Jessica Ardo, Jung-Ah Lee, Janett A. Hildebrand, Diana Guijarro, Hassan Ghasemazadeh, Anna Strömberg, Lorraine S. Evangelista; Publication date: April 1, 2021;



Develop and validate a text message bank to support healthier lifestyle behaviors in older adults at risk for cardiovascular disease utilizing a codesign approach.


Initially, the researchers, based on literature, developed a bank of 68 SMS text messages focusing on healthy eating (24 messages), physical activity (24 messages), and motivational feedback (20 messages), based on a scoping review of the literature on promoting behavioral change to engage in healthy lifestyle behaviors. In the next step, a panel of five experts analyzed every subset of SMS text messages. Further validation was conducted by nine older adults (≥ 60 years). The user demographics, telephone literacy, understanding, and appeal for every SMS text message were evaluated using a 31-item questionnaire.


Participants provided an acceptable understanding of the critical concept found in the 49 SMS text message (physical activity M = 1.73 ± 0.18; diet M = 1.73 ± 0.26; motivation M = 1.85 ± 0.25; range 0–2). The average ratings for physical activity (i.e., likability), healthy eating, and motivation were 8.62 ± 0.64, 8.57 ± 0.76, and 8.40 ± 0.83, respectively (range 0–10).


Co-designers were able to identify the technological and content requirements for each text message and infographic to enhance understanding and appeal.

Practice implications

A feasibility study will need to be conducted as a next step to testing the effectiveness of text messages in a mobile-based intervention to promote healthy behaviors in older adults at high CVD risk.