Submitted to: Journal of Medical Internet Research
Publication Type: Peer reviewed journal
Publication Acceptance Date: 11/21/2008
Publication Date: 12/31/2008
Citation: Ware, L.J., Hurling, R., Bataveljic, O., Fairley, B.W., Hurst, T.L., Murray, P., Rennie, K.L., Tomkins, C.E., Finn, A., Cobain, M.R., Pearson, D.A., Foreyt, J.P. 2008. Rates and determinants of uptake and use of an internet physical activity and weight management program in office and manufacturing work sites in England: Cohort Study. Journal of Medical Internet Research. 10(4):e56. Interpretive Summary: This study examined over a 12-week period the use or nonuse of an internet-based physical activity (PA) and weight management program aimed at employees. Specifically, the authors sought to determine if the program would be used by a wide range of employees at 4 different worksites and if certain characteristics of these employees made them more or less likely to use the program. The internet-based program used in this study was combined with PA and weight monitoring devices which sent captured data back to the Web program. The program also made use of weight management techniques known to be effective such as self monitoring and individualized feedback. The employee participation rate was 12%. This rate is similar to a 10% participation rate seen in another web-based workplace program; however, that program offered employees financial incentive to take part while this one did not. A wide range of workers showed high levels of engagement with the program including both men and women, overweight and obese workers, and shift workers. The frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight. The average PA level recorded throughout the program was 173 minutes of moderate/high intensity PA per week. Individuals with the greatest weight loss spent the most time on the Website and had a lower dropout rate. This study demonstrates that a Web-based weight management system can be successfully used in both office and manufacturing sites. The authors believe that the use of the monitoring devices to capture and send data to the automated web-based coaching program may have encouraged the high levels of engagement.
Technical Abstract: Internet-based physical activity (PA) and weight management programs have the potential to improve employees' health in large occupational health settings. To be successful, the program must engage a wide range of employees, especially those at risk of weight gain or ill health. The aim of the study was to assess the use and nonuse (user attrition) of a Web-based and monitoring device-based PA and weight management program in a range of employees and to determine if engagement with the program was related to the employees' baseline characteristics or measured outcomes. Longitudinal observational study of a cohort of employees having access to the MiLife Web-based automated behavior change system. Employees were recruited from manufacturing and office sites in the Northwest and the South of England. Baseline health data were collected, and participants were given devices to monitor their weight and PA via data upload to the website. Website use, PA, and weight data were collected throughout the 12-week program. Overall, 12% of employees at the four sites (265/2302) agreed to participate in the program, with 130 men (49%) and 135 women (51%), and of these, 233 went on to start the program. During the program, the dropout rate was 5% (11/233). Of the remaining 222 Web program users, 173 (78%) were using the program at the end of the 12 weeks, with 69% (153/222) continuing after this period. Engagement with the program varied by site but was not significantly different between the office and factory sites. During the first 2 weeks, participants used the website, on average, 6 times per week, suggesting an initial learning period after which the frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight (-2.6 kg, SD 3.2, P< .001). The reduction in weight was largest for employees using the program's weight loss mode (-3.4 kg, SD 3.5). Mean PA level recorded throughout the program was 173 minutes (SE 12.8) of moderate/high intensity PA per week. Website interaction time was higher and attrition rates were lower (OR 1.38, P= .03) in those individuals with the greatest weight loss. This Web-based PA and weight management program showed high levels of engagement across a wide range of employees, including overweight or obese workers, shift workers, and those who do not work with computers. Weight loss was observed at both office and manufacturing sites. The use of monitoring devices to capture and send data to the automated Web-based coaching program may have influenced the high levels of engagement observed in this study. When combined with objective monitoring devices for PA and weight, both use of the website and outcomes can be tracked, allowing the online coaching program to become more personalized to the individual.