Parent-targeted mobile phone intervention to increase physical activity in sedentary children: randomized pilot trial.
BACKGROUND
Low levels of moderate-to-vigorous physical activity are associated with adverse health consequences.


OBJECTIVE
The intent of the study was to determine the feasibility and efficacy of a 12-week physical activity promotion program targeting children, which was delivered to parents through mobile phones.


METHODS
Potential participants were recruited through advertisements placed in the newspaper, local hospitals and schools, and an email listserv. Sedentary children aged 6-10 years were randomly assigned to a minimal (MIG) or intensive (IIG) intervention group. Parents in the MIG were given a goal to increase (within 1 month) and maintain their child's activity at 6000 pedometer steps/day above their baseline levels and to monitor their child's steps daily. Parents in the IIG were given the same steps/day and monitoring goals, in addition to text messages and articles containing additional behavioral strategies (based on the Social Cognitive Theory) designed to promote their child's physical activity. The intervention components were delivered via mobile phone. Anthropometrics, body composition, and questionnaires were administered in a clinic. Children wore a New Lifestyles pedometer (NL-1000) each day throughout the intervention and parents were to monitor their child's step counts daily.


RESULTS
Out of 59 children who screened for the study, a total of 27 children (mean age 8.7, SD 1.4 years; 56%, 15/27 female; 59%, 16/27 African American) were enrolled and completed the study. Overall, 97.90% (2220/2268; 98.20%, 1072/1092 for MIG; 97.60%, 1148/1176 for IIG) of expected step data were successfully entered by the parent or study coordinator. Parents in the MIG and IIG were sent approximately 7 and 13 text messages per week, respectively, averaged over the course of the study. IIG parents accessed an average of 6.1 (SD 4.4) articles over the course of the intervention and accessed a fewer number of articles in the last month compared to the first 2 months of the study (P=.002). Children in both the MIG and IIG significantly increased their physical activity, averaged over 12 weeks, by 1427.6 (SD 583.0; P=.02) and 2832.8 (SD 604.9; P<.001) steps/day above baseline, respectively. The between group difference was not statistically significant (P=.10; effect size=.40), nor was the group by time interaction (P=.57). Regardless of group assignment, children who significantly increased their physical activity reported greater increases in physical activity enjoyment (P=.003). The number of behavioral articles accessed by IIG parents was significantly correlated with change in children's steps/day (r=.575, P=.04). Changes in children's steps/day were unrelated to changes in their body composition, mood, and food intake.


CONCLUSIONS
Parent-targeted mobile phone interventions are feasible, yet more intense interventions may be needed to support parents' efforts to increase their children's physical activity to levels that approximate national recommendations.


BACKGROUND
Clinicaltrials.gov NCT01551108; http://clinicaltrials.gov/show/NCT01551108 (Archived by WebCite at http://www.webcitation.org/6TNEOzXNX).
Pennington Biomedical Research Center, Population and Public Health, Baton Rouge, LA, United States. robert.newton@pbrc.edu.
Robert L
http://orcid.org/0000-0002-6863-913X
RL
Newton
Arwen M
http://orcid.org/0000-0002-3024-3527
AM
Marker
H Raymond
http://orcid.org/0000-0002-3856-961X
HR
Allen
Ryan
http://orcid.org/0000-0001-8728-0591
R
Machtmes
Hongmei
http://orcid.org/0000-0002-9478-4592
H
Han
William D
http://orcid.org/0000-0002-3823-4094
WD
Johnson
John M
http://orcid.org/0000-0002-0496-9615
JM
Schuna
Stephanie T
http://orcid.org/0000-0003-3168-0056
ST
Broyles
Catrine
http://orcid.org/0000-0003-4342-5909
C
Tudor-Locke
Timothy S
http://orcid.org/0000-0002-1039-0298
TS
Church
child; mobile health; parents; pedometers; physical activity intervention; text messaging