How does usage of a weight-management intervention vary by context? The story of POWeR

Abstract

Background: POWeR, a web-based weight management intervention, has been trialled in a range of implementation settings. We provide an in-depth comparison of previously unexplored usage patterns across these settings using new visualisation software. Methods: A feasibility trial (N=179) and full RCT (N=834) compared the effect of POWeR with varying levels of nurse support. A community-based public health trial examined the role of brief telephone coaching (N=786). A workplace-based observational study examined usage of POWeR alongside a supplemental Smartphone app (N=942). Findings: Visual analysis enabled comparison of usage patterns within and across each study. For example, a greater proportion of app users than web-only users in the workplace study accessed problem solving advice (33.33% vs. 9.30%), X2(1,N=942)=31.17, p<.001, and optional content (18.33% vs. 4.08%), X2(1, N=942)=21.16, p<.001. Discussion: Comparison of usage patterns across and within different implementation settings can generate explanations for continued engagement or disengagement with health behaviour change interventions, thus helping to improve future implementation.