Empowering, progressing and sustaining employee health behaviours via SMS: An applied study design

Background: Workplaces can provide a highly effective environment for personal health promotion and the implementation of cost-effective workplace wellness programs is becoming increasingly popular. However, many workplace wellness program interventions are formulated without due consideration to theoretical constructs or needs of individual personnel, and thus generic approaches to health promotion are often applied. Most interventions also currently implement a top-down approach and thus deny participants the autonomy and empowerment that has been shown to lead to prolonged results. Purpose: The purpose of this study was to develop a scientifically valid and semi-tailored nutrition and exercise behaviour change intervention to be delivered to participants via Short Message Service (SMS). The study aimed at empowering participants to take responsibility for their own health behaviours, with longitudinal effects, and was applied to workers in the Australian mining sector. Method: A SMS database of factual and motivational messages about the World Health Organisation (2013) guidelines for physical activity and nutrition, health benefits and potential risks associated with poor health behaviour choices was developed for each level of the Stages of Change model incorporating the Health Belief Model constructs. The initial database was tested for construct validity and application to the Stages of Change model via a modified-Delphi technique with experts in the field of psychology, dietetics and nutrition. Each Stage of Change database included approximately 80 messages related to physical activity and nutrition. The database was pilot tested with 46 target participants at focus groups to verify the appropriateness of phrasing and content, and to ensure the development process followed the principles of empowerment. Implications: The process described in this study may be used to inform the development of scientifically valid health behaviour change programs for large groups of individuals including employees and communities residing in rural and remote areas. In addition, the application of theoretical constructs and the effective semi-tailoring of the program in a cost effective manner provides a strong precedent for empirical research techniques in the field of health behaviour change.