Predictors of Self-Determined Module Choice in a Web-Based Computer-Tailored Diet and Physical Activity Intervention: Secondary Analysis of Data From a Randomized Controlled Trial

Abstract

Background Tailoring an online intervention to participant preferences (eg, by giving participants a choice which modules to follow) may increase engagement in the intervention, motivation for behavioral change, and possibly intervention effects. So far, little is known about what characteristics predict these module choices. Filling this knowledge gap is useful for optimizing program engagement. Objective We investigated participant choice for a dietary and/or physical activity (PA) promotion module in our web-based computer-tailored intervention based on self-determination theory (SDT) and motivational interviewing (MI). Furthermore, we investigated which demographic characteristics, current behavior, psychosocial constructs and constructs from SDT and MI, and program-related variables such as advice on which module to follow were associated with these choices. Methods Observational data were used from the randomized controlled trial MyLifestyleCoach of participants who were randomized into the intervention condition, completed the baseline questionnaire, and made a module choice in the opening session of the intervention. Here, they received advice on their own dietary and PA behavior. At the session’s end, they chose which lifestyle modules they would like to follow (both, diet, PA, or no module). Measurements included demographic information; self-reported diet and PA; and several psychosocial, SDT, and MI constructs. In total, data from 619 Dutch adults (59.6% women; mean age was 51.9 [SD 13.5] years) were analyzed. A stepwise multinomial logistic regression analysis was conducted to investigate which characteristics are related to module choice; the diet module served as reference category as almost everyone was advised to follow this module. Results Of this sample, 54.8% (339/619) chose to do both the diet and PA module, 25.4% (157/619) chose to follow the diet module, 17.8% (110/619) preferred to follow no module, and 2.1% (13/619) chose to do the PA module only. Furthermore, it was found that older people, those who consumed more fruit, and those who scored lower on importance to change their current diet were more likely to choose no module compared to the diet module. People who had more motivation to change their current PA and those who received strong advice compared with slight advice to follow the diet module were more likely to choose both modules compared with the diet module only. Conclusions The results show that more than half of the sample was interested in following both the diet and PA module in this online lifestyle intervention. Several characteristics were found to be related to module choice. A future challenge is to examine how this knowledge can be used to improve future interventions, such as tailoring (messages or content) on specific groups or examining where and how MI could be used to motivate people to make a certain module choice. Trial Registration Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333

Use and Appreciation of a Web-Based, Computer-Tailored Diet and Physical Activity Intervention Based on the Self-determination Theory: Evaluation Study of Process and Predictors

“…In general, these findings are in line with previous literature [ 7 , 10 , 12 , 13 , 36 ]. Interestingly, a previous study by our research group discovered a trend that people with physical disabilities were less likely to choose the PA module on top of the diet module [ 22 ]. In this study, we found that they were more likely to complete the first session of the diet module when only the diet module was chosen.…”

“…Other psychosocial constructs, such as intention, could also be relevant to use. In a previous study, we found that these variables are highly correlated [ 22 ]. Therefore, we did not include these variables in our analyses to avoid multicollinearity.…”

“…The participants who decided to select no module received an email giving them the option to make a module choice again 2 weeks later. More information can be found elsewhere [ 22 ].…”

“…For example, the basic psychological need of autonomy can be implemented in an intervention by giving participants the option to choose what parts of the intervention they want to use and when they want to start with these parts or giving participants a choice on which behavior to work. One study found several characteristics, such as current lifestyle behavior, program features, and amotivation to engage in sufficient PA, to be related to module choice within a multiple health behavior intervention [ 22 ].…”

Use of Social Media, Network Avenues, Blog and Scientific Information Systems Through the Website Promoting the Mediterranean Diet as a Method of a Health Safeguarding

“…It is also the study of the relationship between food and health. Healthy nutrition is the key to keeping our bodies healthy (Maramba et al, 2019;Coumans et al, 2020). The Mediterranean Diet (MD) is considered by the Food and Agriculture Organization of the United Nations (FAO) as "the best for people and the most sustainable for the environment."…”