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Table 3 Components, categories and attributes from the semi-structured interviews with TXT2BFiT participantsa

From: Process evaluation of TXT2BFiT: a multi-component mHealth randomised controlled trial to prevent weight gain in young adults

Component Category Attributes Verbatim quote (Gender, Age)
Personal goal of participation in the program 1. Weight loss Health, sustainable “So I guess weight reduction as my main goal…. But having a healthy lifestyle also”. Female, 30
“I have put on a few kilos… I want to lose the weight and lose it in a heathy way. “[I wanted] a program that is manageable in the long run, there are many diets that you can go on, but after a few months you give up. I didn’t want to go on a diet, but more like a long lasting change” Male, 33
2. Improve physical activity behaviours To lead to weight loss and/or weight maintenance, health, forming habits, sustainable, long-term “Just to get into better habits, to maintain exercise habits [was] the main one”. Female, 27
3. Improve eating habits To lead to weight loss and/or weight maintenance, health, forming habits, sustainable, long-term “I hoped to lose some weight and I guess generally get a better idea of healthier eating and good eating behaviours”. Female, 30
4. Long term change To lead to sustained weight loss and/or weight maintenance, behaviour maintenance, long term heath “I need guidance to ensure that that the weight loss that incurred will stay off for a much longer time, so I needed help changing my daily habits” Male, 33
Most helpful 1. Coaching calls Professional, accountability, motivation, personalised, non-judgemental “I liked the phone calls and how they were individualised and I was talking to the same person each time, you get to know them, I found that helpful, being able to talk to someone on a regular basis who knew where I was at the last time and what was going on”. Female, 24
2. Text messages Practical tips and hints, easy to implement ideas, reminders, greater personalisation “I guess the second part for me was the text messages, I thought they were good as well… they weren’t too much and they weren’t too little”. Male, 32
Least helpful 1. Smartphone applications Logging in difficulties, navigation issues, design issues, functional capabilities “I didn’t use the website, I tracked my weight in other ways [through My Fitness Pal] tracking my weight through the website wasn’t practical for me, mainly, because I was trying to access it through an iPhone, so it was fiddly, in fact a lot of the apps were useable, but they were fiddly”. Male, 29
2. Website Logging in difficulties, functional capabilities
3. Sudden decline in program contact Program to maintenance phase change in contact “… The gradually less contact, after the first 3 months, it became hard, some more continuing help”. Male, 24
Coaching calls 1. Professional Appropriate qualifications, listened and understood concerns “I thought the expertise of the nutritionist that was involved was very good, the advice was well planned out and well scoped. I had questions ready for them and I found that really useful because it was expert advice”. Male, 32
2. Accountability Someone checking in, reflection “The calls were fantastic. It was cool to have someone check in and bounce ideas off, set goals and it was all really cool sensible stuff”. Male, 27
3. Motivation External motivation, support “It was good because you want that accountability of an extra person aside from yourself at the beginning stages as a sounding board and external motivator”. Female, 27
4. Personalised Participant directed, collaboration “I felt very positive and empowered, I guess because they relayed information I could really use and actually do something with. For example, when you look for healthy information you can be quite overwhelmed and don’t know where to start, whereas the coaching calls it was very focused…. I liked that [the calls] were very specific and focused on what I could do”. Female, 22
5. Non-judgemental Trust established, supportive environment “… No question was too silly to be asked and discussed. I never felt like I couldn’t ask them anything”. Female, 27
Text messages 1. Tips and hints Practical, non-fact based “Some of the text messages that gave me ideas on how to actually incorporate increased fruit or increased vegetables or increased daily activities, specifically how to increase that in your daily life was really helpful, some of the messages that were intended to be motivational, such as the reasons to increase fruit and vegetables or increase my exercise were good in motivation, but I didn’t think they were as helpful, because we know it is good to be healthy, [I] just have trouble being healthy.” Female, 22
2. Ease of implementation Achievable suggestions, sensible “Any that suggested a practical tip… something that I could implement straight away…. The ones that were helpful were the ones that gave you a specific task to do that day”. Female, 24
