Promoting Early Obesity Prevention Via Mobile Messaging...If We Text It, Will They Come?

Theoretical Background and research questions/hypothesis: Childhood obesity is a health concern that touches even the youngest children.  Early childhood has been identified as a critical period for obesity prevention.  Parent-targeted social marketing via short message service (SMS) messaging is a new and promising way to provide information and promote health behaviors.  In a 2009 report of low-income families’ views on well child care, parents endorsed the use of text messaging for receipt of information and education.  In recent years, the acceptability of SMS messaging for health behavior change has continued to grow. The Community Preventive Services Task Force recommends mobile phone-based interventions for tobacco cessation. In a San Diego based evaluation of Text4baby, a national mobile health program for pregnant women and their infants, 63.1% reported that Text4baby helped them remember an appointment/immunization for themself/their child; 71.3% reported talking to their doctor about a topic that they read on Text4baby. This study examines parent opinions on acceptability, feasibility and content preferences regarding a proposed program to provide healthy active living and obesity prevention information via SMS to families of young children.     

Methods: 16 focus groups at 8 locations throughout the US with parents of children ages 1-5 years. 

Results: Participants were mostly mothers (>90%); the majority of children were publicly insured.  Over 55% of parents viewed childhood obesity as a “very serious” problem.  Participants sent/received M=35 text messages/day and over 85% reported feeling “very comfortable” with their texting ability.  Parents, especially in groups representing underserved populations, were supportive of SMS as a means to deliver information about obesity prevention and child health.  Factors contributing to acceptance included 1) communication preferences ["I prefer text messages to any other form of communication"], 2) desire for brief, highly focused information ["I’d be more inclined to read that because it would be right to the point…you can read it fast, still keep doing what you’re doing but still understand it"] and 3) perceived lack of easily accessible child health information beyond infancy ["…my daughter is 10 months old…information is so readily available but with my 4 ½ year old son, it’s like it falls off"].  Parents valued opportunities to individualize information and favorably assessed content pertaining to well child care/screening reminders, child growth and development, and action strategies to promote healthy behaviors.  Parents acknowledged concerns about spam messaging and emphasized the importance of source visibility.  Use of “text lingo” was uniformly rejected as unprofessional. 

Conclusions: Focus group findings suggest that parents may be receptive to obesity prevention information and strategies delivered via mobile messaging.  For many parents, texting has become a preferred choice for communication.   

Implications for research and/or practice:  The majority of parents now have cell/smart phones and for many in underserved populations, telephones are a primary means to internet access.  For families of young children, use of SMS may be an effective way to enhance obesity prevention knowledge and support positive behavioral change.