User Engagement Associated with Web-Intervention Features to Attain Clinically Meaningful Weight Loss and Weight Maintenance in Rural Women

Patricia A Hageman, Joseph E Mroz, Michael A Yoerger, Carol H Pullen, Patricia A Hageman, Joseph E Mroz, Michael A Yoerger, Carol H Pullen

Abstract

Objective: Purely web-based weight loss and weight-loss maintenance interventions show promise to influence behavior change. Yet, little is known about user engagement with features of web-based interventions that predict clinically meaningful weight loss (≥5% bodyweight loss). This study examines level of website feature engagement with the likelihood of attaining ≥5% bodyweight loss after 6 and 18 months participation in a web-based intervention, among rural women at high risk of obesity-related diseases and disability.

Methods: In this secondary analysis of clinical trial data of 201 rural women, we examined weight change and user engagement, measured as clicks on specific web-based intervention features (messaging and self-tracking), as associated with clinically meaningful weight loss (baseline to 6 months) and weight-loss maintenance (6 to 18 months).

Results: Generalized estimating equations, adjusted for age, intervention group, and intervention phase, revealed high engagement with messaging predicted whether women achieved ≥5% weight loss at 6 months and at 18 months. There was no effect of self-tracking.

Conclusions: Being engaged with messages was associated with attaining clinically meaningful short-term and longer-term weight loss. This trial is registered with NCT01307644.

