Usage analysis of engagement in an online weight-management intervention

Abstract

Background: Online interventions have the potential to provide support for weight management, but engagement is typically limited. Positive Online Weight Management Plus (POWeR+) is an automated online intervention to support weight management based on the principles of self-determination theory. It succeeded in aiding weight loss over a period of 12 months. Aims: To investigate patterns of engagement throughout the intervention, and to investigate associations between engagement with intervention components and outcomes. Methods: POWeR+ consisted of 25 online informational sessions and a weekly weight, eating and physical activity goal review which could be completed for up to a year. 536 participants were randomised to an intervention group and their usage was objectively recorded by the website. An online tool designed to create visualisations of large usage datasets, and statistical analysis was used to explore overall patterns of usage Findings: Good user engagement was observed throughout the intervention. High usage was prompted by factors such as email reminders and unlocking new content in timed stages. Particularly promising engagement was observed in the self-regulatory goal setting module, with a mean of 10.72 (SD=12.60) weekly goal reviews completed, indicating habit formation. Engagement with goal review was higher in participants whose subjective perceptions of having met goals was high. Number of goal reviews completed and number of sessions started was positively associated with weight loss. Discussion: The analysis provides encouraging confirmation that there is an association between engagement and behavioural outcomes. It highlights the potential for linking specific intervention components, and therefore theory, to outcomes.