Use of Text Messaging and Facebook Groups to Support the Healthy Children, Strong Families 2 Healthy Lifestyle Intervention for American Indian Families

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ABSTRACT

Background

Few obesity interventions have been developed for American Indian (AI) families despite the disproportionate risk of obesity experienced within AI communities. The emergence of mobile technologies to enhance intervention delivery could particularly benefit AI communities, many of which are hard to reach and underserved.

Objectives

This study aimed to assess the use and perceptions of text messaging and Facebook to support delivery of the Healthy Children, Strong Families 2 (HCSF2) mailed healthy lifestyle/obesity prevention intervention and discuss lessons learned regarding intervention support via these platforms among AI participants.

Methods

From among AI families with young children (ages 2–5 y), 450 adult-child dyads were recruited from 5 rural and urban communities for a year-long intervention. Intervention content was delivered by mail and supported by text messaging and optional Facebook groups. Participants provided feedback on text message and Facebook components post-intervention, and Facebook analytic data were tracked.

Results

Self-report feedback indicated high satisfaction with both text messaging and Facebook, with tangible content (e.g., recipes, physical activity ideas) cited as most useful. Overall, participants reported higher satisfaction with and perceived efficacy of Facebook content compared with text messaging. Analytic data indicate the optional HCSF2 Facebook groups were joined by 67.8% of adult participants. Among those who joined, 78.4% viewed, 50.8% “liked,” and 22.6% commented on ≥1 post. Engagement levels differed by urban-rural status, with more urban participants “liking” (P = 0.01) and commenting on posts (P = 0.01). Of note, nearly one-third of participants reported changing phone numbers during the intervention.

Conclusions

This study demonstrates high satisfaction regarding mobile delivery of HCSF2 intervention support components. Best practices and challenges in utilizing different mobile technologies to promote wellness among AI families are discussed, with particular focus on urban-rural differences. Future mobile-based interventions should consider the context of unstable technology maintenance, especially in low-resource communities. This work is part of the HCSF2 trial, which is registered at clinicaltrials.gov (NCT01776255).

Keywords:

American Indian
Facebook
text messaging
health promotion
obesity prevention
communication
social media
family-based intervention

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Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 2P-20GM104417-06 and by NIH NHLBI R01HL114912 to AKA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, who had no role in the design, implementation, analysis, or interpretation of the data. This article appears as part of the supplement "Proceedings of the Fourth Annual Conference on Native American Nutrition," sponsored by the Shakopee Mdewakanton Sioux Community’s Seeds of Native Health campaign through a gift to the University of Minnesota. The guest editor of the supplement is Mindy S Kurzer. MSK is supported by the Shakopee Mdewakanton Sioux Community for her role as chair of the conference planning committee and editing the proceedings. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of Current Developments in Nutrition.

Author disclosures: The authors report no conflicts of interest.

Publication costs for this supplement were defrayed in part by the payment of page charges. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of Current Developments in Nutrition.