A pilot comparative study of one-way versus two-way text message program to promote physical activity among people with severe mental illness

Background Low participation in physical activities may contribute to the physical health disparity that has been found between people with severe mental illness (SMI) and the general population. Aims This study examined the feasibility of a telehealth promotion system in people with SMI and compared the daily step counts and health outcomes between those who received one-way versus two-way text messages. Method A pilot single-blinded comparative study was used. Participants were randomly assigned to a one-way text message group (n = 8) or a two-way text message group (n = 7). The intervention for both groups lasted for 12 weeks. All participants were asked to wear a digital pedometer every day. Results During the 12-week intervention, the one-way and two-way text message groups increased their number of daily steps by 331.9 ± 1382.6 and 1245.4 ± 1681.1, on average, respectively. The two-way text message group showed significant improvement in the number of daily steps as compared to the baseline in weeks 6 and 11 (increases of 21% and 32%, respectively, p < 0.05). No significant differences were found between groups or within the one-way text message group. Conclusions The feasibility of the telehealth promotion system was demonstrated among people with SMI and may increase daily step counts. People with SMI may improve their physical activity levels with two-way messaging. Future research should address the small sample limitation and better investigate the efficacy of different characteristics of mobile text messaging.