Department of Dietetics and Human Nutrition, University of Kentucky, 206G Funkhouser Building, Lexington, KY 40506, USA.
Department of Public Health, Brody School of Medicine, East Carolina University, 115 Heart Drive, Mailstop 660, Room 2239, Greenville, NC 27834, USA.
Nutrients. 2019 Mar 11;11(3):593. doi: 10.3390/nu11030593.
Introduction-Text-messaging interventions hold promise for successful weight loss interventions. However, there is limited research on text-messaging interventions to improve dietary intake among rural adolescents, who are at greater risk for obesity and related risk factors. The goal of this study was to test an eight-week, mentor-led text-messaging intervention among 14⁻16-year-old rural adolescents: the "Go Big and Bring It Home" Project to improve fruit and vegetable and healthy beverage intake. Methods and Materials-Eight rural high schools in eastern Kentucky and eastern North Carolina participated ( = 4 were randomized as intervention schools and = 4 were randomized as control schools). Adolescents were recruited to participate in the eight-week text-messaging intervention. The text messages were primarily affective messages, and included a weekly challenge related to consuming fruits, vegetables, or healthy/low-calorie beverages. Undergraduate nutrition students sent text messages on Tuesday and Saturday every week over the eight-week period via the "Group Me" mobile application. Delayed controls received no information or text messages during the eight-week intervention. Fruit and vegetable intake was measured with the National Cancer Institute Fruit and Vegetable screener and beverage intake was assessed using the Beverage Questionnaire-10 (BEVQ-10). Intention-to-treat analyses were conducted among all those that completed the baseline and post-intervention survey ( = 277 intervention students and = 134 delayed control students). All linear regression models were adjusted for race and were clustered on school to control for intraclass correlation. Results-In adjusted analyses, there was a statistically significant positive intervention effect on the primary outcome of fruit and vegetable servings/day with a mean difference between intervention and control participants of 1.28 servings/day (95% Confidence Interval 1.11, 1.48). There was no intervention effect on beverage intake. There was a statistically significant increase in the odds of goal setting for healthier dietary behaviors among intervention participants relative to controls. Conclusion-An eight-week text-messaging intervention led to increases in self-reported fruit and vegetable intake and improvements in goal setting for healthier dietary behaviors. Due to the use of undergraduate students to deliver the messages, and use of an existing web application, this text-messaging intervention can be sustained in underserved, rural environments. Thus there is potential for significant reach and public health impact to improve dietary patterns.
简介-文本信息干预措施有望成为成功的减肥干预措施。然而，针对农村青少年的文本信息干预措施以改善饮食摄入的研究有限，农村青少年肥胖和相关风险因素的风险更高。本研究的目的是测试一项为期八周的导师主导的文本信息干预措施，该措施针对 14-16 岁的农村青少年：“Go Big and Bring It Home”项目旨在改善水果和蔬菜以及健康饮料的摄入量。方法和材料-肯塔基州东部和北卡罗来纳州东部的八所农村高中参与了研究（=4 所随机分配为干预学校，=4 所随机分配为对照组学校）。招募青少年参加为期八周的文本信息干预措施。这些文本信息主要是情感信息，每周都有一个与食用水果、蔬菜或健康/低热量饮料相关的挑战。本科生营养学生在八周期间通过“Group Me”移动应用程序每周二和周六发送文本信息。延迟对照组在八周的干预期间不接收任何信息或文本信息。使用国家癌症研究所水果和蔬菜筛选器测量水果和蔬菜的摄入量，使用饮料问卷-10（BEVQ-10）评估饮料摄入量。对完成基线和干预后调查的所有人进行意向治疗分析（=277 名干预学生和=134 名延迟控制学生）。所有线性回归模型均根据种族进行调整，并按学校进行聚类，以控制组内相关性。结果-在调整后的分析中，干预组与对照组参与者之间水果和蔬菜份/天的主要结果有统计学意义上的正干预效应，平均差异为 1.28 份/天（95%置信区间为 1.11，1.48）。干预对饮料摄入量没有影响。与对照组相比，干预参与者设定更健康饮食行为目标的可能性有统计学显著增加。结论-为期八周的文本信息干预措施导致自我报告的水果和蔬菜摄入量增加，并改善了设定更健康饮食行为目标的行为。由于使用本科生来发送信息，并且使用现有的网络应用程序，因此这种文本信息干预措施可以在服务不足的农村环境中持续进行。因此，它有可能产生重大影响，改善饮食模式，从而产生公共卫生影响。
