The WorkIt! TXT program aims to increase walking among professional women ages 25-45 in Washington, DC through a text message-based intervention. The program objectives are to reduce cardiovascular disease rates by 20% in 10 years and increase weekly steps by 50% in 12 weeks using messages based on social cognitive theory. An initial pilot study of 4 women found an increase in steps but declines in self-efficacy and perceived benefits. Recommendations include improving Fitbit training, setting incremental goals, and providing positive reinforcement messages.

1. WorkIt! TXT
A 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

2. Health Problem
S 42 million women in the US live with cardiovascular
disease
S Leading cause of death in women
S Preventable!

3. Target Population
S Women
S Ages 25-45
S Working in Washington, DC
S Commuting via Metro

4. Program Objectives
S 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.

5. Program Objectives, cont.
S Theoretical Basis: Social Cognitive Theory
S 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.

6. Designing Messages
S Targeted messages that reflect participants’ attitudes and
beliefs about walking
S Limited COs to self-efficacy & positive outcome expectations
S No more than two messages per day
S Interactive messages
S Incorporated FitBit wherever possible
S Conversational/colloquial tone

7. Message Library
S 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

8. Dissemination Plan
S Communication Channels
S Social Media: Facebook, Twitter, Instagram
S Word of Mouth (Interpersonal)
S Mass Media  Earned & Paid
S Change Agents
S Opinion Leaders
S 3 phases
S Horizontal Dissemination

9. Dissemination Plan
S Phase 1 – Two Months
S Opinion Leaders
S Change Agents
S Earned Media
S Bloggers
S Phase 2 – Three Months
S Trial Period
S Limited Participation
S Feedback and Sharing Practices Noted
S Revisions

10. Dissemination Plan
S 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

11. Pilot Study
S 4 women recruited
S 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 daily
S Survey was online via Google Forms
S 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.

12. Baseline Assessment
S 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

13. Post Program Assessment
S Overall increase in steps for all participants after the program
S 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 daily
S However, all agree walking can be beneficial to cardiovascular
health regardless of weight change.
S Too many text messages delivered during the program
S Participant that far exceeded 10,000 steps/day believed time was
less of a barrier than those who did not reach 10,000

14. Recommendations
S Train participants more thoroughly in FitBit use and syncing
S In person brief about the WorkIt! Text program and how it
works with the FitBit
S Longer baseline data collection period for more accurate initial
walking averages
S 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

15. Recommendations cont.
S WorkIt! staff will work with the participants to set realistic goals
based on baseline data
S 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 work
S Pilot testing of FitBit WorkIt! app for smartphones