mHealth intervention to improve physical activity and sedentary behaviour in adolescents: A qualitative study exploring feasibility, preferences and effectiveness

Background. In recent years, technology-based interventions have become a prominent approach to increasing physical activity (PA) and reducing sedentary behaviour (SB) in adolescents. Evidence shows that text messages (SMS) can be an effective and acceptable tool for enhancing these behaviours. In-depth investigations exploring preferences, feasibility and effectiveness of SMS interventions without other components such as smartphone applications are scarce.
Aim. To provide a vital insight into participant preferences of a novel, theory-based SMS intervention, this study addressed the following: 1) Participant preferences for design and content, 2) Psychological and behavioural changes (additional quantitative activity data expected to be available by November) as well as experience of theoretical frameworks used, 3) participant perceptions of feasibility.
Methods. 25 pupils (mean age 17 ± 0.2 years) from a local school were recruited and agreed to receive SMS for 3 weeks. They were informed by Theory of Planned Behaviour and Social Cognitive Theory and involved several behaviour change techniques. 24 participants took part in 4 gender-mixed focus group discussions (38-43 minutes). A semi-structured interview guide was used, with a second researcher facilitating the discussions. Focus groups were audio recorded and transcribed. Braun & Clarke’s (2006) thematic analysis approach was used with two researchers performing dependability and credibility checks, including a critical friends strategy.
Results. Participants perceived the intervention to be feasible as opt-in was straightforward and parents were supportive of their participation. There was no consensus which SMS frequency or timing was preferred. For message content, both behavioural (e.g. providing) and educational messages were popular with our sample. There was also no clear preference for one theory framework and not all participants felt the SMS helped them change their PA or SB. Overall, participants mentioned personalisation of messages would be helpful and timing, frequency and content of messages should be designed depending on an individual’s schedule, goals and PA levels.
Conclusion. This study provides researchers, practitioners and policy makers with crucial evidence to inform the development of more effective messaging-based interventions promoting healthy lifestyles in youth. SMS interventions appear to be feasible, and with personalisation, could support adolescents in increasing PA and reducing SB.