Craving for Change: Culturally Tailored E-Health Intervention to Support SMART Goal Setting of Lifestyle Modifications Among Underserved Racial/Ethnic Families to Combat Obesity




Abed, Fatima
Robinson, Christina
Yockey, Andrew


0000-0003-4990-7458 (Abed, Fatima)
0000-0002-4637-8952 (Robinson, Christina)
0000-0002-2140-2418 (Yockey, Andrew)

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Purpose: Examine the impact of the mixed-method intervention program Family Central E-Health, utilizing interactive, culturally tailored, e-health text messaging to promote healthy lifestyle behaviors in six domains (diet, physical activity, sleep, social connection, tobacco cessation, and stress management), and combat chronic disease such as obesity among a diverse racial/ethnic and low socioeconomic sample of caregivers of overweight/obese children. Methods: A sample of 14 adult caregivers of overweight/obese children receiving care from the University of North Texas Health Science Center Pediatric Mobile Clinic participated in the e-health intervention group (n = 8) or a control group of usual care (n = 6). The transtheoretical behavior change framework was applied to health briefs shared through a bi-directional text messaging software to customize SMART (Specific, Measurable, Attainable, Relevant, and Time) goal setting, monitor attitude (motivation and confidence), and assess behavioral change on the six domains of lifestyle modifications. The study aims were accomplished through weekly surveys throughout the study (6-month duration), at study close, 3 months post-intervention, and 6 months post-intervention. Results: Longitudinal analysis and differences in overall means of motivation and confidence between the two groups were minimal and not statistically significant. Descriptive thematic analysis of the participants’ attitudes and experiences revealed lifestyle modification domains of physical activity, social connection, and stress management with the most utilization in SMART goal setting and initiating health-promoting behaviors. Conclusion: The Family Central E-Health intervention may be an effective and culturally sensitive model for managing and preventing obesity, and alike chronic diseases among diverse racial/ethnic and/or low socioeconomic caregivers and their families. Reduction of harmful health behaviors and initiation of health-promoting behaviors through SMART goal setting within the six lifestyle domains can help address existing health disparities. Health education and lifestyle modification interventions are important and future directions include investigating participant empowerment, resiliency, and wellbeing, especially within underserved and diverse communities.