Acceptability of mHealth Technology for Self‐Monitoring Eating and Activity among Rural Men

OBJECTIVE To examine rural men's use and perceptions of mobile and wireless devices to self-monitor eating and physical activity (mHealth). DESIGN AND SAMPLE Men in this 3-week pilot study used FitBit One® to log daily food intake and monitor activity. A companion application (app) allowed activity monitoring of fellow participants. Health-related text messages were received 1-3 times daily. A purposive sample of 12 rural men (ages 40-67) was recruited by community leaders. MEASURES (1) baseline heart rate, blood pressure, and BMI, (2) FitBit One® usage, (3) investigator-generated surveys on acceptability of mHealth, and (4) focus group on experience with mHealth. RESULTS Men were overweight (n = 3) or obese (n = 9) and 9 of 12 were hypertensive. Nine of twelve wore FitBit One® all 21 days. Eleven of 12 men logged food, with 9 of 12 doing this at least 15 of 21 days. Self-monitoring and daily text messaging increased awareness of energy intake and output. Companion app's food log needed targeting for rural foods. Rotating seasons (occupational, religious, recreational) and weak cellular signals created contextual barriers to self-monitoring eating and activity. CONCLUSIONS FitBit One® and text messaging were perceived as useful among the rural men, while the companion apps require adaptation to reflect dietary norms.

[1]  M. Kegler,et al.  Impact of Improving Home Environments on Energy Intake and Physical Activity: A Randomized Controlled Trial. , 2016, American journal of public health.

[2]  Ryan J Shaw,et al.  Development of a Theoretically Driven mHealth Text Messaging Application for Sustaining Recent Weight Loss , 2013, JMIR mHealth and uHealth.

[3]  K. Patrick,et al.  Text4Diet: a randomized controlled study using text messaging for weight loss behaviors. , 2012, Preventive medicine.

[4]  Elizabeth A. Richards,et al.  Systematic Review of Physical Activity Outcomes of Rural Lifestyle Interventions , 2016, Western journal of nursing research.

[5]  Gregory J Welk,et al.  Validity of consumer-based physical activity monitors. , 2014, Medicine and science in sports and exercise.

[6]  D. James,et al.  Developing Weight Management Messages and Interventions for Baby Boomer Men , 2014, American journal of men's health.

[7]  R. Estacio,et al.  Health Promotion Text Messaging Preferences and Acceptability Among the Medically Underserved , 2015, Health promotion practice.

[8]  J. Oleson,et al.  Perceived correlates of domain-specific physical activity in rural adults in the Midwest. , 2014, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[9]  Rohina Joshi,et al.  An Electronic Clinical Decision Support Tool to Assist Primary Care Providers in Cardiovascular Disease Risk Management: Development and Mixed Methods Evaluation , 2009, Journal of medical Internet research.

[10]  Janice M Morse,et al.  A Review Committee's Guide for Evaluating Qualitative Proposals , 2003, Qualitative health research.

[11]  Adam G Gavarkovs,et al.  Engaging Men in Chronic Disease Prevention and Management Programs , 2016, American journal of men's health.

[12]  B. Paterson A Framework to Identify Reactivity in Qualitative Research , 1994, Western journal of nursing research.

[13]  Jerilyn K Allen,et al.  Mobile phone interventions to increase physical activity and reduce weight: a systematic review. , 2013, The Journal of cardiovascular nursing.

[14]  E. Wouters,et al.  Effect of ‘activity monitor-based’ counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis , 2013, Annals of medicine.

[15]  R. Ohtsuka,et al.  Seasonal fluctuation in energy balance among farmers in Northeast Thailand: The lack of response of energy intake to the change of energy expenditure , 1999, European Journal of Clinical Nutrition.

[16]  S. Laditka,et al.  Farming activities and carrying and lifting: the Agricultural Health Study. , 2012, Journal of physical activity & health.

[17]  Chris Hillbruner,et al.  Seasonality, Household Food Security, and Nutritional Status in Dinajpur, Bangladesh , 2008, Food and nutrition bulletin.

[18]  K. Patrick,et al.  A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial , 2009, Journal of medical Internet research.

[19]  Fangchao Liu,et al.  Mobile phone intervention and weight loss among overweight and obese adults: a meta-analysis of randomized controlled trials. , 2015, American journal of epidemiology.

[20]  Francesc Saigí-Rubió,et al.  Use of mobile phones as a tool for weight loss: a systematic review , 2014, Journal of telemedicine and telecare.

[21]  Johnny Saldaña,et al.  The Coding Manual for Qualitative Researchers , 2009 .

[22]  K. Jones,et al.  Using mobile phones and short message service to deliver self-management interventions for chronic conditions: a meta-review. , 2014, Worldviews on evidence-based nursing.

[23]  M Benjamin Nelson,et al.  Validity of Consumer-Based Physical Activity Monitors for Specific Activity Types. , 2016, Medicine and science in sports and exercise.

[24]  Janice M Morse,et al.  Analytic Strategies and Sample Size , 2015, Qualitative health research.

[25]  John W. Creswell,et al.  Designing and Conducting Mixed Methods Research , 2006 .

[26]  Constance M. Johnson,et al.  Mobile health messages help sustain recent weight loss. , 2013, The American journal of medicine.

[27]  M. Sandelowski Focus on Research Methods Whatever Happened to Qualitative Description? , 2022 .

[28]  A. Monteiro Mobile health , 2014, Radiologia brasileira.

[30]  T. Gilbert,et al.  The 2014 Update of the Rural-Urban Chartbook , 2014 .

[31]  S. Carlson,et al.  Trend and prevalence estimates based on the 2008 Physical Activity Guidelines for Americans. , 2010, American journal of preventive medicine.

[32]  Gabriel A. Koepp,et al.  "Go4Life" exercise counseling, accelerometer feedback, and activity levels in older people. , 2014, Archives of gerontology and geriatrics.

[33]  P. Cudd,et al.  Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.