E-Health Text Messaging based Intervention on Healthy Lifestyle Changes and Obesity in the Socioeconomically Disadvantaged Population

The obesity epidemic, known to be a multifactorial medical condition, in the United States has been declared a public health crisis. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age. (Whitaker, Wright et al. 1997) Naturally, parents are often the strongest role models of their young children, who tend to imitate their eating behaviors as well as other lifestyle behaviors. (Lubna, Paloma et al. 2021) Therefore, it is of paramount importance to have upstream intervention programs to make positive changes in the obesity-promoting lifestyle behaviors of parents that often contribute to. The e-health text messaging platform integrated six major contributing factors of obesity, which included caloric content and quality of diet, physical activity, sleep, social connection, tobacco, and stress management. We hypothesized that if we could change the attitudes, knowledge, and beliefs of the caregivers, then this would cause a ripple effect leading to their children adopting the same healthy lifestyles, thereby decreasing the prevalence of the obesity epidemic.

Subject 4 is a Black or African American female who was part of the intervention arm which received text messages every week for 6 months which included health education on 6 different topics. The participant was surveyed biweekly about her knowledge, attitudes, and behaviors regarding health education topics via text messages. Throughout the study, subject 4 showed high motivation to make positive changes in her life. Her goals consisted of sleeping 8 hours a night, staying hydrated, exercising 30 minutes daily, meditating, praying, and decreasing her sugar intake. Subject 4 mentioned that "consistency” and "accountability” are what motivated her. The platform was able to give her a sense of accountability by ensuring that she was staying consistent by monitoring her progress toward her goals. She mentioned that having goals for her habits impacted her health and wellness by keeping her "consistent.” She indicated that the program greatly supported her on her road to wellness at the end of the study and "it had helped her to stay positive and to leave bad habits.” At the 9 and 12-month follow-ups, she indicated on a scale of 1 to 10 (10 being the most consistent), 10 and 8 respectively, that she was continuing her goals/habits that she had formed to support herself on her road to wellness.

This case illustrates that an e-health intervention program may benefit individuals by providing a platform where they can create personal goals, have a form of accountability that encourages them to make small changes by providing health literate education briefs, and provides a connection to local community resources to support participants to reach their goals. Additionally, this intervention program showed a beneficial impact on the subject’s wellness as indicated by the post-survey responses. This highlights that having an intervention program may be a step in the right direction to making small positive lifestyle changes and eradicating the obesity epidemic one family at a time.