References

    1. Sorgente A., Pietrabissa G., Manzoni G. M., et al. Web-based interventions for weight loss or weight loss maintenance in overweight or obese people: a systematic review of systematic reviews. Journal of Medical Internet Research. 2017;19(6) doi: 10.2196/jmir.6972.e299
    1. Hageman P. A., Pullen C. H., Hertzog M., Pozehl B., Eisenhauer C., S Boeckner L. Web-based interventions alone or supplemented with peer-led support or professional email counseling for weight loss and weight maintenance in women from rural communities: results of a clinical trial. Journal of Obesity. 2017;2017:21. doi: 10.1155/2017/1602627.1602627
    1. Wieland L. S., Falzon L., Sciamanna C. N., et al. Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Cochrane Database of Systematic Reviews. 2012;8 doi: 10.1002/14651858.cd007675.pub2.CD007675
    1. Neve M., Morgan P. J., Jones P. R., Collins C. E. Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a systematic review with meta-analysis. Obesity Reviews. 2010;11(4):306–321. doi: 10.1111/j.1467-789x.2009.00646.x.
    1. Cussler E. C., Teixeira P. J., Going S. B., et al. Maintenance of weight loss in overweight middle-aged women through the internet. Obesity. 2008;16(5):1052–1060. doi: 10.1038/oby.2008.19.
    1. Hwang K. O., Ning J., Trickey A. W., Sciamanna C. N. Website usage and weight loss in a free commercial online weight loss program: retrospective cohort study. Journal of Medical Internet Research. 2013;15(1) doi: 10.2196/jmir.2195.e11
    1. Collins C. E., Morgan P. J., Hutchesson M. J., Callister R. Efficacy of standard versus enhanced features in a web-based commercial weight-loss program for obese adults, part 2: randomized controlled trial. Journal of Medical Internet Research. 2013;15(7) doi: 10.2196/jmir.2626.e140
    1. Krukowski R. A., Harvey-Berino J., Ashikaga T., Thomas C. S., Micco N. Internet-based weight control: the relationship between web features and weight loss. Telemedicine and e-Health. 2008;14(8):775–782. doi: 10.1089/tmj.2007.0132.
    1. Johnson F., Wardle J. The association between weight loss and engagement with a web-based food and exercise diary in a commercial weight loss programme: a retrospective analysis. International Journal of Behavioral Nutrition and Physical Activity. 2011;8:p. 83. doi: 10.1186/1479-5868-8-83.
    1. Khaylis A., Yiaslas T., Bergstrom J., Gore-Felton C. A review of efficacious technology-based weight-loss interventions: five key components. Telemedicine and e-Health. 2010;16(9):931–938. doi: 10.1089/tmj.2010.0065.
    1. MacLean P. S., Wing R. R., Davidson T., et al. NIH working group report: innovative research to improve maintenance of weight loss. Obesity. 2015;23(1):7–15. doi: 10.1002/oby.20967.
    1. Pekkarinen T., Kaukua J., Mustajoki P. Long-term weight maintenance after a 17-week weight loss intervention with or without a one-year maintenance program: a randomized controlled trial. Journal of Obesity. 2015;2015:10. doi: 10.1155/2015/651460.651460
    1. Ryan C., Bergin M., Wells J. S. Theoretical perspectives of adherence to web-based interventions: a scoping review. International Journal of Behavioral Medicine. 2017;25(1):17–29. doi: 10.1007/s12529-017-9678-8.
    1. Beatty L., Binnion C. A systematic review of predictors of, and reasons for, adherence to online psychological interventions. International Journal of Behavioral Medicine. 2016;23(6):776–794. doi: 10.1007/s12529-016-9556-9.
    1. Levine D. M., Savarimuthu S., Squires A., Nicholson J., Jay M. Technology-assisted weight loss interventions in primary care: a systematic review. Journal of General Internal Medicine. 2015;30(1):107–117. doi: 10.1007/s11606-014-2987-6.
    1. Manzoni G. M., Pagnini F., Corti S., Molinari E., Castelnuovo G. Internet-based behavioral interventions for obesity: an updated systematic review. Clinical Practice in Epidemology Mental Health. 2011;4(7):19–28.
    1. Raaijmakers L. C. H., Pouwels S., Berghuis K. A., Nienhuijs S. W. Technology-based interventions in the treatment of overweight and obesity: a systematic review. Appetite. 2015;95:138–151. doi: 10.1016/j.appet.2015.07.008.
    1. Hageman P. A., Pullen C. H., Hertzog M., Boeckner L. S., Walker S. N. Web-based interventions for weight loss and weight maintenance among rural midlife and older women: protocol for a randomized controlled trial. BMC Public Health. 2011;11(1):p. 521. doi: 10.1186/1471-2458-11-521.
    1. U.S. Department of Agriculture, U.S. Department of Health and Human Service. Dietary Guidelines for Americans. 7th. Washington, DC, USA: U.S. Government Printing Office; 2010. .
    1. U.S. Department of Health and Human Services. Washington, DC, USA: U.S. Government Printing Office; 2010. Healthy people 2010: with understanding and improving health. Tech. Rep.
    1. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. Rockville, MD, USA: U.S. Department of Health and Human Services; 2008. .
    1. Pender N., Murdaugh C., Parsons M. Health Promotion in Nursing Practice. Upper Saddle River, NJ, USA: Prentice Hall; 2006.
    1. Brindal E., Freyne J., Saunders I., Berkovsky S., Smith G., Noakes M. Features predicting weight loss in overweight or obese participants in a web-based intervention: randomized trial. Journal of Medical Internet Research. 2012;14(6) doi: 10.2196/jmir.2156.e173
    1. Kelders S. M., Van Gemert-Pijnen J. E. W. C., Werkman A., Nijland N., Seydel E. R. Effectiveness of a web-based intervention aimed at healthy dietary and physical activity behavior: a randomized controlled trial about users and usage. Journal of Medical Internet Research. 2011;13(2) doi: 10.2196/jmir.1624.e32
    1. Arem H., Irwin M. A review of web-based weight loss interventions in adults. Obesity Reviews. 2011;12(5):236–243. doi: 10.1111/j.1467-789x.2010.00787.x.
    1. Eysenbach G. The law of attrition. Journal of Medical Internet Research. 2005;7(1) doi: 10.2196/jmir.7.1.e11.e11
    1. Davies C., Corry K., Van Itallie A., Vandelanotte C., Caperchione C., Mummery W. K. Prospective associations between intervention components and website engagement in a publicly available physical activity website: the case of 10,000 steps Australia. Journal of Medical Internet Research. 2012;14(14) doi: 10.2196/jmir.1792.e4

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe