Personalized mHealth physical activity interventions integrating wearable step trackers with automated text messaging appear to be feasible and acceptable among adults and youth from low-income communities, with step-count findings showing promise particularly for individuals further from meeting physical activity guidelines.
Enrollment rates were approximately 64% for adults and 63% for youth recruited through community health events in low-income urban communities.
Retention for physical activity measures was 84% for adults and 77% for youth over the 7-week intervention.
Message delivery fidelity was extremely high, with 99% of intended automated text messages successfully delivered.
Adults and youth showed high adherence to wearing the Garmin activity monitor throughout the study.
Overall acceptability ratings were high, ranging from 83% to 100%, with nearly all participants indicating they would recommend the program.
Adults and youth replied to a mean of 2.6 and 3.2 two-way text messages respectively, with higher engagement among adults participating with their child.
Pre-post changes in daily steps were positive but not statistically significant for either adults or youth in the overall sample.
Participants in the highest tertile of engagement showed larger step-count increases than the overall sample.
Participants who were meeting less than two-thirds of physical activity guidelines at baseline showed larger step-count increases, with adults approaching statistical significance.
The intervention integrated a Garmin activity monitor with automated, theory-based, personalized text messages using behavior change techniques.
This research tested a 7-week mobile health program designed to help adults and youth from low-income urban communities become more physically active. Participants received a Garmin fitness tracker and automated, personalized text messages four days per week. The messages used evidence-based strategies like goal-setting, self-monitoring, and encouragement, and many messages were customized based on each person's actual step counts and goals. The study enrolled 83 adults and 31 youth through community health events and tracked whether the program was practical to deliver and whether participants liked it. The study found strong evidence that this type of program is both feasible and well-received in this population. Nearly all messages were delivered as intended (99%), participants wore their fitness trackers on about 80% of study days, and 97-100% of participants said they would recommend the program to others. While overall increases in daily steps were positive (about 240 more steps per day for adults and 413 for youth), these changes were not statistically significant in the full group. However, participants who were least active at the start of the study and those who engaged most with the program showed larger step increases, suggesting the program may be especially beneficial for those with the most room for improvement. This research suggests that wearable-integrated, automated text message programs are a promising approach for supporting physical activity in low-income families, a group that has been understudied in mobile health research. The findings are particularly encouraging for reaching individuals who are furthest from meeting physical activity guidelines. The authors note that larger, more rigorous studies—including randomized controlled trials—are needed to fully evaluate how well this type of program works, and that parent-child participation together may be worth exploring further.
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Upload Your LabsCarlson J, Materia F, Moon M, Ryu S, Yeager C, Steel C, et al.. (2026). Automated Physical Activity Support for Adults and Youth From Low-Income Communities: Single-Arm Pilot Study.. JMIR mHealth and uHealth. https://doi.org/10.2196/76991