Year of Award


Document Type


Degree Type

Master of Science (MS)

Degree Name

Health and Human Performance (Community Health Option)

Department or School/College

Department of Health and Human Performance

Committee Chair

Dr. Blakely Brown

Commitee Members

Dr. Laura Dybdal, Dr. Kari Harris


tribal health, childhood obesity, texting, American Indian, SMS


University of Montana

Subject Categories

Community-Based Research | Community Health | Health Information Technology | Life Sciences | Nutrition



Purpose: Childhood obesity and its associated health risks are widely recognized as a major public health crisis in the United States (Johnson & Johnson, 2014; Proctor, 2008; Rogers et al, 2013; Vinci et al, 2016) and worldwide (Elías-Boneta, Toro, Garcia, Torres, & Palacios, 2015). Among children in low-income families, American Indian/Alaska Native (AIAN) children have the highest prevalence of obesity (21.1%) compared to other racial/ethnic groups (14.74% overall) (Pan et al, 2015). Parents play an important role in introducing healthy foods and encouraging physical activity in young children (Birch & Ventura, 2009; Lindsay et al., 2006; Natale et al., 2014). Text messaging is an attractive means of communication because it is portable, cost-effective, accessible, and able to reach across demographic spheres to serve underserved and rural populations (Terry, 2008), and populations with poor health (Fjeldsoe, Marshall, & Miller, 2009). The primary purpose of this pilot study was to assess the feasibility of the SMS (Short Messaging System or text messaging) Parent Action iNtervention (SPAN) obesity prevention intervention for rural white and AI children.

Methods: This 5-week quasi-experimental pre- to posttest pilot study took place on a rural, American Indian (AI) Reservation. Participants were parents whose children were 3 to 5 years old. The intervention consisted of participants receiving three text messages on a particular topic each week that described health behaviors to reduce risk of childhood obesity. The topics included childhood nutrition, physical activity and sleep requirements, and recommendations for limiting screen time and sugary beverage consumption. The main study measures were descriptions of study feasibility (recruitment and retention rates, receipt and response to text messages, satisfaction with message content, timing, frequency, and duration). We also collected information on pre- to posttest changes in participant knowledge/desires for their children related to healthy behaviors and parent-reported child behaviors.

Results: Over 8 weeks, 24 parents of young children expressed interest in participating in the study; following screening, 71% (17/24) met eligibility criteria and were consented to the study. At the end of the 5-week intervention, 100% (17/17) completed the texting intervention and final assessments. All intervention texts (n=289) sent to participants were successfully delivered. Of the 85 survey question texts that requested a response, 95% (81/85) were responded to with any answer, while 91% (78/85) were responded to by answering the survey question. All participants (17/17) reported they found the texts easy to understand and they liked the timing - what time of day they received the messages. Ninety-four percent (16/17) of participants reported enjoying the frequency (3 per week) with which they received messages, and participants either reported 5 weeks was a good amount of time or too short. At the end of the 5-week intervention, improvements were observed in some of the child behaviors.

Conclusion: Findings suggest it is feasible to deliver a text messaging-based childhood obesity prevention intervention to parents living on a rural, AI Reservation. Text messages were well received by parents of young children and texting parents may influence child behavior. Our study targets gaps in the literature and helps guide future research using text messaging to promote child health and prevent obesity.



© Copyright 2017 Julia M. Malich