دورية أكاديمية
Predicting Attrition in a Text-Based Nutrition Education Program: Survival Analysis of Text2BHealthy.
| العنوان: | Predicting Attrition in a Text-Based Nutrition Education Program: Survival Analysis of Text2BHealthy. |
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| المؤلفون: | Grutzmacher SK; School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States., Munger AL; Department of Child and Family Studies, California State University, Los Angeles, Los Angeles, CA, United States., Speirs KE; Department of Family Studies and Human Development, Norton School of Family and Consumer Sciences, University of Arizona, Tucson, AZ, United States., Vafai Y; Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States., Hilberg E; School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States., Braunscheidel Duru E; Maryland Food Supplement Nutrition Education, University of Maryland, College Park, Columbia, MD, United States., Worthington L; Maryland Food Supplement Nutrition Education, University of Maryland, College Park, Columbia, MD, United States., Lachenmayr L; Maryland Food Supplement Nutrition Education, University of Maryland, College Park, Columbia, MD, United States. |
| المصدر: | JMIR mHealth and uHealth [JMIR Mhealth Uhealth] 2019 Jan 21; Vol. 7 (1), pp. e9967. Date of Electronic Publication: 2019 Jan 21. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: JMIR Publications Inc Country of Publication: Canada NLM ID: 101624439 Publication Model: Electronic Cited Medium: Print ISSN: 2291-5222 (Print) Linking ISSN: 22915222 NLM ISO Abbreviation: JMIR Mhealth Uhealth Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Toronto: JMIR Publications Inc., [2013]- |
| مواضيع طبية MeSH: | Nutritional Physiological Phenomena*, Health Education/*methods , Parents/*education , Research Subjects/*psychology, Health Education/standards ; Humans ; Maryland ; Parents/psychology ; Program Evaluation/methods ; Proportional Hazards Models ; Research Subjects/statistics & numerical data ; Surveys and Questionnaires ; Text Messaging/standards ; Text Messaging/statistics & numerical data |
| مستخلص: | Background: Text-based programs have been shown to effectively address a wide variety of health issues. Although little research examines short message service (SMS) text messaging program characteristics that predict participant retention and attrition, features of SMS text message programs, such as program duration and intensity, message content, and the participants' context, may have an impact. The impact of stop messages-messages with instructions for how to drop out of an SMS text message program-may be particularly important to investigate. Objective: The aim of this study was to describe attrition from Text2BHealthy, a text-based nutrition and physical activity promotion program for parents of low-income elementary school children, and to determine the impact of message content and number of stop messages received on attrition. Methods: Using data from 972 parents enrolled in Text2BHealthy, we created Kaplan-Meier curves to estimate differences in program duration for different SMS text message types, including nutrition, physical activity, stop, and other messages. Covariates, including rurality and number of stop messages received, were included. Results: Retention rates by school ranged from 74% (60/81) to 95.0% (132/139), with an average retention rate of 85.7% (833/972) across all schools. Program duration ranged from 7 to 282 days, with a median program duration of 233 days and an average program duration of 211.7 days. Among those who dropped out, program duration ranged from 7 to 247 days, with a median program duration of 102.5 days. Receiving a stop message increased the probability of attrition compared with receiving messages about nutrition, physical activity, or other topics (hazard ratio=51.5, 95% CI 32.46-81.7; P<.001). Furthermore, each additional stop message received increased the probability of attrition (hazard ratio=10.36, 95% CI 6.14-17.46; P<.001). The degree of rurality also had a significant effect on the probability of attrition, with metropolitan county participants more likely to drop out of the program than rural county participants. The interaction between SMS text message type and total number of stop messages received had a significant effect on attrition, with the effect of the number of stop messages received dependent on the SMS text message type. Conclusions: This study demonstrates the potential of SMS text message programs to retain participants over time. Furthermore, this study suggests that the probability of attrition increases substantially when participants receive messages with instructions for dropping out of the program. Program planners should carefully consider the impact of stop messages and other program content and characteristics on program retention. Additional research is needed to identify participant, programmatic, and contextual predictors of program duration and to explicate the relationship between program duration and program efficacy. (©Stephanie K Grutzmacher, Ashley L Munger, Katherine E Speirs, Yassaman Vafai, Evan Hilberg, Erin Braunscheidel Duru, Laryessa Worthington, Lisa Lachenmayr. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 21.01.2019.) |
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| فهرسة مساهمة: | Keywords: diet, food, and nutrition; food assistance; parents; retention; survival analysis; text messaging |
| تواريخ الأحداث: | Date Created: 20190122 Date Completed: 20200129 Latest Revision: 20200309 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC6360389 |
| DOI: | 10.2196/mhealth.9967 |
| PMID: | 30664489 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2291-5222 |
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| DOI: | 10.2196/mhealth.9967 |