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The Deep South Interactive Voice Response (IVR) System-Supported Active Lifestyle (DIAL) Intervention Shows Efficacy
Dori Pekmezi1, Mohanraj Thirumalai2, Nashira I Brown1
1Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
Introduction:
This study tested the efficacy of the Deep South Interactive Voice Response System-Supported Active Lifestyle intervention.
Study Design:
A RCT was conducted from 2020 to 2024. Data were analyzed in 2025 and 2026.
Setting/Participants:
A total of 245 adults were recruited from 6 rural Alabama counties.
Intervention:
Participants were randomly assigned to the Deep South Interactive Voice Response System-Supported Active Lifestyle intervention or wait-list control arms.
Main Outcome Measures:
Moderate-to-vigorous physical activity was assessed at baseline and 6 months.
Results:
The sample was comprised of rural (100%) non-Hispanic Black (97.55%) women (91.02%). Deep South Interactive Voice Response System-Supported Active Lifestyle participants reported significantly greater increases in moderate-to-vigorous physical activity from baseline to 6 months (mean=60 min per week more, on the basis of 7-Day Physical Activity Recalls and Godin Leisure Time Exercise Questionnaires) than control participants (p<0.001). The Deep South Interactive Voice Response System-Supported Active Lifestyle arm was also significantly more likely to reach national physical activity guidelines at 6 months than the control arm on the basis of the Godin findings (OR= 5.38, 95% CI=1.67, 17.28, p<0.01) but not the 7-Day Physical Activity Recall (OR=2.85, 95% CI=0.94, 8.65, p= 0.06) or accelerometer data (OR=2.25, 95% CI=0.097, 5.20, p=0.06). Accelerometer data showed no significant changes in moderate-to-vigorous physical activity over time, yet trends in the data indicated that the percentage meeting national guidelines increased for the Deep South Interactive Voice Response System-Supported Active Lifestyle arm and decreased for the control arm.
Conclusions:
Findings support the efficacy of Deep South Interactive Voice Response System-Supported Active Lifestyle among rural adults in the Deep South. Interactive voice response-automated phone counseling represents a high-reach, low-cost strategy for addressing physical inactivity and related health disparities in underserved rural communities.
Trial Registration:
This study was registered at www.
Clinicaltrials:
gov (NCT03903874; 4-4-2019).
