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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 9 (2007) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/9824


Title: Reach, Engagement, and Retention in an Internet-Based Weight Loss Program in a Multi-Site Randomized Controlled Trial
Authors: Glasgow, Russell E
Nelson, Candace C
Kearney, Kathleen A
Reid, Robert
Ritzwoller, Debra P
Strecher, Victor J
Couper, Mick P
Green, Beverly
Wildenhaus, Kevin
Keywords: Original Paper
Internet
weight loss
recruitment
representativeness
retention
attrition
adherence
behavior change
randomized controlled trial
consumer health informatics
Issue Date: 9-May-2007
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Russell E Glasgow, Candace C Nelson, Kathleen A Kearney, Robert Reid, Debra P Ritzwoller, Victor J Strecher, Mick P Couper, Beverly Green, Kevin Wildenhaus. Reach, Engagement, and Retention in an Internet-Based Weight Loss Program in a Multi-Site Randomized Controlled Trial. J Med Internet Res 2007;9(2):e11 <URL: http://www.jmir.org/2007/2/e11/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2007/2/e11/ ] Background: Research increasingly supports the conclusion that well-designed programs delivered over the Internet can produce significant weight loss compared to randomized controlled conditions. Much less is known about four important issues addressed in this study: (1) which recruitment methods produce higher eHealth participation rates, (2) which patient characteristics are related to enrollment, (3) which characteristics are related to level of user engagement in the program, and (4) which characteristics are related to continued participation in project assessments. Methods: We recruited overweight members of three health maintenance organizations (HMOs) to participate in an entirely Internet-mediated weight loss program developed by HealthMedia, Inc. Two different recruitment methods were used: personal letters from prevention directors in each HMO, and general notices in member newsletters. The personal letters were sent to members diagnosed with diabetes or heart disease and, in one HMO, to a general membership sample in a particular geographic location. Data were collected in the context of a 2×2 randomized controlled trial, with participants assigned to receive or not receive a goal setting intervention and a nutrition education intervention in addition to the basic program. Results: A total of 2311 members enrolled. Bivariate analyses on aggregate data revealed that personalized mailings produced higher enrollment rates than member newsletters and that members with diabetes or heart disease were more likely to enroll than those without these diagnoses. In addition, males, those over age 60, smokers, and those estimated to have higher medical expenses were less likely to enroll (all P < .001). Males and those in the combined intervention were less likely to engage initially, or to continue to be engaged with their Web program, than other participants. In terms of retention, multiple logistic regressions revealed that enrollees under age 60 (P < .001) and those with higher baseline self-efficacy were less likely to participate in the 12-month follow-up (P = .03), but with these exceptions, those participating were very similar to those not participating in the follow-up. Conclusions: A single personalized mailing increases enrollment in Internet-based weight loss. eHealth programs offer great potential for recruiting large numbers of participants, but they may not reach those at highest risk. Patient characteristics related to each of these important factors may be different, and more comprehensive analyses of determinants of enrollment, engagement, and retention in eHealth programs are needed.
Description: Reviewer: Christensen, Helen
URI: http://dx.doi.org/10.2196/jmir.9.2.e11
http://hdl.handle.net/1807/9824
ISSN: 1438-8871
Rights: © Russell E Glasgow, Candace C Nelson, Kathleen A Kearney, Robert Reid, Debra P Ritzwoller, Victor J Strecher, Mick P Couper, Beverly Green, Kevin Wildenhaus. Originally published in the Journal of Medical Internet Research (http://www.jmir.org, 09.05.2007). Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, including full bibliographic details and the URL (see "please cite as" above), and this statement is included.
Appears in Collections:Volume 9 (2007)

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