Effectiveness of 6 months of tailored text message reminders for obese male participants in a worksite weight loss program: randomized controlled trial

Abstract

Background: Worksite nutrition and physical activity interventions are important to help overweight and obese employees lose weight, but costs and insufficient sustained motivation prevent the majority of these programs from succeeding. Tailored text messaging in aiding weight management has been effective in several studies, but no studies have evaluated the effect of a tailored text message service on weight loss in a worksite health promotion program.

Objective: We studied the efficacy of a tailored text-messaging intervention for obese male participants in a worksite weight loss program of 6 months duration.

Methods: The study was an unblinded, randomized controlled trial. Men with a body mass index greater than 25 kg/m(2) were recruited from the Korea District Heating Corporation, the Korea Expressway Corporation, and the Korea Gas Corporation. The participants were identified by nurse managers. Participants were randomly allocated to 1 of the following 2 groups for 24 weeks: (1) intervention group, which received tailored text message reminders every other day plus 4 offline education sessions and brief counseling with monthly weight check by nurses for weight control over 6 months and (2) control group, which received the 4 offline education sessions and brief counseling with monthly weight check by nurses about weight control over 6 months. The primary outcome was the difference in weight loss at 6 months. A mixed-model repeated-measures analysis was performed to evaluate the effect of the intervention group's weight loss compared with the control group.

Results: A total of 205 obese men were randomized into either the intervention (n=104) or the control group (n=101). At the end of 6 months, the intervention group (n=63) had lost 1.71 kg (95% CI -2.53 to -0.88) and the control group (n=59) had lost 1.56 kg (95% CI -2.45 to -0.66); the difference between the 2 groups was not significant (mean difference -0.15, 95% CI -1.36 to 1.07). At the end of the study, 60% (34/57) of the intervention group rated the message program as helpful for weight control and 46% (26/57) would recommend the text message service to their friends.

Conclusions: Tailored text message reminders did not have a significant effect on weight loss in obese men as part of a worksite weight loss program.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN): 39629189; http://www.isrctn.com/ISRCTN39629189?q=39629189&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search (Archived by WebCite at http://www.webcitation.org/6VsFkwJH6).

Keywords: health promotion; text messaging; weight reduction program; worksite.

Figure 1

Screenshot of text message reminders in worksite weight loss program.

Figure 2

Flow diagram for participant enrollment and retention.

Figure 3

Changes in body weight between text message group and control group from baseline to 6 months.

Figure 4

Changes in percent body fat between text message group and control group from baseline to 6 months.

Figure 5

Changes in physical activities assessed by International Physical Activity Questionnaires Short Form (IPAQ-SF) between text message group and control group from baseline to 6 months.