223364 An online community reduces attrition in an Internet-mediated walking program

Monday, November 8, 2010 : 2:48 PM - 3:06 PM

Caroline R. Richardson, MD , Department of Family Medicine / Health Services Research and Development Center for Excellence, University of Michigan / Ann Arbor VA, Ann Arbor, MI
Lorraine Buis, PhD , College of Nursing - Adult Health, Wayne State University, Detroit, MI
Adrienne Janney, MSI , NA, Arbor Research Collaborative for Health, Ann Arbor, MI
David E. Goodrich, EdD , Health Services Research and Development Center for Excellence, Veterans Administration Medical Center, Ann Arbor, MI
Ananda Sen, PhD , Department of Statistics, Center for Statistical Consultation and Research (CSCAR) / University of Michigan, Ann Arbor, MI
Michael Hess, MSI , Department of Family Medicine, University of Michigan, Ann Arbor, MI
Laurie Fortlage, MS, RD , Department of Family Medicine, University of Michigan, Ann Arbor, MI
Paul J. Resnick, PhD , School of Information, University of Michigan, Ann Arbor, MI
Brian J. Zikmund-Fisher, PhD , Center for Behavioral and Decision Sciences in Medicine, University of Michigan, Ann Arbor, MI
Victor J. Strecher, PhD, MPH , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
John D. Piette, PhD , Department of Internal Medicine, University of Michigan, Ann Arbor, Ann Arbor, MI
Background: Automated, Internet-mediated behavior-change interventions can be disseminated widely and at a low per-person cost. They also allow users to receive support at a time and place that is convenient for them. However, some of these programs suffer from high rates of attrition. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Methods: A randomized controlled trial of sedentary but ambulatory adult patients from an academic health system who use email regularly, and with at least one of the following: overweight (BMI ≥ 25), type 2 diabetes and/or coronary artery disease. All participants (n=324) wore enhanced pedometers for 16 weeks, uploaded step-count data and logged into the study website to view personalized feedback and goals. Those randomized to the “with online community” (WOC) group were able to post messages and read messages from other participants while those randomized to the “no online community group” (NOC) could not access this feature. Results: Participants increased their average daily steps by 1888 steps/day (Intention to treat: paired t-test, sem 133, p<.001), and there was no significant difference between groups. However, the percentage of completers was 13% higher in the WOC group than the NOC group (NOC: 66%, WOC: 79%, logistic regression, or = 0.49, p=.019). Conclusion: Online communities may be useful for solving the attrition problem in Internet-mediated health behavior change interventions.

Learning Areas:
Chronic disease management and prevention
Communication and informatics
Implementation of health education strategies, interventions and programs

Learning Objectives:
1. Describe qualitatively and quantitatively the impact of adding online community features to an Internet-mediated walking program. 2. List 5 key design features in developing an active online community. 3. Describe 3 limitations to using online community features in physical activity interventions.

Keywords: Physical Activity, Internet

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: NA

Qualified on the content I am responsible for because: I am the Principal Investigator on the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.