Buis Lorraine R, Hirzel Lindsey, Turske Scott A, Des Jardins Terrisca R, Yarandi Hossein, Bondurant Patricia
University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.
J Med Internet Res. 2013 Dec 19;15(12):e282. doi: 10.2196/jmir.2929.
Although there is great enthusiasm in both the public and private sector for the further development and use of large-scale consumer-facing public health applications for mobile platforms, little is known about user experience and satisfaction with this type of approach. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing, mobile phone-based health information service targeting type 2 diabetes, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. This program was marketed via large public health campaigns and drew many users within the respective communities.
The purpose of this investigation was to use the RE-AIM framework to document txt4health efficacy by focusing on perceptions of satisfaction, usage, and behavior change among individuals who used txt4health in pilot studies in Southeast Michigan and Greater Cincinnati.
We conducted a multimodal user survey with txt4health users recruited via text message through the program to understand participant perceptions of program use and satisfaction, as well as self-reported perceptions of behavior change as a result of using txt4health.
Txt4health users reported very high levels of program satisfaction, with 67.1% (108/161) reporting satisfaction scores of ≥8 on a 10-point scale, with 10 equivalent to most satisfied (mean 8.2, SD 1.6). All survey participants agreed/strongly agreed that the messages included in txt4health were clear and easy to understand (100.0%, 160/160), and most found txt4health made them knowledgeable about their risk for type 2 diabetes (88.1%, 140/159) and made them conscious of their diet and physical activity (88.8%, 142/160). Most participants reported that txt4health helped them to make behavior changes related to diet; after having completed txt4health, most agreed/strongly agreed that they are more likely to replace sugary drinks, such as juice or soda, with water (78.0%, 124/159), have a piece of fresh fruit instead of dessert (74.2%, 118/159), substitute a small salad for chips or fries when dining out (76.1%, 121/159), buy healthier foods when grocery shopping (79.7%, 126/158), and eat more grilled, baked, or broiled foods instead of fried (75.5%, 120/159).
Results from this study suggest that participants in txt4health, a large-scale, public health-focused text message program targeting type 2 diabetes, have positive perceptions of the program and that participation has led to positive behavior change.
尽管公共部门和私营部门都对进一步开发和使用面向消费者的大规模移动平台公共卫生应用程序充满热情，但对于此类方法的用户体验和满意度却知之甚少。作为灯塔社区合作协议计划的一部分，txt4health于2010年在3个灯塔社区推出，这是一项面向公众的、基于手机的健康信息服务，目标人群为2型糖尿病患者：密歇根州底特律的东南密歇根灯塔社区、俄亥俄州辛辛那提的大辛辛那提灯塔社区以及路易斯安那州新奥尔良的新月城灯塔社区。该项目通过大型公共卫生活动进行推广，并在各自社区吸引了众多用户。
本调查的目的是使用RE-AIM框架，通过关注在密歇根州东南部和大辛辛那提的试点研究中使用txt4health的个体对满意度、使用情况和行为改变的看法，来记录txt4health的效果。
我们通过该项目以短信方式招募txt4health用户，进行了多模式用户调查，以了解参与者对项目使用和满意度的看法，以及使用txt4health后自我报告的行为改变看法。
txt4health用户报告的项目满意度非常高，67.1%（108/161）的用户在10分制中报告的满意度得分≥8分，10分表示最满意（平均8.2分，标准差1.6）。所有调查参与者都同意/强烈同意txt4health中的信息清晰易懂（100.0%，160/160），大多数人发现txt4health使他们了解了自己患2型糖尿病 的风险（88.1%，140/159），并使他们意识到自己的饮食和身体活动（88.8%，142/160）。大多数参与者报告说txt4health帮助他们在饮食方面做出了行为改变；完成txt4health后，大多数人同意/强烈同意他们更有可能用水代替果汁或苏打水等含糖饮料（78.0%，124/159），吃一片新鲜水果而不是甜点（74.2%，118/159），外出就餐时用小份沙拉代替薯片或薯条（76.1%，121/159），购物时购买更健康的食品（79.7%，126/158），以及多吃烤、烘或烤的食物而不是油炸食品（75.5%，120/159）。
本研究结果表明，参与txt4health（一项针对2型糖尿病的大规模、以公共卫生为重点的短信项目）的参与者对该项目有积极的看法，并且参与导致了积极的行为改变。
