Effectiveness of User- and Expert-Driven Web-based Hypertension Programs: an RCT

Liu, Sam; Brooks, Dina; Thomas, Scott; Eysenbach, Günther; Nolan, Robert P.

doi:10.1016/j.amepre.2018.01.009

Cited by 43 publications

(102 citation statements)

References 18 publications

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“…The study characteristics are presented in Table 1 . The identified articles included 6 areas of chronic health conditions: arthritis (n=1) [ 25 ], celiac disease (n=1) [ 26 ], metabolic disorders other than weight issues (n=8; metabolic syndrome [ 27 ], cardiac condition [ 28 ], hypertension [ 29 ], type 2 diabetes [ 30 - 33 ], and GDM [ 34 ]), multiple sclerosis (n=1) [ 35 ], overweight and obesity (n=7 studies) [ 13 , 36 - 41 ], and respiratory diseases (n=2; asthma [ 42 ] and COPD [ 43 ]). No study related to epilepsy, inflammatory bowel disease, or chronic kidney disease was found.…”

Section: Resultsmentioning

confidence: 99%

“…Among the selected studies, goal setting (n=11) and self-monitoring (n=13) were frequently reported. The participants were able to select their goal from a predetermined area (eg, physical activity or dietary habits) [ 27 , 29 , 36 - 38 ] or the goal was provided by the research team at the beginning of the intervention [ 13 , 29 , 30 , 40 , 41 , 43 ]. The predetermined topics were chosen according to clinical guidelines [ 13 , 29 , 37 , 41 ] based on participants’ self-reported physical activity baseline information (eg, number of steps) [ 30 , 43 ] or self-reported performance from the previous week [ 33 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

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Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence

Xie¹,

Itzkovitz²,

Roy‐Fleming³

et al. 2020

J Med Internet Res

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Background Chronic diseases contribute to 71% of deaths worldwide every year, and an estimated 15 million people between the ages of 30 and 69 years die mainly because of cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Web-based educational interventions may facilitate disease management. These are also considered to be a flexible and low-cost method to deliver tailored information to patients. Previous studies concluded that the implementation of different features and the degree of adherence to the intervention are key factors in determining the success of the intervention. However, limited research has been conducted to understand the acceptability of specific features and user adherence to self-guided web interventions. Objective This systematic review aims to understand how web-based intervention features are evaluated, to investigate their acceptability, and to describe how adherence to web-based self-guided interventions is defined and measured. Methods Studies published on self-guided web-based educational interventions for people (≥14 years old) with chronic health conditions published between January 2005 and June 2020 were reviewed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement protocol. The search was performed using the PubMed, Cochrane Library, and EMBASE (Excerpta Medica dataBASE) databases; the reference lists of the selected articles were also reviewed. The comparison of the interventions and analysis of the features were based on the published content from the selected articles. Results A total of 20 studies were included. Seven principal features were identified, with goal setting, self-monitoring, and feedback being the most frequently used. The acceptability of the features was measured based on the comments collected from users, their association with clinical outcomes, or device adherence. The use of quizzes was positively reported by participants. Self-monitoring, goal setting, feedback, and discussion forums yielded mixed results. The negative acceptability was related to the choice of the discussion topic, lack of face-to-face contact, and technical issues. This review shows that the evaluation of adherence to educational interventions was inconsistent among the studies, limiting comparisons. A clear definition of adherence to an intervention is lacking. Conclusions Although limited information was available, it appears that features related to interaction and personalization are important for improving clinical outcomes and users’ experience. When designing web-based interventions, the selection of features should be based on the targeted population’s needs, the balance between positive and negative impacts of having human involvement in the intervention, and the reduction of technical barriers. There is a lack of consensus on the method of evaluating adherence to an intervention. Both investigations of the acceptability features and adherence should be considered when designing and evaluating web-based interventions. A proof-of-concept or pilot study would be useful for establishing the required level of engagement needed to define adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence

Xie¹,

Itzkovitz²,

Roy‐Fleming³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…With the advancement in Internet-enabled digital devices (e.g., smartphones, tablets, computers, wearables) and improved access to the Internet, there is emerging evidence these innovative digital technologies can help deliver population-based chronic disease prevention programs without overtaxing health-care resources [ 33 – 35 ]. Future studies need to examine the effectiveness, implementation and scale-up of these Internet-based interventions aimed to manage childhood obesity.…”

Section: Discussionmentioning

confidence: 99%

“…ES effect size, SD Standard Deviation, CI Confidence intervals. *p < 0.05 evidence these innovative digital technologies can help deliver population-based chronic disease prevention programs without overtaxing health-care resources [33][34][35]. Future studies need to examine the effectiveness, implementation and scale-up of these Internet-based interventions aimed to manage childhood obesity.…”

Section: Outcomementioning

confidence: 99%

Evaluation of the scale-up and implementation of mind, exercise, nutrition … do it! (MEND) in British Columbia: a hybrid trial type 3 evaluation

