Online Program

Txt4health mhealth campaign: Assessing the health belief model

Tuesday, November 5, 2013 : 5:30 p.m. - 5:50 p.m.

David Kulick, MPH, Crescent City Beacon Initiative, Louisiana Public Health Institute, New Orleans, LA
Snigdha Mukherjee, PhD, Louisiana Public Health Institute, New Orleans, LA
Thomas Carton, PhD, Louisiana Public Health Institute, New Orleans, LA
Lisanne Brown, PhD MPH, Louisiana Public Health Institute, New Orleans, LA
Anjum Khurshid, MBBS, PhD, Health Systems Development, Louisiana Public Health Institute, New Orleans, LA
Nebeyou Abebe, MA, PMP, Associate Director, Health Systems, Louisiana Public Health Institute, New Orleans, LA
Txt4health is a mobile health program that engages individuals in the Greater New Orleans community in diabetes risk awareness and behavior change through interactive text messages. It communicates with participants regarding diabetes health information, goal setting, and prompts for behavior change over the course of 14 weeks. Txt4health is based on the Health Belief Model (HBM) attempting to initiate behavior change through raising awareness of participant health risk perception and providing cues to action. The program evaluation includes the use of a validated Patient Activation Measure (PAM) which assesses an individual's readiness to manage their own health. This presentation uses the HBM paradigm and PAM to understand self-reported health behavior. A multi-method approach was used to evaluate the program, including a population-based, pre- and post-marketing campaign survey (N=1402) combining telephone RDD with internet; participant satisfaction survey (N=59) administered through a text-delivered URL link; and program data (N=1,200) from the interactive text messaging program. The PAM was administered in the post-campaign survey and the programs satisfaction survey that can be linked to program participation data. The population-based survey shows a higher than expected percentage of people ready to manage their own health. Similarly, program participants who are aware of their risk for diabetes indicated greater desire to manage their health and a higher engagement in healthy behaviors indicated by their response to PAM and self-reported behaviors. Awareness of risk for diabetes is associated with greater readiness to engage in health management as demonstrated by self-reported healthy behaviors. The results validate using HBM to understand health behaviors in the population-based survey and among the sub-sample of participants of the txt4health program. As ‘mhealth' programs scale from the trial level to the population level, it will be important to utilize theory based, validated measures to understand how the program initiates health behavior change.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the health belief model as it applies to mhealth programs Explain and discuss the connection between the Patient Activation Measure and health behavior change models in mhealth Describe the use of evaluation methodologies in population-based mhealth initiatives and corresponding lessons learned.

Keyword(s): Information Technology, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in mobile health for over five years and have been managing the Text4Health program since its inception.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.