Walking Intervention Through Texting for Adolescents

It is well established that physical activity (PA) directly correlates with many health benefits, especially when active habits are formed during childhood and adolescence. PA practiced in adolescence has been seen to carry into adulthood, helping to combat a host of chronic diseases, such as obesity and diabetes. However, in recent years there has been a steady decline in PA among adolescents, followed by a resulting rise in sedentary behavior. Walking Intervention Through Texting for Adolescents, or WalkIT-A, was an 11.5-week intervention that built upon behavioral theory to provide an incentive-based, adaptive, physical activity intervention to inactive adolescents. The goal of this study was to investigate an intervention which combined walking with pointed behavior change strategies to incite a larger increase in PA. Using single-case, reversal (ABA) design, the study was aimed at shaping physical activity behavior in adolescents aged 12-17 through a mobile health intervention that paired adaptive goal setting with financial incentives to increase step count. The intervention was delivered using a semi-automated texting, mobile-Health (mHealth) platform, which incorporated FitBit tracking technology, adaptive goals, motivational messages, performance feedback, and points/incentives. It was hypothesized that during the adaptive intervention phase participants would increase both steps per day and active minutes compared to baseline values. Upon conclusion of the study, the three adolescent participants exhibited increased steps and active minutes during the intervention period compared to baseline and withdrawal phases. However, the specific trends identified suggest the need for future research to incorporate even stronger intervention components to overcome PA "drop-off" midway through the intervention, along with other external, environmental influencers. Despite this need, the use of adaptive goal setting combined with incentives can be an effective means to incite PA behavior change in adolescents.