3. Personalised More personally relevant content, further targeting “Some messages told me about things I was already doing, I have given that information in the baseline interview….I have no soft drink, that data was available and should have been personalised a bit more if possible”. Female, 32
4. Reminders Appropriate timing, habit forming “I thought they were all sort of reminder ones…. They were sent at good times, like before I was about to buy something for dinner or eat my lunch”. Male, 32
5. Small amounts of information Easy to read, appropriate delivery medium, increased chance of reading content and/or adapting the targeted behaviour “I really liked the [text messages], they were constant and I didn’t have to go out of my way to get them, they popped up and were helpful and gave good tips…” Female, 30
Emails 1. Limit Limited to coaching call summary email “When I got the more personal ones, like after the nutritionist coaching call, which contained the goals we discussed, I printed them out and put them on the wall at my office, so that worked quite well, but for the other ones… it might be check out the website, or we have some new tools, but I was just too busy to follow-up with that”. Female, 30
2. Greater personalisation Coaching call summary email increased change of reading content as personally relevant “I think the emails were the aspect I dismissed the most easily, as I do get a lot of emails during the day”. Female, 33
3. Larger amounts of information Include links to program resources personally relevant to the participant “[Emails] are flexible, as they give you heaps of different things to read, but it wasn’t enforced and I could work it around my own time, and that flexibility still made it good to get the help that I needed without the feeling that I had to go out of my way to do it”. Male, 28
Website and smartphone applications 1. Comparable to commercially available smartphone applications Reverted to other commercially available smartphone applications “I decided that I already have apps on my phone that I use to track diet and exercise, so I kept using those ones…. I think it was the usability of the TXT2BFiT ones, especially trying to use [the apps] on my phone, I found them a bit difficult to navigate” Female, 32
2. Improved self-monitoring capabilities Reverted to other commercially available self-monitoring devices
3. Easily accessible Change to standalone non web-based applications, more user friendly mobile website, contain personal information from coaching calls (not available in other applications) “…. They weren’t particularly intuitive or user friendly, but the content was useful once I got in, but the usability was the issue. I suppose I was looking for a central place where I could record all my information and where I could get more information, I was expecting the apps to be more user friendly and more practical.” Male, 29
External motivators 1. Commercially available smartphone apps My Fitness Pal, Map My Run “My Fitness Pal, I used this to set my goals with [the dietitians], it is very easy to use, you can scan food items and learn what you are eating, so you can easily keep an eye on how much you have eaten, but also see the proportions of the food you have eaten in relation to your daily goals”. Male, 33
2. Commercially available self-monitoring devices Fitbit, Jawbone “I got a FitBit and that tracks steps and sleep and links to My Fitness Pal so that has been helpful to reach my goals”. Female, 32
3. Social support Family, partners, gym memberships, sporting groups “Two friends of mine, we put a hard line of [getting] a six pack by Christmas, so that was a motivating factor, so going to the gym with them and working together definitely helps, so it was motivating for me to have that social support, it helped a lot”. Male, 33
Improvements 1. Greater personalisation Text messages, emails, website “It does need more tailoring…. More individual or specific, more personalised and more specific to the goals I was trying to achieve… it would give me more of sense of accountability”. Female, 24
2. More centralised Smartphone application consolidation (4 into 1), personal goals available from coaching calls to track progress “I found having all of my data in one central location motivating, as I could see how much exercise affected how much I ate for the day and it also have a pedometer in it, so as long as I had my phone with me I could count how many steps I took that day and when I stood on the scales it would send it to my phone and I would have my weight and my body fat content there and everything was connected and in the one place and that was really helpful”. Female, 23
  1. a30 intervention participants completed the semi-structured telephone interviews at 9-months