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TEXT2COPE: Correlates of Healthy Beliefs, Behaviors, and Mobile Messaging in Families with an Overweight or Obese Preschooler

Sunday, 26 July 2015: 11:10 AM

Lisa K. Militello, PhD, MPH, MSN, BSN, CPNP, RN
College of Nursing, Ohio State University, Columbus, OH
Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN
College of Nursing, The Ohio State University, Columbus, OH
Eric C. Hekler, PhD
School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
Leigh Small, PhD, RN, CPNP-PC, FNAP, FAANP, FAAN
Department of Family and Community Health Nursing, Virginia Commonwealth University, Richmond, VA
Diana L. Jacobson, PhD, RN, PNP-BC
College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ

Maladaptive thinking or faulty cognitive appraisal by parents of overweight/obese (OW/OB) preschoolers can manifest through obesogenic behaviors.  The TEXT2COPE program targeted the critical inputs of parental knowledge, attitude, and beliefs towards healthy lifestyle behaviors synergized with mobile technology. Correlations among the study variables (i.e., the intervention, cognitive beliefs, perceived difficulty, healthy lifestyle behaviors) are presented.

Purpose: To evaluate the relationship among the study variables (i.e., the intervention, cognitive beliefs, perceived difficulty, healthy lifestyle behaviors).  Secondary evaluation was conducted to evaluate the association of text messaging among study variables at posttest.  

Methods:  The pilot study used a one-group pre- and posttest design. Participants were provided with education about healthy nutrition and physical activity and elements of cognitive behavior skills building through clinic visits, manualized content, and tailored and adaptive text messages.

Given the small sample size (n=15), lack of homoscedasticity, and nonparametric distribution of two outcome variables (activity knowledge, healthy lifestyle beliefs), the data better fulfilled the assumptions for Spearman’s rank order correlation, reported as Spearman’s r correlation coefficient (rs).

Results:  Collectively at baseline, parental beliefs towards healthy lifestyles significantly correlated with perceived difficulty (rs= .598, p<.05) and behavior (rs= .545, p<.05).  This indicated that the stronger the parental belief in their ability to engage in healthy behaviors, the less perceived difficulty. 

At posttest, neither the total number of text messages (SMS) sent, nor the total number of tailored SMS sent associated with study variables.  However, participant response to static messages (with automatic feedback response generated) was significantly inversely associated with belief scores (rs = -.522, p<.05) and perceived difficulty scores (rs = -.677, p<.01).  That is, for those participants who scored better on the belief and perceived difficulty measures, the lower the response rate to static SMS.

Conclusion: Parental healthy lifestyle beliefs were significantly related to their perceived difficulty and behavior skills in engaging in a healthy lifestyle.  Nutrition and activity knowledge did not correlate with beliefs, perceived difficulty, or healthy lifestyle behaviors.  Text messaging facilitated tailored and adaptive implementation of the program.  The study findings support existing literature using a cognitive behavioral skills-building program, while being novel in its approach.

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