New University of Michigan research says that a simple tool right in your back pocket may help decrease your risk for type 2 diabetes: Text messages on your phone.

An overwhelming majority of surveyed people who enrolled in customized texting service txt4health piloted in Detroit and Cincinnati last year said the free mobile education program made them more aware of their diabetes risk and more likely to make diet-related behavior changes and lose weight. The service was also launched in New Orleans but those participants were not included in the study.

While the program seemed to work well for those who completed it, only 39 percent stuck through all 14 weeks. The findings appear in two new studies published online in the Journal of Medical Internet Research today.

"We found that this method of health intervention had potential to significantly influence people's health habits and have great reach - however, sustained participant engagement across the 14 weeks was lower than desired," says lead author of both studies Lorraine R. Buis, Ph.D., assistant professor in the Department of Family Medicine at the U-M Medical School.

"It's clear that a text message program may not be appropriate for everyone; however, for a large subset of people, this may be a feasible, acceptable, and useful strategy to motivate positive behavior changes."

Most participants reported that after completing the program, they were more likely to replace sugary drinks with water (78 percent), have a piece of fresh fruit instead of dessert (74 percent), substitute a small salad for chips or fries when dining out (76 percent), buy healthier foods when grocery shopping (80 percent), and eat more grilled, baked, or broiled foods instead of fried (76 percent).

The majority of survey respondents also reported that text messages were easy to understand (100 percent), that the program made them knowledgeable of their risk for developing type 2 diabetes (88 percent) and more aware of their dietary and physical activity habits (89 percent). Eighty-eight percent also said they enjoyed participating in the program.

The txt4health initiative is a large, public health focused text message-based program that aims to raise type 2 diabetes risk awareness, as well as facilitate weekly weight and physical activity self-monitoring to lower diabetes risk.

Both pilots were supported by the Office of the National Coordinator for Health Information Technology. In Detroit, the program was by the Southeast Michigan Beacon Community and Cincinnati's program was led by the Greater Cincinnati Beacon Collaborative. The groups launched txt4health as part of each city's campaign to educate the public about diabetes and prevention.

Researchers enrolled 1,838 participants in the program who were asked to answer background questions in order to get personalized health tips and recommendations over 14 weeks. Overall, roughly 74 percent of participants completed the diabetes risk assessment, 89 percent tracked their weight and 55 percent reported their physical activity at least once during the program.

"Text message programs may be a useful tool when used as a component in a broad-based public health campaign," Buis says. "However, sole reliance on this strategy may be cautioned when targeting a general population because the level of individual engagement widely varies.

"We need to further explore ways to improve retention rates among participants."

Lindsey Hirzel, M.A., of Wayne State University; Scott A. Turske, B.A. and Terrisca R. Des Jardins, M.H.S.A, of the Southeast Michigan Beacon Community; Hossein Yarandi, Ph.D., of Wayne State University; and Patricia Bondurant, D.N.P., R.N., of the Greater Cincinnati Beacon Collaborative

Reference: "Use of a Text Message Program to Raise Type 2 Diabetes Risk Awareness and Promote Health Behavior Change (Part I): Assessment of Participant Reach and Adoption," J Med Internet Res 2013: doi:10.2196/jmir.2928

"Use of a Text Message Program to Raise Type 2 Diabetes Risk Awareness and Promote Health Behavior Change (Part II): Assessment of Participants' Perceptions on Efficacy," J Med Internet Res 2013: doi:10.2196/jmir.2929