An adaptive text message intervention to promote psychological well-being and reduce cardiac risk: The Text4Health controlled clinical pilot trial.

Autor: Celano CM; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Healy BC; Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA., Jacobson LH; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Bell M; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Carrillo A; Faculty of Psychology, University of Valencia, Spain., Massey CN; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Chung WJ; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Legler SR; Division of Hospital Medicine, Mayo Clinic, Rochester, MN, USA., Huffman JC; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Electronic address: jhuffman@mgh.harvard.edu.
Jazyk: angličtina
Zdroj: Journal of psychosomatic research [J Psychosom Res] 2024 Feb; Vol. 177, pp. 111583. Date of Electronic Publication: 2023 Dec 30.
DOI: 10.1016/j.jpsychores.2023.111583
Abstrakt: Objective: In a two-arm pilot trial, we examined the feasibility, acceptability, and preliminary efficacy of a 12-week, adaptive text message intervention (TMI) to promote health behaviors and psychological well-being in 60 individuals with multiple cardiac risk conditions (i.e., hypertension, hyperlipidemia, and/or type 2 diabetes) and suboptimal adherence to exercise or dietary guidance.
Methods: Participants were allocated to receive the TMI or enhanced usual care (eUC). The TMI included daily adaptive text messages promoting health behaviors, twice-weekly messages to set goals and monitor progress, and monthly phone check-ins. Feasibility (primary outcome) and acceptability were measured by rates of successful text message delivery and daily participant ratings of message utility (0-10 Likert scale). We also assessed impact on health behavior adherence, psychological health, and functional outcomes.
Results: The TMI was feasible (99.3% of messages successfully sent) and well-accepted (mean utility = 7.4/10 [SD 2.6]). At 12 weeks, the TMI led to small-sized greater improvements in moderate to vigorous physical activity (d = 0.37), overall physical activity (d = 0.23), optimism (d = 0.20), anxiety (d = -0.36), self-efficacy (d = 0.22), and physical function (d = 0.20), compared to eUC. It did not impact other outcomes substantially at this time point.
Conclusion: This 12-week, adaptive TMI was feasible, well-accepted, and associated with small-sized greater improvements in health behavior and psychological outcomes. Though larger studies are needed, it has the potential to be a scalable, low-intensity program that could be used in clinical practice.
Clinicaltrials: govregistration:NCT04382521.
Competing Interests: Declaration of Competing Interest Funding: This research project was supported by the National Institute of Nursing Research [R21NR018738 (to Dr. Huffman)] and by a Clinical and Translational Science Award (1UL1TR002541-01). Time for analysis and article preparation was also funded by the National Heart, Lung, and Blood Institute [R01HL155301 (to Dr. Celano)]. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health. The sponsor had no role in the design, analysis, interpretation, or publication of the study. The authors report no other relevant conflicts of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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