Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time, Food Insecurity/Food Assistance
Intervention Type: Direct Education, Social Marketing
Intervention Reach and Adoption
This intervention was created based on feedback from the target audience after they encountered challenges when attending in-person six-week workshops but still wanted to receive healthy eating and physical activity education. RMPRC staff collaborated with Maryland’s SNAP-Ed Text2BHealthy program initially and then developed an intervention based on the Theory of Planned Behavior change specific to the target audience in Colorado. To ensure inclusion of the large Hispanic population in Colorado, all T2LH materials were prepared in English but were translated and culturally adapted for Spanish-speaking participants. A formative evaluation was also completed in October 2017, which informed the development and evaluation of the final T2LH intervention.
Setting: Child care (Learn), School (Learn)
Target Audience: Preschool (<5 years), Elementary School, Parents/Mothers/Fathers
Race/Ethnicity: No special focus
- Year 1 message library consists of four cycles with seven to eight core texts, two to four evaluation questions per cycle.
- Year 2 message library consists of two cycles with seven to eight core texts, two to three evaluation questions per cycle.
Some items, including message library, platform protocols, sample recruitment materials, and bilingual (English and Spanish) nutrition education materials, are available on the Culture of Wellness in Preschools website.
The unintended benefits of the intervention include:
- The level of reported goal-setting and behavior change was much higher than anticipated
- There were statistically significant differences (p<0.05) between Spanish and English-speaking participants in all outcomes (except in goal setting for sugary drinks) that favored Spanish-speaking families
- The length of time that participants remained on the program was unexpected and prompted the development of a second year of intervention
The challenges include:
- Parents were having a hard time using their phone to opt-in to the program
To address this challenge, a flyer was designed showing the steps to opt–in to the program and staff were trained to help parents one-on-one. Additionally, sign-up sheets were used for parents to write down their phone number and preferred language. Potentially, partnerships between preschools and schools could further promote T2LH and improve parent recruitment.
Evidence-based Approach: Practice-tested
|Readiness and Capacity – Short Term (ST)||Changes – Medium Term (MT)||Effectiveness and Maintenance – Long Term (LT)||Population Results (R)|
|Individual||ST1, ST3||MT1, MT3|
|Sectors of Influence|
ST1: Healthy Eating
- ST1a and ST1b: 81% of respondents (247/305) reported setting goals for fruit and vegetable setting.
- ST1l: 86% of respondents (173/201) reported setting goals for drinking water instead of sugary beverages.
ST3: Physical Activity and Reduced Sedentary Behavior
- ST3a: 80% of respondents (176/220) reported setting goals to increase physical activity.
MT1: Healthy Eating
- MT1g: 83% of respondents (167/201) reported an increase in drinking water.
- MT1h: 85% of respondents (171/201) reported drinking fewer sugar-sweetened beverages (e.g., regular soda or sports drinks).
- MT1l and MT1m: 76% of respondents (243/320) reported an increase in the cups of fruits and vegetables consumed per day.
MT3: Physical Activity and Reduced Sedentary Behavior
- MT3a: 69% of respondents (152/220) reported an increase in physical activity.
- Evaluation questions:
- Example questions: Healthy Eating
- ST1: The past few weeks, we sent texts about setting a goal to eat more fruits and vegetables. Did you set a goal?
- MT1: The past few weeks, we sent texts about eating fruits and vegetables. Are you eating more fruits and vegetables because of these texts?
- Example questions: Healthy Eating
- Formative evaluation interview guide and protocol
- Phone interview guide and protocol
- User-engagement evaluation protocol