title: Feasibility and effectiveness of an automated bilingual text message intervention for weight loss: pilot study.
abstract: BACKGROUND
  Little is known about the feasibility and acceptability of tailored text message based weight loss programs for English and Spanish-language speakers.
  
  
  OBJECTIVE
  This pilot study evaluated the feasibility, acceptability, and estimated impact of a tailored text message based weight loss program for English and Spanish-language speakers. The purpose of this pilot study was to inform the development of a full-scale randomized trial.
  
  
  METHODS
  There were 20 overweight or obese participants (mean age 40.10, SD 8.05; 8/20, 40% male; 9/20, 45% Spanish-speakers) that were recruited in San Diego, California, from March to May 2011 and evaluated in a one-group pre/post clinical trial. For 8 weeks, participants received and responded to 3-5 text messages daily sent from a fully automated text messaging system. They also received printed weight loss materials and brief 10-15 minute weekly counseling calls. To estimate the impact of the program, the primary outcome was weight (kg) measured during face-to-face measurement visits by trained research staff. Pre and post differences in weight were analyzed with a one-way repeated measures analysis of variance. Differences by language preference at both time points were analyzed with t tests. Body mass index and weight management behaviors also were examined. Feasibility and acceptability were determined by recruitment success, adherence (ie, percentage of replies to interactive text messages and attrition), and participant satisfaction.
  
  
  RESULTS
  Participants who completed the final assessment (N=18) decreased body weight by 1.85 kg (F1,17=10.80, P=.004, CI∆ 0.66-3.03, η(2)=0.39). At both time points, there were no differences in weight by language preference. Participants responded to 88.04% (986/1120) of interactive text messages, attrition rate was 10% (2/20), and 94% (19/20) of participants reported satisfaction with the program.
  
  
  CONCLUSIONS
  This fully automated text message based weight program was feasible with English and Spanish-speakers and may have promoted modest weight loss over an 8-week period.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01171586; http://clinicaltrials.gov/ct2/show/NCT01171586 (Archived by WebCite at http://www.webcitation.org/6Ksr6dl7n).
authors.affiliation: Center for Wireless & Population Health Systems (CWPHS), Qualcomm Institute/Calit2, University of California, San Diego, La Jolla, CA, United States. jkolodzi@ucsd.edu.
authors.forename: Julia K
authors.identifier: 0000-0003-0936-4006
authors.initials: JK
authors.lastname: Kolodziejczyk
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Norman
authors.forename: Angelica
authors.initials: A
authors.lastname: Barrera-Ng
authors.forename: Lindsay
authors.initials: L
authors.lastname: Dillon
authors.forename: Simon
authors.initials: S
authors.lastname: Marshall
authors.forename: Elva
authors.initials: E
authors.lastname: Arredondo
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: Fred
authors.initials: F
authors.lastname: Raab
authors.forename: William G
authors.initials: WG
authors.lastname: Griswold
authors.forename: Mark
authors.initials: M
authors.lastname: Sullivan
authors.forename: Kevin
authors.initials: K
authors.lastname: Patrick
keywords: Hispanic Americans; cellular phone; diet; health behavior; obesity; physical activity; text messaging; weight loss