The effect of automated text messaging and goal setting on pedometer adherence and physical activity in patients with diabetes: A randomized controlled trial
Open accessAbstract
INTRODUCTION: Activity-monitoring devices may increase activity, but their effectiveness in sedentary, diseased, and less-motivated populations is unknown. METHODS: Subjects with diabetes or pre-diabetes were given a Fitbit and randomized into three groups: Fitbit only, Fitbit with reminders, and Fitbit with both reminders and goal setting. Subjects in the reminders group were sent text-message reminders to wear their Fitbit. The goal-setting group was sent a daily text message asking for a step goal. All subjects had three in-person visits (baseline, 3 and 6 months). We modelled daily steps and goal setting using linear mixed-effects models. RESULTS: 138 subjects participated with 48 in the Fitbit-only, 44 in the reminders, and 46 in the goal-setting groups. Daily steps decreased for all groups during the study. Average daily steps were 7123, 6906, and 6854 for the Fitbit-only, the goal-setting, and the reminders groups, respectively. The reminders group was 17.2 percentage points more likely to wear their Fitbit than the Fitbit-only group. Setting a goal was associated with a significant increase of 791 daily steps, but setting more goals did not lead to step increases. CONCLUSION: In a population of patients with diabetes or pre-diabetes, individualized reminders to wear their Fitbit and elicit personal step goals did not lead to increases in daily steps, although daily steps were higher on days when goals were set. Our intervention improved engagement and data collection, important goals for activity surveillance. This study demonstrates that new, more-effective interventions for increasing activity in patients with pre-diabetes and diabetes are needed.
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Sending patients with diabetes or pre-diabetes daily text reminders or asking for a daily step goal made them 17% more likely to wear their Fitbit and increased daily steps by 791 on days they submitted a step goal, but overall average steps over 6 months did not change.
“Another study showed sending patients with diabetes or pre-diabetes daily text reminders or asking for a daily step goal made participants 17% more likely to wear their Fitbit and increase daily steps (791 more steps) on the days they submitted a step goal.Despite these temporary improvements, the overall average number of steps by participants over 6 months did not change.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [105]
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References 24 · Cited by 52
- Authors
- Polgreen, L. A., Anthony, C., Carr, L., Simmering, J. E., Evans, N. J., Foster, E. D., Segre, A. M., Cremer, J. F., & Polgreen, P. M.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Polgreen, Linnea A.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-05-02
- Volume
- 13
- Issue
- 5
- Pages
- e0195797
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5931450
- OpenAlex
- W2802588208
- Cited by
- 52
- References
- 24
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 14 · 2020: 14 · 2019: 6
- FWCI
- 12.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- National Heart, Lung, and Blood Institute (K25HL 122305)
- Fraternal Order of Eagles Diabetes Research Center
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Keywords
- diabetes mellitus, prediabetes, physical activity, pedometers, Fitbit, SMS reminders, goal setting, step goals, device adherence, activity monitoring, wearable activity trackers, sedentary patients
- MeSH terms
- Adult, Automation, Diabetes Mellitus, Type 2, Female, Goals, Humans, Male, Patient Compliance, Walking, Text Messaging
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