Improving Food Literacy Through mHealth (Text Messaging) To A Predominantly Low-Income, Rural Population In The Appalachian High Country

Low income, rural dwelling individuals are at higher risk of obesity and chronic disease, in large part due to isolation from proper health education and health care. High Country Community Health (HCCH) and Appalachian State University developed a tailored 24-week, community-based mHealth prevention and health risk reduction program called My Quest in the High Country to support these individuals. From December 2019 to January 2020, HCCH patients were recruited by the HCCH RD using a standardized Recruitment Script. Participants received a scale, FitBit, text messages (n=1-2/ day), weekly eNewsletter, targeted videos, and weekly individualized physical activity feedback. Participants completed an online pre- and post-assessment survey. Analyses included McNemar, Wilcoxon Signed Rank, and descriptives. Significance set at p<.05. Participants (n=14) were female (71.4%), made less than $15,000 per year (64.2%), with a mean age of 51.36. Participant food security status did not improve significantly during the study. Positive and significant changes in body weight and blood pressure were observed, suggesting that mHealth interventions are impactful in a rural, low-income population. The targeted video education did not significantly change food security status or food literacy behavior; participant feedback showed that similar interventions may have a positive impact on behavior change.