• Hanna Glock, Borgström BolmsjöBeataB0000-0001-7655-0613Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden., Milos NymbergVeronicaV0000-0002-3836-3048Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden., Moa Wolff, and Susanna Calling.
• Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
• Scand J Prim Health Care. 2023 Dec 1; 41 (4): 457468457-468.

ObjectiveCardiovascular disease can be prevented through lifestyle changes, but such changes are often hard to attain. Text message interventions with lifestyle advice have shown small but promising effects. Our objective was to explore participant experience of a text message lifestyle intervention for patients with hypertension, and implications for future lifestyle interventions.Design And SubjectsFourteen participants were purposefully selected for telephone interviews after completion of a text message lifestyle intervention. A semi-structured interview guide with open-ended questions was used. Interviews were recorded and transcribed verbatim. The material was analyzed through systematic text condensation as described by Malterud, a data-driven analysis style that includes deductive elements.SettingPrimary care in three regions in southern Sweden.ResultsThe analysis resulted in three themes. 'Blood pressure and lifestyle, how seriously to take it?' revealed a remaining need for knowledge regarding to what extent lifestyle affects risk for cardiovascular disease. 'The text messages - a useful reminder in need of tailoring' described that the design of the intervention was satisfactory, but suggested improvements through increased individualization. Finally, 'Water off a duck's back or a kick in the pants - when does behavior change?' showed how some participants responded to the push to change while others did not, supplying material for further analysis in a framework of behavioral change theory.ConclusionA key to adoption was advice that was applicable in daily life. Timing in relation to a diagnosis of hypertension or other motivational factors, and tailoring to prior knowledge, habits, and limitations could increase effectiveness.

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