Intervention Use and Action Planning in a Web-Based Computer-Tailored Weight Management Program for Overweight Adults: Randomized Controlled Trial

Abstract

BackgroundThere are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used.ObjectiveThe aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain; and to examine the quality of the goals and action plans that were generated using the online planning tools.MethodsData were obtained with a randomized controlled effect evaluation trial in which the online computer-tailored intervention was compared to a website containing generic information about prevention of weight gain. The tailored intervention included self-regulation techniques such as personalized feedback, goal setting, action planning, monitoring, and other techniques aimed at weight management. Participants included 539 overweight adults (mean age 46.9 years, mean body mass index [BMI] 28.03 kg/m2, 31.2% male, 11% low education level) recruited from the general population. Use of the intervention and its planning tools were derived from server registration data. Physical activity, fat intake, motivational factors, and self-regulation skills were self-reported at baseline. Descriptive analyses and logistic regression analyses were used to analyze the results.ResultsUse of the tailored intervention decreased sharply after the first modules. Visiting the first tailored intervention module was more likely among participants with low levels of fat intake (OR 0.77, 95% CI 0.62-0.95) or planning for change in PA (OR 0.23, 95% CI 0.05-0.97). Revisiting the intervention was more likely among participants high in restrained eating (OR 2.45, 95% CI 1.12-5.43) or low in proactive coping skills for weight control (OR 0.28, 95% CI 0.10-0.76). The planning tools were used by 5%-55% of the participants, but only 20%-75% of the plans were of good quality.ConclusionsThis study showed that psychological factors such as self-regulation skills and action planning were associated with repeated use of an online, computer-tailored self-regulation intervention aimed at prevention of weight gain among adults being overweight. Use of the intervention was not optimal, with a limited number of participants who visited all the intervention modules. The use of the action and coping planning components of the intervention was mediocre and the quality of the generated plans was low, especially for the coping plans. It is important to identify how the use of action planning and coping planning components in online interventions can be promoted and how the quality of plans generated through these tools can be improved.Trial RegistrationNetherlands Trial Register: NTR1862; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1862 (Archived by WebCite at http://www.webcitation.org/6QG1ZPIzZ).

Who Uses Action Planning in a Web‐Based Computer‐Tailored Intervention to Reduce Workplace Sitting and What do Action Plans Look Like? Analyses of the Start to stand Intervention among Flemish Employees

“…However, overall attrition is a common plague in eHealth interventions, and losses of up to 60–80 per cent of participants have been reported elsewhere (Geraghty, Torres, Leykin, Perez‐Stable, & Munoz, ). Compared to the present study, previous eHealth interventions including planning tools showed a similar number of planning tool users in dietary intake (18–58%) and physical activity (16–64%) (van Genugten, van Empelen, & Oenema, ; Storm et al., ; Van der Mispel et al., ) interventions. In one study, the intervention component with the highest attrition was action planning (compared to other intervention components such as, for example, self‐monitoring) (Van der Mispel et al., ).…”

Short- and Medium-Term Efficacy of a Web-Based Computer-Tailored Nutrition Education Intervention for Adults Including Cognitive and Environmental Feedback: Randomized Controlled Trial

“…However, to fit with self-regulation, participants formulated their own goals and plans [ 72 ]. This may have resulted in goals and plans of low quality, as is found in another Web-based computer-tailored intervention [ 73 ]. Goals and plans of low quality may decrease the effects of self-regulation on behavior.…”

“…Another reason for finding small ES may be the nonoptimal exposure to the different modules and sessions, which often happens in Internet interventions [ 73 , 74 ]. In addition, participants could choose their own target behavior(s) and were consequently not necessarily exposed to all modules.…”

Long-term efficacy of a Web-based computer-tailored nutrition education intervention for adults including cognitive and environmental feedback: a randomized controlled trial

“…For example, the progression and maintenance of the behavior change were targeted in the second and third session of the intervention. However, exposure to these two follow-up sessions was very low, which is often observed in online interventions [ 66 , 67 ]. Consequently, participants may have not sufficiently integrated self-regulation skills in daily life, which may have resulted in not adopting new habits.…”