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Table 1 Enhanced Care text messaging matrix

From: Feasibility and acceptability of technology-based caregiver engagement strategies delivered in a summertime childhood obesity prevention intervention: results from an internal pilot of the Camp NERF (Nutrition, Education, Recreation, and Fitness) study

Week Theme Type of messagea Text message
1 Fast food Response Today at Camp NERF, your child learned about healthy fast food items. Are you in for trying healthier items at fast food restaurants? Please reply with “Yes” or “No”.
1 Fast food Information Camp NERF staff wants to help! Here is a strategy you and your child can use when choosing healthier items at fast food restaurants: Next time you or your child want to order french fries, you guys can share a medium order instead of ordering a large. Try it!
1 Fast food Response Attention all Camp NERF parents! Did you complete the Fast Food Challenge this week? Please reply with “Yes” or “No”.
2 Screen time Response Happy Tuesday Camp NERF parents! Yesterday at camp, your child learned about “screen-time” and its consequences to our health. Screen-time is the total amount of time someone spends in front of any kind of screen, whether that be a TV, computer, cell-phone, or other handheld device. Doctors recommend that children should have no more than 2 hours of screen-time each day. This week, we challenge you to limit your child to 2 hours or less of screen-time. Are you in? Please reply with “Yes” or “No”.
2 Screen time Information Camp NERF parents, did you know that too much screen-time is also related to overweight and obesity? Here is a reason why: spending too much time sitting in front of a TV or computer screen means that we are not spending enough time being physically active, preventing our body from burning enough calories to balance the calories we eat. I hope this will encourage you to help limit your child’s screen-time this week! Do not forget to add us on Facebook: just type Camp NERF in the search bar and click “join group”!
2 Screen time Response Good evening Camp NERF parents! Did you complete the Screen-Time challenge this week? Please reply with “Yes” or “No”.
3 Breakfast Response Week 6 of Camp NERF has begun and it’s all about BREAKFAST – the importance of eating breakfast every day, and the healthy food options for a perfect kick-start to our day! So far, we have learned to watch out for cereals with extra sugar and to add fresh or frozen fruits to whole-grain cereals to give our bodies a boost of energy. This week, we challenge you to simply add some fruit to you and your child’s breakfast! Whether you give them a fresh banana, cut up strawberries to add to their cereal or oatmeal, or make a breakfast smoothie with 100% fruit juice, we encourage you to BOOST their BREAKFAST! Are you in? Please reply with “Yes” or “No”.
3 Breakfast Information Happy Friday Camp NERF parents! Along with learning about breakfast this week, we also learned about calcium-rich foods that are good for building STRONG bones. Did you know that many calcium-rich foods are also perfect breakfast options? - like low-fat plain milk, low-fat yogurt, and low-fat cheese! However, we can also get calcium by eating other foods, such as spinach, almonds, eggs, oatmeal, broccoli, and sunflower seeds to name a few. Whether you get your calcium from dairy or from the other items I have listed, it is still important to get calcium every day for best bone and teeth health. Good luck with this week’s challenge!
3 Breakfast Response Good evening Camp NERF parents! Just checking in to see how this week’s BOOST your BREAKFAST Challenge went! Did you complete the challenge? Please reply with “Yes” or “No”.
  1. aResponse: Text message that requires a response from the participants; Information: Text message that provides information to the participants with no option for response