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Does brief telephone support improve engagement with a web-based weight management intervention? Randomized controlled trial

Does brief telephone support improve engagement with a web-based weight management intervention? Randomized controlled trial
Does brief telephone support improve engagement with a web-based weight management intervention? Randomized controlled trial
Background: Recent reviews suggest Web-based interventions are promising approaches for weight management but they identify difficulties with suboptimal usage. The literature suggests that offering some degree of human support to website users may boost usage and outcomes.

Objective: We disseminated the POWeR (“Positive Online Weight Reduction”) Web-based weight management intervention in a community setting. POWeR consisted of weekly online sessions that emphasized self-monitoring, goal-setting, and cognitive/behavioral strategies. Our primary outcome was intervention usage and we investigated whether this was enhanced by the addition of brief telephone coaching. We also explored group differences in short-term self-reported weight loss.

Methods: Participants were recruited using a range of methods including targeted mailouts, advertisements in the local press, notices on organizational websites, and social media. A total of 786 adults were randomized at an individual level through an online procedure to (1) POWeR only (n=264), (2) POWeR plus coaching (n=247), or (3) a waiting list control group (n=275). Those in the POWeR plus coaching arm were contacted at approximately 7 and 28 days after randomization for short coaching telephone calls aimed at promoting continued usage of the website. Website usage was tracked automatically. Weight was assessed by online self-report.

Results: Of the 511 participants allocated to the two intervention groups, the median number of POWeR sessions completed was just one (IQR 0-2 for POWeR only, IQR 0-3 for POWeR plus coach). Nonetheless, a substantial minority completed at least the core three sessions of POWeR: 47 participants (17.8%, 47/264) in the POWeR-only arm and 64 participants (25.9%, 64/247) in the POWeR plus coaching arm. Participants in the POWeR plus coaching group persisted with the intervention for longer and were 1.61 times more likely to complete the core three sessions than the POWeR-only group (?21=4.93; OR 1.61, 95% CI 1.06-2.47; n=511). An intention-to-treat analysis showed between-group differences in weight loss (F2,782=12.421, P<.001). Both intervention groups reported more weight loss than the waiting list control group. Weight loss was slightly, but not significantly, greater in the POWeR plus coaching group. A large proportion of participants assigned to POWeR plus coaching refused phone calls or were not contactable (57.9%, 143/247). Exploratory analyses identified health and sociodemographic differences between those who did and did not engage in coaching when it was made available to them. Users who engaged with coaching used the intervention more and lost more weight than those who did not.

Conclusions: In common with most Web-based intervention studies, usage of POWeR was suboptimal overall. However, our findings suggest that supplementing Web-based weight management with brief human support could improve usage and outcomes in those who take it up.

Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 98176068; http://www.controlled-trials.com/ISRCTN98176068 (Archived by WebCite at http://www.webcitation.org/6OKRjM2oy).
internet, adherence, behavioral, obesity, randomized controlled trial, weight loss
1438-8871
e95
Dennison, Laura
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Morrison, Leanne
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Lloyd, Scott
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Phillips, Dawn
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Stuart, Beth
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Williams, Sarah
f98f47db-b1d6-42c2-b0eb-7c0cb9a981d0
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8
Michie, Susan
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Little, Paul
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Yardley, Lucy
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Dennison, Laura
15c399cb-9a81-4948-8906-21944c033c20
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
Lloyd, Scott
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Phillips, Dawn
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Stuart, Beth
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Williams, Sarah
f98f47db-b1d6-42c2-b0eb-7c0cb9a981d0
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Murray, Elizabeth
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Michie, Susan
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Little, Paul
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Yardley, Lucy
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Dennison, Laura, Morrison, Leanne, Lloyd, Scott, Phillips, Dawn, Stuart, Beth, Williams, Sarah, Bradbury, Katherine, Roderick, Paul, Murray, Elizabeth, Michie, Susan, Little, Paul and Yardley, Lucy (2014) Does brief telephone support improve engagement with a web-based weight management intervention? Randomized controlled trial. Journal of Medical Internet Research, 16 (3), e95. (doi:10.2196/jmir.3199). (PMID:24681761)

Record type: Article

Abstract

Background: Recent reviews suggest Web-based interventions are promising approaches for weight management but they identify difficulties with suboptimal usage. The literature suggests that offering some degree of human support to website users may boost usage and outcomes.

