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Promoting lifestyle change through text messages to patients with hypertension: A randomized controlled trial in Swedish primary care

Glock, Hanna LU ; Björk Javanshiri, Amanda LU ; Borgström Bolmsjö, Beata LU ; Jakobsson, Ulf LU orcid ; Milos Nymberg, Veronica LU orcid ; Wolff, Moa LU and Calling, Susanna LU (2025) In Preventive Medicine Reports 51. p.1-8
Abstract
Objective
We aimed to investigate whether health-promoting text messages sent to patients with hypertension in primary care could affect lifestyle habits, and if the Theory of Planned Behavior could be used to identify moderators of intervention effects.
Methods
From September 2020 to December 2022, patients with hypertension were randomly selected from the patient register at 10 Swedish primary health care centers and randomized 1:1 to receive health-promoting text messages or treatment as usual (N = 401). The intervention group received four text messages per week for six months. Self-reported measures of lifestyle habits were collected through a questionnaire at baseline and after six months. Predictors of behavioral change... (More)
Objective
We aimed to investigate whether health-promoting text messages sent to patients with hypertension in primary care could affect lifestyle habits, and if the Theory of Planned Behavior could be used to identify moderators of intervention effects.
Methods
From September 2020 to December 2022, patients with hypertension were randomly selected from the patient register at 10 Swedish primary health care centers and randomized 1:1 to receive health-promoting text messages or treatment as usual (N = 401). The intervention group received four text messages per week for six months. Self-reported measures of lifestyle habits were collected through a questionnaire at baseline and after six months. Predictors of behavioral change according to the Theory of Planned Behavior were collected through a baseline questionnaire. The data were analyzed according to the intention-to-treat principle. We compared lifestyle habits between the intervention and control groups at follow-up with adjustment for baseline measures through logistic regression analysis and analysis of covariance.
Results
The text message group had a statistically significant decrease in the proportion of participants with alcohol use above four standard drinks per week (OR 0.35, 95 % CI 0.15–0.81), and in the proportion of participants being physically inactive (OR 0.60, 95 % CI 0.37–0.98). The effect could not be explained or predicted by a pragmatic adaptation of the Theory of Planned Behavior.
Conclusions
Health-promoting text messages could be offered to Swedish primary care patients with hypertension as part of the effort to improve their lifestyle habits. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Health behavior, Hypertension, Lifestyle, Primary care, Randomized controlled trial, Text Messaging, Theory of Planned Behavior
in
Preventive Medicine Reports
volume
51
article number
103009
pages
1 - 8
publisher
Elsevier
external identifiers
  • pmid:40065756
  • scopus:85217889964
ISSN
2211-3355
DOI
10.1016/j.pmedr.2025.103009
language
English
LU publication?
yes
id
6c85f89b-addc-4258-8166-571d9612bcf3
date added to LUP
2025-04-29 20:53:01
date last changed
2025-04-30 07:24:39
@article{6c85f89b-addc-4258-8166-571d9612bcf3,
  abstract     = {{Objective<br/>We aimed to investigate whether health-promoting text messages sent to patients with hypertension in primary care could affect lifestyle habits, and if the Theory of Planned Behavior could be used to identify moderators of intervention effects.<br/>Methods<br/>From September 2020 to December 2022, patients with hypertension were randomly selected from the patient register at 10 Swedish primary health care centers and randomized 1:1 to receive health-promoting text messages or treatment as usual (N = 401). The intervention group received four text messages per week for six months. Self-reported measures of lifestyle habits were collected through a questionnaire at baseline and after six months. Predictors of behavioral change according to the Theory of Planned Behavior were collected through a baseline questionnaire. The data were analyzed according to the intention-to-treat principle. We compared lifestyle habits between the intervention and control groups at follow-up with adjustment for baseline measures through logistic regression analysis and analysis of covariance.<br/>Results<br/>The text message group had a statistically significant decrease in the proportion of participants with alcohol use above four standard drinks per week (OR 0.35, 95 % CI 0.15–0.81), and in the proportion of participants being physically inactive (OR 0.60, 95 % CI 0.37–0.98). The effect could not be explained or predicted by a pragmatic adaptation of the Theory of Planned Behavior.<br/>Conclusions<br/>Health-promoting text messages could be offered to Swedish primary care patients with hypertension as part of the effort to improve their lifestyle habits.}},
  author       = {{Glock, Hanna and Björk Javanshiri, Amanda and Borgström Bolmsjö, Beata and Jakobsson, Ulf and Milos Nymberg, Veronica and Wolff, Moa and Calling, Susanna}},
  issn         = {{2211-3355}},
  keywords     = {{Health behavior; Hypertension; Lifestyle; Primary care; Randomized controlled trial; Text Messaging; Theory of Planned Behavior}},
  language     = {{eng}},
  pages        = {{1--8}},
  publisher    = {{Elsevier}},
  series       = {{Preventive Medicine Reports}},
  title        = {{Promoting lifestyle change through text messages to patients with hypertension: A randomized controlled trial in Swedish primary care}},
  url          = {{http://dx.doi.org/10.1016/j.pmedr.2025.103009}},
  doi          = {{10.1016/j.pmedr.2025.103009}},
  volume       = {{51}},
  year         = {{2025}},
}