"Think of these messages as digital check-ins from your physician, gently but persistently reminding you to fit more exercise into your day," says Seth Martin. "The strategy appears to work." (Credit: iStockphoto)

communication

Doctor’s ‘good job!’ text can get you moving

Fitness tracker users who receive an encouraging text from their doctor may significantly increase their physical activity levels.

A new pilot study indicates it may not be enough to use technology to make people aware of how much physical activity they’ve logged; they may also need a gentle nudge to get to their goals.

“Think of these messages as digital check-ins from your physician, gently but persistently reminding you to fit more exercise into your day,” says Seth Martin, a preventive cardiologist and assistant professor at Johns Hopkins University School of Medicine. “The strategy appears to work.”

The idea that tracking physical activity can motivate people to do more is not new, researchers say. But the automated yet customized text messages—congratulating people or encouraging them to go just a bit farther—appear to make the real difference.

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In the study, participants who received text nudges were twice as likely to walk farther and reach a preset goal of 10,000 steps daily.

Researchers caution that the study followed people only for a few weeks, so it remains unclear whether the observed changes in activity will persist over time. To answer that question, investigators are conducting a long-term follow-up.

As reported in the Journal of the American Heart Association, the trial involved 48 men and women, ages 18 to 69, followed over a month at the preventive cardiology clinic; all had reported low levels of physical activity.

Using a relatively cheap activity tracker, researchers measured participants’ normal, or baseline, daily physical activity levels during week one. During the following two weeks, a third of the participants—the control group—had their activity levels tracked but could not view data showing how much they moved.

The remaining two-thirds could use their smartphones to view their daily activity levels, including total step count and aerobic activity. Half of those participants also received personalized text messages bearing the names of their cardiologists three times a day. The other half received no such messages but could assess their daily report if they wanted to.

The messages detailed a patient’s current activity “balance,” with the number of steps taken and number needed to reach the 10,000-steps-a-day goal. The timing of texts was also synchronized with each patient’s waking, lunch, and dinner times.

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People who were on track to reach or surpass the 10,000-step mark received congratulatory messages such as “Jon, you are on track to have a VERY ACTIVE day! Outstanding! We might as well call you LeBron James!”

Those who remained well below their goals received encouraging or booster messages such as “Jane, giving someone a call tonight? Consider walking while you talk. Your exercise prescription for tonight is 3,878 steps.”

Those who received text messages took, on average, 2,534 more steps per day than those who didn’t, and an average 3,376 more than patients in the control group. Overall, 81 percent of those in the text-message group reached their 10,000-steps-a-day goal, compared with 44 percent of the other two groups.

Text messages increased total activity time by 21 minutes a day, on average, and aerobic time by 13 minutes.

“Our results suggest that harnessing smart technology into clinical efforts could catalyze behavioral changes that have the potential to reduce disease risk and shape health,” says senior investigator Michael Blaha. “If sustained long term, the clinical impact of such changes could be rather dramatic.”

Clinicians and public health experts recommend that people should get a minimum of 30 minutes of physical activity a day at least three times a week to minimize their risk of cardiovascular disease. More than half of Americans fall short of these recommendations.

The PJ Schafer Cardiovascular Research Fund and the National Institutes of Health funded the work. Digital physical activity tracking devices were provided by Fitbug. The company did not pay for the research, participate in data analysis, or influence the conclusions.

Source: Johns Hopkins University

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