Engagement with eHealth Self-Monitoring in a Primary Care-Based Weight Management Intervention.
Engagement with eHealth Self-Monitoring in a Primary Care-Based Weight Management Intervention.
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DOI：
10.1371/journal.pone.0140455
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Bennett GG
中科院分区：
文献类型：
--
作者：
Wolin KY;Steinberg DM;Lane IB;Askew S;Greaney ML;Colditz GA;Bennett GG
虽然电子健康方法有望提高行为改变干预措施的覆盖范围和成本效益，但随着时间的推移，参与者的参与度下降，特别是自我监测行为，这对电子健康方法提出了挑战。这些都是慢性病预防和管理方面的重大关切，因为持久的影响对于推动有意义的变革至关重要。“Be Fit，Be Well”是一种电子健康减肥干预措施，允许参与者自行选择自我监测模式（网络或交互式语音应答（IVR））。参与者可以改变他们的方式。因此，这项研究提供了一个独特的机会，以检查干预方式的选择和不断变化的方式对干预参与和结果的影响。从社区卫生中心招募的干预参与者（n = 180）预计在24个月的干预过程中每周自我监测健康行为。我们检查了干预组参与者的方式（网络，IVR或改变方式）的干预参与趋势。大多数（61%）参与者选择IVR自我监控，而39%选择网络。56%选择网络监控的人在研究期间改为IVR，而最初选择IVR的人没有变化。两种方式的自我监控都有所下降，但选择IVR的人的完成率较高。自我监测方式与体重或血压结果之间没有关联。这是第一项在电子健康干预中比较网络和IVR自我监测的研究，参与者可以选择和改变他们的自我监测模式。IVR显示了实现一致参与的承诺。
While eHealth approaches hold promise for improving the reach and cost-effectiveness of behavior change interventions, they have been challenged by declining participant engagement over time, particularly for self-monitoring behaviors. These are significant concerns in the context of chronic disease prevention and management where durable effects are important for driving meaningful changes. “Be Fit, Be Well” was an eHealth weight loss intervention that allowed participants to self-select a self-monitoring modality (web or interactive voice response (IVR)). Participants could change their modality. As such, this study provides a unique opportunity to examine the effects of intervention modality choice and changing modalities on intervention engagement and outcomes. Intervention participants, who were recruited from community health centers, (n = 180) were expected to self-monitor health behaviors weekly over the course of the 24-month intervention. We examined trends in intervention engagement by modality (web, IVR, or changed modality) among participants in the intervention arm. The majority (61%) of participants chose IVR self-monitoring, while 39% chose web. 56% of those who selected web monitoring changed to IVR during the study versus no change in those who initially selected IVR. Self-monitoring declined in both modalities, but completion rates were higher in those who selected IVR. There were no associations between self-monitoring modality and weight or blood pressure outcomes. This is the first study to compare web and IVR self-monitoring in an eHealth intervention where participants could select and change their self-monitoring modality. IVR shows promise for achieving consistent engagement.