title: Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: a qualitative study using parent focus groups and interviews.
abstract: BACKGROUND
  Text messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children.
  
  
  OBJECTIVE
  Our aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change.
  
  
  METHODS
  We conducted focus groups and follow-up interviews with parents of overweight and obese children, aged 6-12 years, seen for "well-child" care in eastern Massachusetts. A professional moderator used a semistructured discussion guide and sample text messages to catalyze group discussions. Seven participants then received 3 weeks of text messages before a follow-up one-on-one telephone interview. All focus groups and interviews were recorded and transcribed verbatim. Using a framework analysis approach, we systematically coded and analyzed group and interview data to identify salient and convergent themes.
  
  
  RESULTS
  We reached thematic saturation after five focus groups and seven follow-up interviews with a total of 31 parents of diverse race/ethnicity and education levels. Parents were generally enthusiastic about receiving text messages to support healthy behaviors for their children and preferred them to paper or email communication because they are brief and difficult to ignore. Participants anticipated high responsiveness to messaging endorsed by their child's doctor and indicated they would appreciate messages 2-3 times/week or more as long as content remains relevant. Suggestions for maintaining message relevance included providing specific strategies for implementation and personalizing information. Most felt the negative features of text messaging (eg, limited message size) could be overcome by providing links within messages to other media including email or websites.
  
  
  CONCLUSIONS
  Text messaging is a promising medium for supporting pediatric obesity-related behavior change. Parent perspectives could assist in the design of text-based interventions.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01565161; http://clinicaltrials.gov/show/NCT01565161 (Archived by WebCite at http://www.webcitation.org/6LSaqFyPP).
authors: Division of General Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, United States. msharifi@partners.org.
authors: Mona
authors: M
authors: Sharifi
authors: Eileen M
authors: EM
authors: Dryden
authors: Christine M
authors: CM
authors: Horan
authors: Sarah
authors: S
authors: Price
authors: Richard
authors: R
authors: Marshall
authors: Karen
authors: K
authors: Hacker
authors: Jonathan A
authors: JA
authors: Finkelstein
authors: Elsie M
authors: EM
authors: Taveras
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D050177:Overweight / Q000523:psychology / Q000628:therapy; D010290:Parents / Q000523:psychology; D063766:Pediatric Obesity / Q000523:psychology* / Q000628:therapy*; D017216:Telemedicine; D060145:Text Messaging
keywords: child; health behavior; obesity; overweight; telemedicine; text messaging