Date of Award
Master of Science (MS)
Stewart Chang Alexander
Stewart Chang Alexander
Committee Member 1
William B. Collins
Committee Member 2
Aim: To describe the theoretical basis, and implementation of a randomized controlled trial to improve the diet and nutrition of low-income families in Indiana.
Background: Changing difficult behaviors requires more than education. Beyond education, people benefit from counseling that focuses on increasing motivation and confidence, assistance with overcoming barriers, identifying social support, and creating specific action plans. Widespread use of short-message services (SMS), commonly known as text messaging, provides one potential tool for researchers to help individuals change difficult behaviors.
Although promising, one of the limitations with current SMS interventions is that most have relied on providing reminder texts at the conclusion of an education/counseling session(s). The aim of our study is to explore what types of SMS behavior change techniques are most effective at helping individuals make challenging behavior change regarding diet and nutrition.
Method: To describe the design and rationale of an SMS randomized four-arm control trial that compares the dietary changes of an intervention using: 1) a standardized educational information Reminding Group; 2) Counseling SMS Group; 3) a Brief Personalized Coaching Group; each of which are compared to 4) the usual care control condition of a No SMS Group.
A total of up to 300 Supplemental Nutrition Assistance Program recipients enrolled in the Small Steps to Health program in the state of Indiana will be randomized into one of four groups for three months to determine the efficacy of text-based behavioral interventions focusing on diet and nutrition. Every two weeks, participants will focus on a specific dietary behavior corresponding with the first four lessons taught in the Small Steps class.
The main outcome measured is improvement in overall diet using a Self- 24-Hour Dietary Recall (ASA-24). Secondary outcomes are: specific behavior changes (as described above) as well as confidence, motivation and outcome expectation. Study completion is anticipated in May 2016.
Conclusion: The results of this SMS intervention will inform the Small Steps program on the best way to incorporate technology into their program.
Ingersoll, Lukas T., "mHealth to Improve the Diet Among Low-Income Populations Enrolled in an Established U.S. Nutrition Program: Design and Rationale of a Randomized Controlled Trial" (2016). Open Access Theses. 778.