Journal of Nutrition Education and Behavior
Volume 40, Issue 6 , Pages 385-391, November 2008

Use of Text Messaging for Monitoring Sugar-sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

  • Jennifer R. Shapiro, PhD

      Affiliations

    • Department of Psychiatry, University of North Carolina at Chapel Hill
    • Corresponding Author InformationAddress correspondence to: Jennifer R. Shapiro, PhD, The University of North Carolina at Chapel Hill, Department of Psychiatry, CB 7160, Chapel Hill, NC 27599; Phone: (919) 966-5262; Fax: (919) 966-4180
  • ,
  • Stephanie Bauer, PhD

      Affiliations

    • Centre for Psychotherapy Research, University of Heidelberg, Germany
  • ,
  • Robert M. Hamer, PhD

      Affiliations

    • Department of Psychiatry, University of North Carolina at Chapel Hill
    • Department of Biostatistics, University of North Carolina at Chapel Hill
  • ,
  • Hans Kordy, PhD

      Affiliations

    • Centre for Psychotherapy Research, University of Heidelberg, Germany
  • ,
  • Dianne Ward, EdD

      Affiliations

    • Department of Nutrition, University of North Carolina at Chapel Hill
  • ,
  • Cynthia M. Bulik, PhD

      Affiliations

    • Department of Psychiatry, University of North Carolina at Chapel Hill
    • Department of Nutrition, University of North Carolina at Chapel Hill

Abstract 

Objective

To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children.

Design

All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via paper diaries (PD) or participated in a no-monitoring control (C) for 8 weeks.

Setting

University of North Carolina at Chapel Hill.

Participants

Fifty-eight children (age 5-13) and parents participated; 31 completed (SMS: 13/18, PD: 7/18, C: 11/22).

Intervention

Children and parents participated in a total of 3 group education sessions (1 session weekly for 3 weeks) to encourage increasing physical activity and decreasing screen time and sugar-sweetened beverage consumption.

Main Outcome Measures

Treatment acceptability, attrition, and adherence to self-monitoring.

Analysis

Descriptive statistics and nonparametric tests were used to analyze differences across time and group.

Results

Children in SMS had somewhat lower attrition (28%) than both PD (61%) and C (50%), and significantly greater adherence to self-monitoring than PD (43% vs 19%, P < .02).

Conclusions and Implications

Short message service may be a useful tool for self-monitoring healthful behaviors in children, although the efficacy of this approach needs further study. Implications suggest that novel technologies may play a role in improving health.

Key Words: children, diet, physical activity, technology, monitoring

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 Support for this research project was provided by the Ambulatory Pediatric Association Young Investigator Award; an unrestricted gift from the Gatorade Company for the Get Kids in Action Partnership with the University of North Carolina at Chapel Hill; National Institutes of Health grants 5T32MH19111-15 and DK56350 and an Alexander von Humboldt Stiftung German-American Trans-Coop grant.

PII: S1499-4046(07)00995-5

doi:10.1016/j.jneb.2007.09.014

Journal of Nutrition Education and Behavior
Volume 40, Issue 6 , Pages 385-391, November 2008