Poster Topical Area: Nutrition Education and Behavioral Sciences
Poster Board Number: 168
Objectives: Excess weight gain during pregnancy is associated with adverse outcomes during and after pregnancy, such as increased incidence of gestational diabetes mellitus and labor and delivery complications. Approximately 60% of overweight women gain excessive weight during pregnancy. The purpose of this study was to develop short mobile messages for an intervention to prevent excessive gestational weight gain in low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai'i.
Methods: A series of 18 messages of 160 characters or less focused on reinforcing WIC's recommendations for pregnant women were developed. To refine message wording, cognitive testing was conducted in five pregnant WIC participants age ≥ 18 years between 15-20 weeks of gestation. Cognitive interviews conducted individually at WIC and other locations lasted approximately one hour and evaluated whether text messages were understandable and appropriate for the target population. Participants were asked to state the meaning of messages in their own words, as well as ways to make them clearer. After messages were revised, the Flesch-Kincaid formula was used to determine reading level. To further ensure cultural relevance, messages were also reviewed by an obstetrician/gynecologist with experience in low-income groups.
Results: Participants in cognitive interviews made suggestions that resulted in modification of text. These included shortening words and sentences when possible, and providing specific examples of foods containing nutrients such as iron and folic acid, as well as examples of foods falling into the categories of "dark green," "orange" and "red" vegetables. Participants also suggested providing more specific guidance regarding the increase in calorie needs during pregnancy. The resulting messages had a Flesch-Kincaid grade level of 5.7. The obstetrician/gynecologist approved the revised messages.
Conclusions: Cognitive testing procedures demonstrated relevance of messages to the target population. Evaluation of reading level indicated low reading difficulty. Messages are appropriate for use in a text-message intervention for health promotion in low-income women in Hawai'i WIC.
University of Hawaii at Manoa