Text Based Mobile Technology and Weight Loss
Text Based Mobile Technology and Weight Loss
Hispanic populations in the US are dis-proportionally affected by high rates of obesity and
 diabetes; according to the Centers for Disease Control and Prevention, Latinos are the
 minority group with the second-highest obesity prevalence in adults. In comparison to the
 general female population (61.2%), Mexican American women (73%) have a greater overweight or
 obese percentage. In addition, more than 50% of Hispanic men and women are expected to
 develop type-2 diabetes over their lifetime, compared to 40% among whites. Hispanics are also
 50% more likely to die from diabetes compared to whites. In many cases Hispanic populations
 do not have the knowledge, self-confidence and resources to participate in mainstream
 physical activity and nutrition interventions, which are usually geared towards the general
 population without considering cultural and linguistic differences.

 Information and communication technologies in the form of Internet and mobile phone access
 have grown enormously during the past decade; these technologies have the potential to affect
 food intake and physical activity as well as weight loss. Approximately 95% of countries have
 mobile telephone networks and about 70% of people worldwide use mobile phones.

 CareMessage is a Google-backed 501(c)3 nonprofit technology organization based in San
 Francisco that uses 'smart' text and voice messaging to enable clinical staff to provide
 automated yet personalized support to patients struggling with chronic conditions. The
 CareMessage™ Adult Obesity texting program adapts the Health Belief Model by strategically
 implementing behavioral concepts to help improve self-efficacy.

 The investigators will pilot test its effectiveness among a sample of Hispanic women who are
 at risk of obesity and diabetes by sending a culturally-sensitive and
 linguistically-appropriate text-based message three to 5 times a week, encouraging lifestyle
 modifications (diet and exercise education and behavior modification).
The investigators will collect data on 40 obese (Body Mass Index 30-45) Hispanic women ages
 21 to 65 years. The purpose of this research study is to test the efficacy of a mobile phone
 text message-based intervention on weight loss.

 After verifying eligibility and enrolling in the study, participants will come to Washington
 University School of Medicine, at Barnes-Jewish Hospital and fill out some questionnaires.
 The investigators will perform a brief exam that measures the lean and fat tissue using Dual
 Energy x-ray Absorptiometry (DXA) technology and will also do a modified 3-hour oral glucose
 tolerance test (MOGTT).

 Participants will wear an accelerometer (activity monitor) over a 7-day period at the
 beginning (before being randomized and enrolled in the intervention) and at the end of the
 study.

 Half of the participants will be randomized to the intervention group. The intervention group
 will be enrolled in the CareMessage™ Adult Obesity texting program, which sends a text
 message 3 to 5 times a week, encouraging lifestyle modifications (diet and exercise
 education, and behavioral strategies) that can lead to healthy weight loss. The control group
 will receive an initial talk about weight loss but will not be enrolled in any program or
 intervention.

 After six months have passed, participants will return to Washington University School of
 Medicine, regardless of the group they were assigned to, for two final visits (a short one,
 to pick up another activity monitor seven days before the study ends, and a longer visit, to
 do some final testing and fill out some questionnaires).
Inclusion Criteria (for both control and intervention groups)

 -  Women between 18 21 and 65 years old,

 -  Poor to normal English literacy,

 -  Of Hispanic or Latin American origin,

 -  Having access to a smart phone,

 -  Obese (BMI 30-45).

 -  Non-institutionalized population,

 -  Currently not involved in any other weight loss program,

 -  Sedentary population (exercising less than 90 minutes per week).

 For the phone screening we will need the following data elements:

 -  Female

 -  BMI

 -  Age

 -  Ethnicity

 Exclusion Criteria (for both groups):

 -  Participants with a history of and/or current mental or physical disabilities.

 -  Participants with BMI over 45