Objective: There has been increased attention at the role that social media and technology may have in improving health outcomes. However, there remains limited interventions utilizing a peer based model with text messages as a way to improve dietary intake and decrease sugar-sweetened beverage intake. The goal of this study was to test a randomized control trial 8-week peer-led text message intervention among 14–16 year rural adolescents.
Description: Eight schools participated in the randomized control trial (n = 4 intervention schools and n = 4 control schools and n = 350 intervention students and n = 150 control). The text message consisted of primarily affective messages with a challenge each week related to consuming fruits, vegetables, or low-calorie beverages. Undergraduate dietetics and human nutrition students sent text messages on Tuesday and Saturday over the 8-week period via the “Group Me” app.
Evaluation: Intent to treat (ITT) analyses was conducted among all those that completed baseline and post intervention survey data (n = 339) compared to controls (n = 151). A 3-way comparison was conducted as well among responders compared to non-responders and controls. Among those that participated in the intervention there was a .25 serving increase of fruit per week and a .34 serving increase of vegetables per week compared to control adolescents. Among those that responded frequently (more than two return text messages) there was a .75 serving increase of fruit per week and a .82 serving increase of vegetables per week compared to those that infrequently responded (less than two returned text messages).
Conclusions and Implications: A peer-led text message intervention appears to be effective at improving fruit and vegetable intake among rural adolescents. High level of engagement in texting between peers is associated with even greater gains in healthy food choices. Insurance companies, health departments, and other health care organizations may want to consider how to incorporate healthy nudges through text messages to reach rural families with adolescents as a way to improve health outcomes.