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Using Photos to Develop Text Messages to Promote Walking




Sending text messages (TMs) is a promising global intervention to help adults increase their engagement in walking as a form of physical activity (PA). But, little is known about how effective and acceptable TMs are developed.


Our study was designed to (a) determine the acceptability, among low-income adults, of receiving TMs to increase their walking and (b) develop, using photos to prompt discussion, a participant-generated database of TMs to promote walking.


In 2011, three focus groups (low-income, sedentary adults) met at community clinics (one focus group at each of three clinics). To promote dialogue to help develop TMs, we created a discussion guide and a set of 40 photos depicting barriers to increasing PA or showing people walking. A content analysis of TMs developed was done using audiotaped transcripts, photo page notes, flip chart notes, and field notes.


Twelve TM themes emerged, including 172 TMs developed by the 23 study participants (age 50 ± 6.3 years).


Using TMs to help achieve walking goals is an acceptable method of promoting PA with adults. Using culturally relevant photos to prompt discussion, focus groups can develop a database of PA-related TMs to promote walking.

Clinical Relevance

Physical inactivity is a significant contributor to adult health problems worldwide, and walking is a realistic method of increasing PA. Using focus groups and photos, individuals can generate acceptable, personalized and innovative TMs to promote walking.