Design and implementation of an interactive website to support long-term maintenance of weight loss

Victor J Stevens, Kristine L Funk, Phillip J Brantley, Thomas P Erlinger, Valerie H Myers, Catherine M Champagne, Alan Bauck, Carmen D Samuel-Hodge, Jack F Hollis, Victor J Stevens, Kristine L Funk, Phillip J Brantley, Thomas P Erlinger, Valerie H Myers, Catherine M Champagne, Alan Bauck, Carmen D Samuel-Hodge, Jack F Hollis

Abstract

Background: For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition.

Objective: This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year.

Methods: The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts.

Results: The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use.

Conclusions: Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient.

Trial registration: clinicaltrials.gov NCT00054925.

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Overview of website design team; spheres and domains
Figure 2
Figure 2
Steps in the website development process
Figure 3
Figure 3
Overview of the WLM key interactive features
Figure 4
Figure 4
Sample screenshot of the website home page
Figure 5
Figure 5
Sample screenshot of a participant’s goal setting page
Figure 6
Figure 6
Overview of automated prompt system
Figure 7
Figure 7
Percent of participants with at least one log-in per month

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Source: PubMed

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