Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment.

cardiovascular disease consumer preferences lifestyle change mHealth persuasive health technology rehabilitation respiratory disease secondary prevention visual communication

Journal

Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882

Informations de publication

Date de publication:
20 09 2021
Historique:
received: 07 12 2020
accepted: 21 07 2021
revised: 15 02 2021
entrez: 20 9 2021
pubmed: 21 9 2021
medline: 29 10 2021
Statut: epublish

Résumé

Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement. This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation. A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model. There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons. A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.

Sections du résumé

BACKGROUND
Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement.
OBJECTIVE
This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation.
METHODS
A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model.
RESULTS
There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons.
CONCLUSIONS
A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.

Identifiants

pubmed: 34542413
pii: v23i9e26224
doi: 10.2196/26224
pmc: PMC8491117
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e26224

Informations de copyright

©Michael Choi, Rebecca Raeside, Karice Hyun, Stephanie R Partridge, Aravinda Thiagalingam, Julie Redfern. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 20.09.2021.

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Auteurs

Michael Choi (M)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Rebecca Raeside (R)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Karice Hyun (K)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia.

Stephanie R Partridge (SR)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia.

Aravinda Thiagalingam (A)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Department of Cardiology, Westmead Hospital, Sydney, Australia.
George Institute for Global Health, University of New South Wales, Sydney, Australia.

Julie Redfern (J)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
George Institute for Global Health, University of New South Wales, Sydney, Australia.
Research Education Network, Western Sydney Local Health District, Sydney, Australia.

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