Download Full Text (532 KB)

Publication Date



Background and Purpose.

Increasing resources for meeting physical activity guidelines is important for reducing health disparities experienced in marginalized communities. Mobile health (mHealth) interventions are particularly promising for delivering low cost, wide reaching interventions, but few interventions exist that are appropriate for youth and adults from this population group. This study evaluated a pilot mHealth physical activity intervention, Active KC, delivered to children and adults from marginalized communities in Kansas City, MO.


164 participants aged 8-88 years (83% Black, 81% female) recruited through community health events and Children’s Mercy primary care clinics were enrolled into Active KC. The 7-week theory-based intervention followed a 1-week baseline and integrated a Garmin activity monitor with personalized text messages sent by an automated system developed by Children’s Mercy Research Institute’s Research Informatics team. Messages were sent 5 days each week to facilitate self-monitoring and self-efficacy based on the participant’s Garmin health data. Post-intervention surveys were used to measure intervention acceptability. Garmin data were analyzed using mixed-effects regression to evaluate changes in daily step counts.


A priori analytic inclusion criteria resulted in an analytic sample of 29 youth and 66 adults (≥1 day of baseline data and <40 and <20 minutes/day of MVPA at baseline, respectively). Youth’s daily steps increased from a mean of 6,356 (SD=2,040) at baseline to 7,056 (SD=2340) at Weeks 6-7 (B=700, 95% CI=-644, 2045, ES=0.34). Adult’s daily steps increased from a mean of 4,124 (SD=1,447) at baseline to 4,697 (SD=1,931) at Weeks 6-7 (B=573, 95% CI=-65, 1211, ES=0.40). Daily step increases were larger in those with lower baseline values (increases of B=1795 and B=1724 for youth and adults) and who engaged more with the text messages (B=1,011 and B=903). 99% of participants indicated the intervention helped them be more physically active and 98% indicated they would recommend the intervention to family and friends. Qualitative data indicated that parents and children particularly enjoyed participating in the intervention together. Participants provided input on content appropriateness and refinements while and after receiving the intervention.


Results indicate mHealth interventions that integrate consumer wearables and personalized text messaging can have high acceptability and support increases in physical activity in a marginalized community sample. Future research will focus on enhancing implementation and evaluating optimal levels of resources and contact necessary for improving participant adoption, engagement, and intervention effectiveness.

Document Type


Acceptability And Behavior Change In A Pilot mHealth Physical Activity Intervention