Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
J Med Internet Res. 2021 Sep 20;23(9):e26224. doi: 10.2196/26224.
Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement.
This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation.
A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model.
There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons.
A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.
支持健康生活方式的改变是心血管和肺康复计划的一个关键目标。短信文本消息程序已被证明在降低心血管疾病风险、减肥、增加身体活动和戒烟方面有效。随着手机的普及，短信文本消息程序的优化可能会带来更大的人群效益。视觉信息（即基于图像的消息）有可能通过数字技术传达健康信息，并提高参与度。
本研究旨在确定和了解患者对支持心血管和肺康复的以生活方式为重点的视觉文本消息的偏好。
通过 4 个阶段的迭代过程进行离散选择实验，以了解患者对视觉信息特征的偏好。属性和水平的发展产生了 3 个属性（目的、图像类型和网页地址），随后根据完全析因设计构建了 16 个选择集。正在接受心血管和肺康复的患者（在网上）对视觉信息选择集的偏好进行了调查。受访者被要求在 16 对关于关键生活方式行为（即身体活动和营养）的视觉信息之间进行选择。使用条件逻辑回归模型对数据进行了分析。
共有 54 名独特受访者的 1728 个观察结果。与患者偏好相关的两个因素是有目的与无目的相比（比值比[OR]1.93，95%置信区间[CI]1.40-2.65）和真实图像与卡通图像相比（OR1.26，95%CI1.04-1.54）。有目的的信息比无目的的信息不受欢迎（OR0.55，95%CI0.42-0.74）。总体而言，患者更喜欢色彩鲜艳、带有支持图像文本的正面图像，并且更喜欢真实人物的图像而不是卡通图像。
离散选择实验是一种用于确定患者对旨在支持生活方式行为改变的视觉信息干预措施偏好的科学方法。使用视觉辅助工具的短信文本消息程序可以通过使用增益框架、使用真实图像和避免损失框架来提高患者的满意度。需要进一步研究来探索这种视觉信息程序的实施可行性以及与这些程序相关的健康和行为结果。