Objective: We disseminated the POWeR (“Positive Online Weight Reduction”) Web-based weight management intervention in a community setting. POWeR consisted of weekly online sessions that emphasized self-monitoring, goal-setting, and cognitive/behavioral strategies. Our primary outcome was intervention usage and we investigated whether this was enhanced by the addition of brief telephone coaching. We also explored group differences in short-term self-reported weight loss.

Methods: Participants were recruited using a range of methods including targeted mailouts, advertisements in the local press, notices on organizational websites, and social media. A total of 786 adults were randomized at an individual level through an online procedure to (1) POWeR only (n=264), (2) POWeR plus coaching (n=247), or (3) a waiting list control group (n=275). Those in the POWeR plus coaching arm were contacted at approximately 7 and 28 days after randomization for short coaching telephone calls aimed at promoting continued usage of the website. Website usage was tracked automatically. Weight was assessed by online self-report.

Results: Of the 511 participants allocated to the two intervention groups, the median number of POWeR sessions completed was just one (IQR 0-2 for POWeR only, IQR 0-3 for POWeR plus coach). Nonetheless, a substantial minority completed at least the core three sessions of POWeR: 47 participants (17.8%, 47/264) in the POWeR-only arm and 64 participants (25.9%, 64/247) in the POWeR plus coaching arm. Participants in the POWeR plus coaching group persisted with the intervention for longer and were 1.61 times more likely to complete the core three sessions than the POWeR-only group (?21=4.93; OR 1.61, 95% CI 1.06-2.47; n=511). An intention-to-treat analysis showed between-group differences in weight loss (F2,782=12.421, P<.001). Both intervention groups reported more weight loss than the waiting list control group. Weight loss was slightly, but not significantly, greater in the POWeR plus coaching group. A large proportion of participants assigned to POWeR plus coaching refused phone calls or were not contactable (57.9%, 143/247). Exploratory analyses identified health and sociodemographic differences between those who did and did not engage in coaching when it was made available to them. Users who engaged with coaching used the intervention more and lost more weight than those who did not.

Conclusions: In common with most Web-based intervention studies, usage of POWeR was suboptimal overall. However, our findings suggest that supplementing Web-based weight management with brief human support could improve usage and outcomes in those who take it up.

Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 98176068; http://www.controlled-trials.com/ISRCTN98176068 (Archived by WebCite at http://www.webcitation.org/6OKRjM2oy).

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e-pub ahead of print date: 28 March 2014
Published date: March 2014
Keywords: internet, adherence, behavioral, obesity, randomized controlled trial, weight loss
Organisations: Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 363691
URI: https://eprints.soton.ac.uk/id/eprint/363691
ISSN: 1438-8871
PURE UUID: 49f737b5-b1cf-4f8d-8f2d-a2e43310bc53
ORCID for Laura Dennison: ORCID iD orcid.org/0000-0003-0122-6610
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X
ORCID for Katherine Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 31 Mar 2014 12:24
Last modified: 17 Sep 2019 01:07

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Contributors

Author: Laura Dennison ORCID iD
Author: Leanne Morrison ORCID iD
Author: Scott Lloyd
Author: Dawn Phillips
Author: Beth Stuart
Author: Sarah Williams
Author: Paul Roderick ORCID iD
Author: Elizabeth Murray
Author: Susan Michie
Author: Paul Little
Author: Lucy Yardley ORCID iD

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