Tomayko Emily J, Webber Eliza J, Cronin Kate A, Prince Ronald J, Adams Alexandra K
Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA.
Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Curr Dev Nutr. 2021 May 17;5(Suppl 4):32-39. doi: 10.1093/cdn/nzaa110. eCollection 2021 Jun.
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.
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.
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.
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" (= 0.01) and commenting on posts (= 0.01). Of note, nearly one-third of participants reported changing phone numbers during the intervention.
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).
尽管美国印第安（AI）社区肥胖风险不成比例，但针对AI家庭的肥胖干预措施却很少。移动技术的出现有助于加强干预措施的实施，这对AI社区尤其有益，因为其中许多社区难以接触且服务不足。
本研究旨在评估短信和脸书在支持“健康儿童，强壮家庭2（HCSF2）”邮寄式健康生活方式/肥胖预防干预措施实施方面的使用情况和认知，并讨论在这些平台上为AI参与者提供干预支持的经验教训。
从有幼儿（2至5岁）的AI家庭中，从5个农村和城市社区招募了450对成年-儿童二元组参与为期一年的干预。干预内容通过邮件提供，并辅以短信和可选的脸书群组。参与者在干预后对短信和脸书组件提供反馈，并跟踪脸书分析数据。
自我报告反馈表明对短信和脸书都高度满意，具体内容（如食谱、体育活动想法）被认为最有用。总体而言，与短信相比，参与者对脸书内容的满意度和感知效果更高。分析数据表明HCSF2脸书可选群组有67.8%的成年参与者加入。在加入的人中，78.4%浏览过、50.8%“点赞”过，22.6%对≥1条帖子发表过评论。参与程度因城乡状况而异，城市参与者“点赞”（=0.01）和评论帖子（=0.01）的更多。值得注意的是，近三分之一的参与者报告在干预期间更换了电话号码。
本研究表明对HCSF2干预支持组件的移动交付高度满意。讨论了利用不同移动技术促进AI家庭健康的最佳实践和挑战，特别关注城乡差异。未来基于移动设备的干预措施应考虑技术维护不稳定的情况，尤其是在资源匮乏的社区。这项工作是HCSF（2）试验的一部分，该试验已在clinicaltrials.gov（NCT01776255）上注册。
