An internet-based self-administered intervention for promoting healthy habits and weight loss in hypertensive people who are overweight or obese: a randomized controlled trial

Abstract

BackgroundThe prevalence of overweight and obesity is on the rise worldwide with severe physical and psychosocial consequences. One of the most dangerous is hypertension. Lifestyle changes related to eating behaviour and physical activity are the critical components in the prevention and treatment of hypertension and obesity. Data indicates that the usual procedures to promote these healthy habits in health services are either insufficient or not efficient enough. Internet has been shown to be an effective tool for the implementation of lifestyle interventions based on this type of problem. This study aims to assess the efficacy of a totally self-administered online intervention programme versus the usual medical care for obese and overweight participants with hypertension (from the Spanish public health care system) to promote healthy lifestyles (eating behaviour and physical activity).MethodA randomized controlled trial will be conducted with 100 patients recruited from the hypertension unit of a public hospital. Participants will be randomly assigned to one of two conditions: a) SII: a self-administered Internet-based intervention protocol; and b) MUC-medical usual care. The online intervention is an Internet-delivered, multimedia, interactive, self-administered programme, composed of nine modules designed to promote healthy eating habits and increase physical activity. The first five modules will be activated at a rate of one per week, and access for modules 5 to 9 will open every two weeks. Patients will be assessed at four points: before the intervention, after the intervention (3 months), and at 6 and 12 months (follow-up). The outcome variables will include blood pressure, and Body Mass Index, as primary outcome measures, and quality of life and other lifestyle and anthropometrical variables as secondary outcome measures.DiscussionThe literature highlights the need for more studies on the benefits of using the Internet to promote lifestyle interventions. This study aims to investigate the efficiency of a totally self-administered Internet − +based programme for promoting healthy habits and improving the medical indicators of a hypertensive and overweight population.Trial registrationNCT02445833

Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review

“…In approximately two-thirds of the interventions, specific behavioral change theories were mentioned as applied. Interventions that did not specify behavior change theories referred to behavioral strategies or techniques as crucial factors for behavior change [18,50,52,55,58,62, 64,67-70,75,78-82]. Multimedia Appendix 7 shows an overview of the behavior change theories specified as applied in the weight loss and weight loss maintenance interventions.…”

“…Several technologies supporting weight loss maintenance stimulated motivation through motivational feedback messages and praise , often personalized and automated [47,51,53,54,56,57,62]. These messages were applied to motivate the user to stay on course or to provide support on good or bad days, often connected to self-reported feelings, weight (eg, when weight enters a red zone ), or behaviors related to activities or food.…”

An internet-based approach for lifestyle changes in patients with NAFLD: Two-year effects on weight loss and surrogate markers

“…The number of internet-based approaches for lifestyle changes in self-management programs has increased in several settings, both in adolescents and in adults, [25][26][27] and in different non-communicable diseases. [28][29][30][31][32] The most recent approaches allow for interaction with therapists, and also with peers in discrete groups, while maintaining privacy. Accordingly, they tend to overcome the drawbacks of classical approaches, based on face-to-face or group-based meetings with counselors, reaching the limited audience able to attend the clinic during working hours, in countries where treatment is regulated by a universal healthcare system, or are able to pay for private treatment.…”

Analysis of the efficacy of an internet-based self-administered intervention (“Living Better”) to promote healthy habits in a population with obesity and hypertension: An exploratory randomized controlled trial

“…Once patients agreed to participate, they were asked for their informed consent at the hospital, and allocated to one of two groups: IG and CG. Randomizations were performed using random allocation software (with the program Epidat 4.1) [29].…”