Liu

Weismiller²,

Strange³

et al. 2020

BMC Pediatr

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Background: The Mind, Exercise, Nutrition … Do it! (MEND) childhood obesity intervention was implemented in British Columbia (B.C.), Canada from April 2013 to June 2017. The study objective was: a) to describe and explore program reach, attendance, satisfaction, acceptability, fidelity, and facilitators and challenges during scale-up and implementation of MEND in B.C. while b) monitoring program effectiveness in improving children's body mass index (BMI) z-score, waist circumference, dietary and physical activity behaviours, and psychological well-being. Methods: This prospective, pragmatic implementation evaluation (Hybrid Type 3 design) recruited families with children and adolescents aged 7-13 with a BMI ≥ 85th percentile for age and sex. The 10-week MEND B.C. program was delivered in 27 sites, throughout all five B.C. health regions (Northern, Interior, Island, Fraser, and Vancouver Coastal) over 4 years. Families attended two weekly in-person group sessions aimed to increase physical activity and promote healthy eating. BMI z-score and waist circumference were measured at baseline and follow-up. Dietary and physical activity behaviours and psychological well-being were measured using validated questionnaires. A mixedmethod approach was used to collect and analyze the data. Results: One hundred thirty-six MEND B.C. programs were delivered over 4 years. The program reached 987 eligible participants. 755 (76.5%) children and adolescents completed the program. The average program attendance was 81.5%. Parents reported the program content was easy to understand, culturally suitable, respectful of family's financial situation, and provided adequate information to build a healthy lifestyle. Children achieved significant positive changes across all four evaluation years in BMI z-score (d = − 0.13), nutrition behaviours (d = 0.64), physical activity levels (d = 0.30), hours of screen time per week (d = − 0.38) and emotional distress (d = − 0.21). Challenges to continued program implementation included: recruitment, resource requirement for implementation, and the need to tailor the program locally to be more flexible and culturally relevant.

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“…With the advancement in Internet-enabled digital devices (e.g., smartphones, tablets, computers, wearables) and improved access to the Internet, there is emerging evidence these innovative digital technologies can help deliver population-based chronic disease prevention programs without overtaxing health-care resources [35][36][37]. Future studies need to examine the effectiveness, implementation and scale-up of these Internet-based interventions aimed to manage childhood obesity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Scale-up and Implementation of Mind, Exercise, Nutrition…Do It! (MEND) in British Columbia: A Hybrid Trial Type 3 Evaluation

Liu

Weismiller

Strange³

et al. 2020

Preprint

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Background The Mind, Exercise, Nutrition…Do it! (MEND) childhood obesity intervention was implemented in British Columbia (B.C.), Canada from April 2013 to June 2017. The study objective was: a) to describe and explore program reach, attendance, satisfaction, acceptability, fidelity, and facilitators and challenges to implementation during scale-up and implementation of MEND in B.C. while b) monitoring program effectiveness in improving children’s body mass index (BMI) z-score, waist circumference, dietary and physical activity behaviours, and psychological well-being.Methods This prospective, pragmatic implementation evaluation (Hybrid Type 3 design) recruited families with children aged 7-13 with a BMI ≥ 85th percentile for age and sex. The 10-week MEND B.C. program was delivered in 27 sites, throughout all five B.C. health regions (Northern, Interior, Island, Fraser, and Vancouver Coastal) over four years. A mixed-method approach was used to collect and analyze the data. Evaluation measures included: program reach, attendance, fidelity, acceptability, satisfaction, facilitators and challenges to implementation, and effectiveness (change in children’s BMI z-score, physical activity, screen-time, eating behaviours, self-esteem and emotional distress).Results 136 MEND B.C. programs were delivered over four years. The program reached 987 eligible children. 755 (76.5%) children completed the program. The average program attendance was 81.5%. Parents reported the program content was easy to understand, culturally suitable for their family, respectful of their family's financial situation and provided adequate information to build a healthy lifestyle. Children achieved significant positive changes across all four evaluation years in BMI z-score, nutrition behaviours, physical activity levels, hours of screen time per week and emotional distress (p<0.05). Challenges to continued program implementation included: recruitment, resource requirement for implementation and the need to tailor the program locally to be more flexible and culturally relevant.Conclusions Scaling up efficacious childhood obesity interventions into real-world settings is critical to combat the obesity epidemic. Future family-based childhood obesity management interventions need to explore strategies to enhance program delivery flexibility while optimizing the use of health care resources.

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Effectiveness of User- and Expert-Driven Web-based Hypertension Programs: an RCT

Cited by 43 publications

References 18 publications

Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence

Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence

Evaluation of the scale-up and implementation of mind, exercise, nutrition … do it! (MEND) in British Columbia: a hybrid trial type 3 evaluation

Evaluation of the Scale-up and Implementation of Mind, Exercise, Nutrition…Do It! (MEND) in British Columbia: A Hybrid Trial Type 3 Evaluation

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