Cargando…

Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach

BACKGROUND: Unhealthy lifestyle behaviors often co-occur and are related to chronic diseases. One effective method to change multiple lifestyle behaviors is web-based computer tailoring. Dropout from Internet interventions, however, is rather high, and it is challenging to retain participants in web...

Descripción completa

Detalles Bibliográficos
Autores principales: Schulz, Daniela N, Schneider, Francine, de Vries, Hein, van Osch, Liesbeth ADM, van Nierop, Peter WM, Kremers, Stef PJ
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Gunther Eysenbach 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376514/
https://www.ncbi.nlm.nih.gov/pubmed/22403770
http://dx.doi.org/10.2196/jmir.1968
_version_ 1782235835477786624
author Schulz, Daniela N
Schneider, Francine
de Vries, Hein
van Osch, Liesbeth ADM
van Nierop, Peter WM
Kremers, Stef PJ
author_facet Schulz, Daniela N
Schneider, Francine
de Vries, Hein
van Osch, Liesbeth ADM
van Nierop, Peter WM
Kremers, Stef PJ
author_sort Schulz, Daniela N
collection PubMed
description BACKGROUND: Unhealthy lifestyle behaviors often co-occur and are related to chronic diseases. One effective method to change multiple lifestyle behaviors is web-based computer tailoring. Dropout from Internet interventions, however, is rather high, and it is challenging to retain participants in web-based tailored programs, especially programs targeting multiple behaviors. To date, it is unknown how much information people can handle in one session while taking part in a multiple behavior change intervention, which could be presented either sequentially (one behavior at a time) or simultaneously (all behaviors at once). OBJECTIVES: The first objective was to compare dropout rates of 2 computer-tailored interventions: a sequential and a simultaneous strategy. The second objective was to assess which personal characteristics are associated with completion rates of the 2 interventions. METHODS: Using an RCT design, demographics, health status, physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking were self-assessed through web-based questionnaires among 3473 adults, recruited through Regional Health Authorities in the Netherlands in the autumn of 2009. First, a health risk appraisal was offered, indicating whether respondents were meeting the 5 national health guidelines. Second, psychosocial determinants of the lifestyle behaviors were assessed and personal advice was provided, about one or more lifestyle behaviors. RESULTS: Our findings indicate a high non-completion rate for both types of intervention (71.0%; n = 2167), with more incompletes in the simultaneous intervention (77.1%; n = 1169) than in the sequential intervention (65.0%; n = 998). In both conditions, discontinuation was predicted by a lower age (sequential condition: OR = 1.04; P < .001; CI = 1.02-1.05; simultaneous condition: OR = 1.04; P < .001; CI = 1.02-1.05) and an unhealthy lifestyle (sequential condition: OR = 0.86; P = .01; CI = 0.76-0.97; simultaneous condition: OR = 0.49; P < .001; CI = 0.42-0.58). In the sequential intervention, being male (OR = 1.27; P = .04; CI = 1.01-1.59) also predicted dropout. When respondents failed to adhere to at least 2 of the guidelines, those receiving the simultaneous intervention were more inclined to drop out than were those receiving the sequential intervention. CONCLUSION: Possible reasons for the higher dropout rate in our simultaneous intervention may be the amount of time required and information overload. Strategies to optimize program completion as well as continued use of computer-tailored interventions should be studied. TRIAL REGISTRATION: Dutch Trial Register NTR2168
format Online
Article
Text
id pubmed-3376514
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Gunther Eysenbach
record_format MEDLINE/PubMed
spelling pubmed-33765142012-06-19 Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach Schulz, Daniela N Schneider, Francine de Vries, Hein van Osch, Liesbeth ADM van Nierop, Peter WM Kremers, Stef PJ J Med Internet Res Original Paper BACKGROUND: Unhealthy lifestyle behaviors often co-occur and are related to chronic diseases. One effective method to change multiple lifestyle behaviors is web-based computer tailoring. Dropout from Internet interventions, however, is rather high, and it is challenging to retain participants in web-based tailored programs, especially programs targeting multiple behaviors. To date, it is unknown how much information people can handle in one session while taking part in a multiple behavior change intervention, which could be presented either sequentially (one behavior at a time) or simultaneously (all behaviors at once). OBJECTIVES: The first objective was to compare dropout rates of 2 computer-tailored interventions: a sequential and a simultaneous strategy. The second objective was to assess which personal characteristics are associated with completion rates of the 2 interventions. METHODS: Using an RCT design, demographics, health status, physical activity, vegetable consumption, fruit consumption, alcohol intake, and smoking were self-assessed through web-based questionnaires among 3473 adults, recruited through Regional Health Authorities in the Netherlands in the autumn of 2009. First, a health risk appraisal was offered, indicating whether respondents were meeting the 5 national health guidelines. Second, psychosocial determinants of the lifestyle behaviors were assessed and personal advice was provided, about one or more lifestyle behaviors. RESULTS: Our findings indicate a high non-completion rate for both types of intervention (71.0%; n = 2167), with more incompletes in the simultaneous intervention (77.1%; n = 1169) than in the sequential intervention (65.0%; n = 998). In both conditions, discontinuation was predicted by a lower age (sequential condition: OR = 1.04; P < .001; CI = 1.02-1.05; simultaneous condition: OR = 1.04; P < .001; CI = 1.02-1.05) and an unhealthy lifestyle (sequential condition: OR = 0.86; P = .01; CI = 0.76-0.97; simultaneous condition: OR = 0.49; P < .001; CI = 0.42-0.58). In the sequential intervention, being male (OR = 1.27; P = .04; CI = 1.01-1.59) also predicted dropout. When respondents failed to adhere to at least 2 of the guidelines, those receiving the simultaneous intervention were more inclined to drop out than were those receiving the sequential intervention. CONCLUSION: Possible reasons for the higher dropout rate in our simultaneous intervention may be the amount of time required and information overload. Strategies to optimize program completion as well as continued use of computer-tailored interventions should be studied. TRIAL REGISTRATION: Dutch Trial Register NTR2168 Gunther Eysenbach 2012-03-08 /pmc/articles/PMC3376514/ /pubmed/22403770 http://dx.doi.org/10.2196/jmir.1968 Text en ©Daniela N Schulz, Francine Schneider, Hein de Vries, Liesbeth ADM van Osch, Peter WM van Nierop, Stef PJ Kremers. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.03.2012. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Schulz, Daniela N
Schneider, Francine
de Vries, Hein
van Osch, Liesbeth ADM
van Nierop, Peter WM
Kremers, Stef PJ
Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title_full Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title_fullStr Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title_full_unstemmed Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title_short Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach
title_sort program completion of a web-based tailored lifestyle intervention for adults: differences between a sequential and a simultaneous approach
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376514/
https://www.ncbi.nlm.nih.gov/pubmed/22403770
http://dx.doi.org/10.2196/jmir.1968
work_keys_str_mv AT schulzdanielan programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach
AT schneiderfrancine programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach
AT devrieshein programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach
AT vanoschliesbethadm programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach
AT vannieroppeterwm programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach
AT kremersstefpj programcompletionofawebbasedtailoredlifestyleinterventionforadultsdifferencesbetweenasequentialandasimultaneousapproach