Simple and rationale-providing SMS reminders to promote accelerometer use: a within-trial randomised trial comparing persuasive messages

Background: Literature on persuasion suggests compliance increases when requests are accompanied with a reason (i.e. the "because-heuristic"). The reliability of outcomes in physical activity research is dependent on sufficient accelerometer wear-time. This study tested whether SMS reminders-especially those that provided a rationale-are associated with increased accelerometer wear-time.

Methods: We conducted a within-trial partially randomised controlled trial during baseline data collection in a school-based physical activity intervention trial. Of 375 participants (mean age = 18.1), 280 (75%) opted to receive daily SMS reminders to wear their accelerometers. These 280 participants were then randomised to receive either succinct reminders or reminders including a rationale. Data was analyzed across groups using both frequentist and Bayesian methods.

Results: No differences in total accelerometer wear minutes were detected between the succinct reminder group (Mdn = 4909, IQR = 3429-5857) and the rationale group (Mdn = 4808, IQR = 3571-5743); W = 8860, p = 0.65, CI95 = - 280.90-447.20. Similarly, we found no differences in wear time between participants receiving SMS reminders (Mdn = 4859, IQR = 3527-5808) and those not receiving them (Mdn = 5067, IQR = 3201-5885); W = 10,642.5, p = 0.77, CI95 = - 424.20-305.30. Bayesian ANOVA favored a model of equal weartime means, over one of unequal means, by a Bayes Factor of 12.05. Accumulated days of valid accelerometer wear data did not differ either. Equivalence testing indicated rejection of effects more extreme than a Cohen's d (standardised mean difference) of ±~0.3.

Conclusions: This study casts doubt on the effectiveness of using the because-heuristic via SMS messaging, to promote accelerometer wear time among youth. The because-heuristic might be limited to face-to-face communication and situations where no intention for or commitment to the behavior has yet been made. Other explanations for null effects include non-reading of messages, and reminder messages undermining the self-reminding strategies which would occur naturally in the absence of reminders.

Trial registration: DRKS DRKS00007721 . Registered 14.04.2015. Retrospectively registered.