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Title: A text-messaging and pedometer program to promote physical activity in people at high risk of type 2 diabetes: A development and feasibility study for the PROPELS Trial
Authors: Morton, K. L.
Sutton, S. R.
Hardeman, W.
Troughton, Jacqui
Yates, Tom
Griffin, S. J.
Davies, Melanie J.
Khunti, Kamlesh
Eborall, Helen Claire
First Published: 15-Dec-2015
Publisher: JMIR Publications
Citation: JMIR mHealth and uHealth, 2015, 3 (4), e105
Abstract: Background: Mobile technologies for health (mHealth) represent a promising strategy for reducing type 2 diabetes (T2DM) risk. The PROPELS trial investigates whether structured group-based education alone or supplemented with a follow-on support programme combining self-monitoring with pedometers and tailored text-messaging is effective in promoting and maintaining physical activity (PA) among people at high risk of T2DM. Objective: This paper describes the iterative development of the PROPELS follow-on support programme and presents evidence on its acceptability and feasibility. Methods: We used a modified mHealth development framework with four phases: 1) conceptualisation of the follow-on support programme using theory and evidence; 2) formative research including focus groups (participants: n=15, aged 39-79 years); 3) pre-testing focus groups using a think aloud protocol (participants: n= 20, aged 52-78 years); and 4) piloting (participants: n= 11). Analysis was informed by the constant comparative approach, with findings from each phase informing subsequent phases. Results: The first three phases informed the structure, nature and content of the follow-on support programme, including the frequency of text-messages; the need for tailored content and two-way interaction; the importance of motivational messages based on encouragement and reinforcement of affective benefits (e.g., enjoyment), with minimal messages about weight and T2DM risk; and the need for appropriate language. The refined programme is personalised and tailored to the individual’s perceived confidence, previous activity levels and PA goals. The pilot phase indicated that the programme appeared to fit well with everyday routines and was easy to use, also by older adults. Conclusions: We developed a feasible and innovative text-messaging and pedometer programme based on evidence and behaviour change theory and grounded in the experiences, views and needs of people at high diabetes risk. A large scale trial is testing the effectiveness of this four-year programme over and above structured group education alone. Trial registration: ISRCTN83465245
DOI Link: 10.2196/mhealth.5026
ISSN: 2291-5222
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © Katie Morton, Stephen Sutton, Wendy Hardeman, Jacqui Troughton, Tom Yates, Simon Griffin, Melanie Davies, Kamlesh Khunti, Helen Eborall. Originally published in JMIR Mhealth and Uhealth (, 15.12.2015. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Appears in Collections:Published Articles, Dept. of Health Sciences

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