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Culturally-Adapted, Telephone-Based System to Promote Physical Activity

Culturally-Adapted, Telephone-Based System to Promote Physical Activity Boston Medical Center
Boston
Hypertension
African American

Project


Patients received weekly telephone calls from an automated health monitoring and counseling system.

An automated, interactive behavior change program is delivered to patients by telephone, which individually tailors health messages based on a range of individual and cultural variables, functioning as an at-home monitor, educator and conduit of messaging designed to reinforce or change health-related behaviors. Patients receive one call per week for 12 weeks that lasts about 10 minutes. Patients are asked about their levels of physical activity. Based on their responses, the system provides feedback, assistance in developing goals for healthy behaviors, and a physical activity ‘prescription’ for the upcoming week. The system also explores the benefits of and possible barriers to regular physical activity. The telephone system delivers messages that are specifically tailored to the patient’s cultural background and most closely aligned with the patient’s own personal values.

Rationale


Moderate physical activity can play an important role in reducing blood pressure. Even though the health benefits of regular physical activity have been well-established, many Americans do not engage in leisure-time physical activities. Interactive, computer-based telephone systems can help encourage healthy behaviors: they are flexible, easy to use, and have a relatively low cost to implement. These telephone systems can be accessed by patients at any time, and from any location. An automated telephone system may be particularly helpful for patients who experience obstacles to participating in face-to-face behavior-change programs. The culturally adapted intervention being investigated by this study has the potential to be even more helpful: ‘culture neutral’ interventions intended for a general audience often have poorer outcomes than those that are specifically adapted to the cultural background of patients.

Summary Results


Weekly telephone calls from an automated health monitoring and counseling system did not lower blood pressure among hypertensive patients. However, participants reported a significant increase in moderate-or-greater physical activity (MOD+PA). At 3 months, patients in the intervention group were significantly more likely than the control group to meet national recommendations (≥ 30 minutes per week of MOD+PA at least 5 days per week), as measured by both the 2009 Behavior Risk Factor Surveillance System (OR 3.09) and the 7-Day Physical  Activity Recall surveys (OR 2.30). 

Publications


Principal Investigators

  • Julien J. Dedier, MD, MPH (Assistant Professor of Medicine, Boston Medical Center)
  • Robert H. Friedman, MD (Chief of the Medical Information Systems Unit, Boston Medical Center)