Implementing text-messaging to support and enhance delivery of health behavior change interventions in low- to middle-income countries: case study of the Lifestyle Africa intervention.

Creator(s)

Frank T. Materia, Children's Mercy HospitalFollow
Joshua M. Smyth
Thandi Puoane
Lungiswa Tsolekile
Kathy Goggin, Children's Mercy Kansas CityFollow
Stephen R. Kodish
Andrew T. Fox, Children's Mercy HospitalFollow
Ken Resnicow
Scott Werntz
Delwyn Catley, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

8-10-2023

Identifier

DOI: 10.1186/s12889-023-16388-y; PMCID: PMC10416414

Abstract

The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with expertise and first-hand experience to establish specific development steps for building and implementing SMS systems to support HBC programming in LMICs. Specifically, we provide real-world examples of each development step by describing our experience in designing and delivering an SMS system to support a culturally-adapted DPP designed for delivery in South Africa. We outline eight key SMS development steps, including: 1) determining if SMS is appropriate; 2) developing system architecture and programming; 3) developing theory-based messages; 4) developing SMS technology; 5) addressing international SMS delivery; 6) testing; 7) system training and technical support; and 8) cost considerations. We discuss lessons learned and extractable principles that may be of use to other mHealth and HBC researchers working in similar LMIC contexts.Trial registration Clinicaltrials.gov, NCT03342274 . Registered 10 November 2017.

Journal Title

BMC public health [electronic resource]

Volume

23

Issue

1

First Page

1526

Last Page

1526

Keywords

Community health worker; Diabetes prevention program; Global health; Health behavior change; Implementation; LMIC; SMS; Text messaging; mHealth

Comments

Grant support

• R01HL126099/HL/NHLBI NIH HHS/United States

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Publisher's Link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16388-y

Recommended Citation

Materia FT, Smyth JM, Puoane T, et al. Implementing text-messaging to support and enhance delivery of health behavior change interventions in low- to middle-income countries: case study of the Lifestyle Africa intervention. BMC Public Health. 2023;23(1):1526. Published 2023 Aug 10. doi:10.1186/s12889-023-16388-y