title: Designing a Text Messaging Intervention to Improve Physical Activity Behavior Among Low-Income Latino Patients With Diabetes: A Discrete-Choice Experiment, Los Angeles, 2014-2015.
abstract: Automated text messaging can deliver self-management education to activate self-care behaviors among people with diabetes. We demonstrated how a discrete-choice experiment was used to determine the features of a text-messaging intervention that are important to urban, low-income Latino patients with diabetes and that could support improvement in their physical activity behavior.
  
  
  
  In a discrete-choice experiment from December 2014 through August 2015 we conducted a survey to elicit information on patient preferences for 5 features of a text-messaging intervention. We described 2 hypothetical interventions and in 7 pairwise comparisons asked respondents to indicate which they preferred. Respondents (n = 125) were recruited in person from a diabetes management program of a safety-net ambulatory care clinic in Los Angeles; clinicians referred patients to the research assistant after routine clinic visits. Data were analyzed by using conditional logistic regression.
  
  
  
  We found 2 intervention features that were considered by the survey respondents to be important: 1) the frequency of text messaging and 2) physical activity behavior-change education (the former being more important than the latter). Physical activity goal setting, feedback on physical activity performance, and social support were not significantly important.
  
  
  
  A discrete-choice experiment is a feasible way to elicit information on patient preferences for a text-messaging intervention designed to support behavior change. However, discrepancies may exist between patients' stated preferences and their actual behavior. Future research should validate and expand our findings.
authors.affiliation: Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, 650 Charles Young Dr S, 31-269 CHS Box 951772, Los Angeles, CA 90095-1772. Email: ramirezma@ucla.edu.
authors.forename: Magaly
authors.initials: M
authors.lastname: Ramirez
authors.affiliation: School of Social Work and Viterbi School of Engineering, University of Southern California, Los Angeles, California.
authors.forename: Shinyi
authors.initials: S
authors.lastname: Wu
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Keck School of Medicine, University of Southern California, Los Angeles, California. Dr Ramirez was affiliated with the Viterbi School of Engineering, University of Southern California, Los Angeles, California, when the research was conducted.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Beale
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data; D011203:Poverty; D064876:Safety-net Providers; D012648:Self Care / Q000379:methods*; D012944:Social Support; D060145:Text Messaging / Q000706:statistics & numerical data*