Research: mHealth Tools Coupled With Texting Messaging Can Impact Health Behaviors | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Research: mHealth Tools Coupled With Texting Messaging Can Impact Health Behaviors

December 29, 2015
by Heather Landi
| Reprints

There is ongoing interest in and discussion about the use of mobile health (mHealth) solutions, from wearables to fitness trackers and text messaging, to change patients’ behavior and impact health outcomes. In a clinical trial, researchers at John Hopkins University School of Medicine found that an automated mHealth intervention that utilized both activity tracking and text messaging significantly increased physical activity levels of cardiology patients.

In an article published in the Journal of the American Heart Association, medical researchers reported the findings of their mActive clinical trial, an automated mHealth intervention for physical activity promotion.

According to the researchers, the mActive mobile intervention provides the first “mobile, fully automated, physician-designed, integrated tracking-texting intervention.”

“mActive has the potential to modify behavior in real time, while also being potentially reproducible, affordable, and widely scalable,” the researchers wrote.

In the clinical trial, researchers enrolled outpatients at an academic cardiovascular disease prevention center in Baltimore, M.D. who were also smartphone users. During the clinical trial, patients used the Fitbug Orb for digital physical activity tracking along with the smartphone and Web interfaces with the goal of 10,000 steps per day.

According to researchers, to enable real-time activity data to inform smart texts, the application programming interfaces of Fitbug linked with a smart texting system.

“Smart text content was written by the physician investigators and reflected behavioral change theories, particularly of feedback loops and habit formation, integrated with cardiovascular knowledge and clinical experience,” the researchers wrote. “Each participant was a patient of a study physician with texts aiming to leverage the physician-patient relationship, using the physician’s name in texts.”

During the study, smart texts were sent to some participants three times a day. The smart texts offered either positive reinforcement when a participant was on track to attain or had already attained his or her daily step goal, or as a booster message sent to motivate individuals when they were not tracking to surpass their step goal.

The participants were separated into three groups – those who had no access to their activity level data and did not receive smart texts, those who had access to activity level data and did not receive smart texts and those with access to activity level data and received smart texts.

The study found that 44 percent of participants in the two groups that did not receive smart texts met or exceeded the daily 10,000 step goal. In contrast, 81 percent of participants in the group that received smart texts achieved or exceeded the daily 10,000 step target.

“The differential in activity levels was significant; participants receiving texts increased their daily steps over those not receiving texts by 2,534 and over blinded controls by 3,376,” the researchers wrote, highlighting the results of the last two-week phase of the study.

“In mActive, coupling smart texts with activity tracking led to the best physical activity outcomes. Nearly twice as many participants in the text-receiving arm achieved the 10 000 steps/day goal compared with the other groups,” the researchers wrote. “The mActive trial lends support to the notion of new mHealth devices as facilitators, not drivers, of behavior change, because sequential randomization suggested that unblinding to device data did not significantly modify behavior, whereas coupling it with smart texts did.”

And, researchers concluded that “if sustained, the change in physical activity from the mActive tracking-texting intervention may be clinically significant.”

“However, the influence of behavioral counseling may be limited in the current health care delivery model wherein clinicians tend to see patients for brief visits every several months or annually. Aimed to fill the gap, the mActive system is physician designed and intended to leverage the clinician-patient relationship while functioning automatically without day-to-day involvement of the physician.

The medical researchers also concluded that the mActive model could be applied the activity tracking apps already built into smartphones.

“Our technique might also enhance the development of cardiac rehabilitation programs using

mHealth. Overall, our resource-efficient strategy may facilitate more continuous monitoring and feedback between the health system and patients,” the researchers wrote.

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



Analysis: Healthcare Ransomware Attacks Decline in First Half of 2018

In the first half of 2018, ransomware events in major healthcare data breaches diminished substantially compared to the same time period last year, as cyber attackers move on to more profitable activities, such as cryptojacking, according to a new report form cybersecurity firm Cryptonite.

Dignity Health, UCSF Health Partner to Improve the Digital Patient Experience

Dignity Health and UCSF Health are collaborating to develop a digital engagement platform that officials believe will provide information and access to patients when and where they need it as they navigate primary and preventive care, as well as more acute or specialty care.

Report: Digital Health VC Funding Surges to Record $4.9 Billion in 2018

Global venture capital funding for digital health companies in the first half of 2018 was 22 percent higher year-over-year (YoY) with a record $4.9 billion raised in 383 deals compared to the $4 billion in 359 deals in the same time period last year, according to Mercom Capital Group’s latest report.

ONC Roundup: Senior Leadership Changes Spark Questions

The Office of the National Coordinator for Health IT (ONC) has continued to experience changes within its upper leadership, leading some folks to again ponder what the health IT agency’s role will be moving forward.

Media Report: Walmart Hires Former Humana Executive to Run Health Unit

Reigniting speculation that Walmart and insurer Humana are exploring ways to forge a closer partnership, Walmart Inc. has hired a Humana veteran to run its health care business, according to a report from Bloomberg.

Value-Based Care Shift Has Halted, Study Finds

A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.