-in-time adaptive intervention for adolescent physical activity and prepare the intervention for more rigorous testing.
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