Text Messaging Helps Kids Live Healthy?

Hard to imagine a few years ago, but a surprising number of kids today have their own mobile phones. One of the most popular use of these phones is text messaging.

A new study by Shapiro and colleagues from the University of North Carolina, Chapel Hill, published in J Nutr Educ Behav looks at the use of text messaging for monitoring sugar-sweetened beverages, physical activity, and screen time in children.

Following a brief psychoeducational intervention (1 session weekly for 3 weeks), 58 children (age 5-13) were randomised to SMS with feedback, use of paper diaries (PD) or to a no-monitoring control (C) for 8 weeks. The education sessions aimed to encourage the kids to increase physical activity, decrease “screen time” and reduce consumption of sugar-sweetened beverages. All of the children were given pedometers to track the number of steps they took each day, as well as goals to meet for the number of steps taken, minutes of screen time and number of sugar-sweetened beverages consumed per day.

The text messaging and paper diary groups answered three questions each day: (1) what was the number on your pedometer today?; (2) how many sugar-sweetened beverages did you drink today?; and (3) how many minutes of screen time did you have today?

Unfortunately, only 31 kids (53%) completed the study (SMS: 13/18, PD: 7/18, C: 11/22). Children in SMS had somewhat lower attrition (28%) than both PD (61%) and C (50%), and significantly greater adherence to self-monitoring than PD (43% vs 19%, P < .02).

While the authors conclude that text messaging may be a useful tool for self-monitoring healthful behaviors in children, I remain skeptical.

Indeed, I am yet to be convinced that childhood obesity can be effectively addressed by targeting individual behaviours – a far more promising approach would be to change the overall environment (fewer pizza days, neighbourhoods that are condusive to walking to school and playing outside (less screen time), parents who have time to sit down with their kids for a home-cooked meal, etc.).

Texting kids (or for that matter adults) to promote healthy living strikes me as little more than a gimmick, with minimal long-term impact, if at all.

Edmonton, Alberta