More than 8 million women have a history of heart attack and/or anginaOver 1/3 of deaths in women over 20 caused by cardiovascular disease- heart attacks kill 5x more women than breast cancerPreventable through changes in diet, quitting smoking, and increasedphysical activity
After baseline survey, participants received introductory letter to the program.Recruiters (team members) distributed FitBits, reviewed installation procedures, dashboard features, FitBit features, & answered questions. During this time, participants’ step counts ranged from under 500 up to 12,497. Participants were asked to wear FitBits for 14 additional days. During the program two text messages were delivered to participants each day, one in the morning and a second after lunch.
Most were very confident in their ability to walk during the workday (3- Very Confident, 1- Unconfident)Neutral about their ability to walk 10,000 steps (1- unconfident, 2- neutral, 1- confident). Preliminary measures of positive outcome expectation for walking were positive (2- very beneficial, 1- beneficial, 1- neutral).
It is worth noting however that the participant that far exceeded 10,000 steps (17,000) per day believed that time was less of a barrier while the participant that achieved the fewest steps in one day (8,500) believed time was more of a barrier.
They will be briefed in person as to what WorkIt! Text is all about and how the text messaging and the FitBit can work together, in addition to the information provided in the welcome letter. Rather than the recommended goal of 10,000 steps per day for each participant, WorkIt! staff will work with the participants to set realistic goals based on their baseline step counts-make program more relevant, attainableand engaging
Work it final presentation ph6570
WorkIt! TXTA text message-based walking campaign for urban professional women Shriya Kothur, Jessica Havlak, Philip Carroll, Monica Williams GW School of Public Health and Health Services S
Health ProblemS 42 million women in the US live with cardiovascular diseaseS Leading cause of death in womenS Preventable!
Target PopulationS WomenS Ages 25-45S Working in Washington, DCS Commuting via Metro
Program ObjectivesS Health Objective: S To reduce incidence of cardiovascular disease in the target audience by 20% in 10 years from intervention initiation.S Behavioral Objective: S To increase the number of steps taken weekly by the target audience by 50% in 12 weeks.
Program Objectives, cont.S Theoretical Basis: Social Cognitive TheoryS Communication Objectives: S Increase target audience self efficacy to walk 10,000 steps daily from baseline evaluations by 20% in 2 weeks after intervention initiation. S Increase target audience’s positive outcome expectations that walking 10,000 steps is good for health from baseline evaluations by 25% in 2 weeks after intervention initiation. S Decrease perception of barriers to walking 10,000 steps daily among target audience from baseline evaluations by 20% in 2 weeks after intervention initiation.
Designing MessagesS Targeted messages that reflect participants’ attitudes and beliefs about walkingS Limited COs to self-efficacy & positive outcome expectationsS No more than two messages per dayS Interactive messagesS Incorporated FitBit wherever possibleS Conversational/colloquial tone
Message LibraryS Based on user feedback, we made the following adjustments to our message library: S Limited messages to 1x per day on weekends S Included more goal-oriented messages S Tweaked messages so they were more encouraging; less guilt-inducing S Added in more specificity
Dissemination PlanS Communication Channels S Social Media: Facebook, Twitter, Instagram S Word of Mouth (Interpersonal) S Mass Media Earned & Paid S Change Agents S Opinion LeadersS 3 phasesS Horizontal Dissemination
Dissemination PlanS Phase 1 – Two Months S Opinion Leaders S Change Agents S Earned Media S BloggersS Phase 2 – Three Months S Trial Period S Limited Participation S Feedback and Sharing Practices Noted S Revisions
Dissemination PlanS Phase 3 - Large Scale Distribution S Print Media Advertisement S Washington Post, New York Times S Billboards/Posters S Metro, high traffic public transit locations
Pilot StudyS 4 women recruitedS Pre/post surveys used to gather demographics & assess the self- efficacy to walk 10,000 steps, perceived barriers to walking 10,000 steps, & perceived benefits to health from walking 10,000 steps dailyS Survey was online via Google FormsS After baseline survey, participants received introductory letter to the program.S Participants were asked to wear the FitBit for two days for baseline walking data.S Participants were asked to wear FitBits for 14 additional days and received 2 text messages/day.
Baseline AssessmentS Pre-Assessment S No more than 1 text message/day S Most were very confident in their ability to walk during the workday S Neutral about their ability to walk 10,000 S Perceived cardiovascular benefits of walking were positive, regardless of weight change S Weather, work schedule, & time were the most common perceived barriers
Post Program AssessmentS Overall increase in steps for all participants after the programS Decline in self-efficacy to walk 10,000 steps, reinforced perceived barriers to walking 10,000 steps, & decline perceived benefits to health from walking 10,000 steps dailyS However, all agree walking can be beneficial to cardiovascular health regardless of weight change.S Too many text messages delivered during the programS Participant that far exceeded 10,000 steps/day believed time was less of a barrier than those who did not reach 10,000
RecommendationsS Train participants more thoroughly in FitBit use and syncingS In person brief about the WorkIt! Text program and how it works with the FitBitS Longer baseline data collection period for more accurate initial walking averagesS Incremental increases in goals overtime to decrease feelings of guilt S Congratulations you averaged ___ steps this week! Try to increase your daily average by 1,000. Go to www.WorkITTxt.com for ideas
Recommendations cont.S WorkIt! staff will work with the participants to set realistic goals based on baseline dataS Positive reinforcement through interactive messaging at the end of the day and week S Did you meet your goal today? S No That’s OK take a few extra laps around the block before bed. Check out www.WorkITTxt.com for tips to increase your steps. S Yes Great Job keep up the good workS Pilot testing of FitBit WorkIt! app for smartphones