Bradbury Katherine, Dennison Laura, Little Paul, Yardley Lucy
Centre for Applications of Health Psychology, University of Southampton, UK.
Br J Health Psychol. 2015 Feb;20(1):45-55. doi: 10.1111/bjhp.12125. Epub 2014 Nov 19.
This article illustrates the use of mixed methods in the development and evaluation of the Positive Online Weight Reduction (POWeR) programme, an e-health intervention designed to support sustainable weight loss. The studies outlined also explore how human support might enhance intervention usage and weight loss.
Mixed methods were used to develop and evaluate POWeR. In the development phase, we drew on both quantitative and qualitative findings to plan and gain feedback on the intervention. Next, a feasibility trial, with nested qualitative study, explored what level of human support might lead to the most sustainable weight loss. Finally, a large community-based trial of POWeR, with nested qualitative study, explored whether the addition of brief telephone coaching enhances usage.
Findings suggest that POWeR is acceptable and potentially effective. Providing human support enhanced usage in our trials, but was not unproblematic. Interestingly, there were some indications that more basic (brief) human support may produce more sustainable weight loss outcomes than more regular support. Qualitative interviews suggested that more regular support might foster reliance, meaning patients cannot sustain their weight losses when support ends. Qualitative findings in the community trial also suggested explanations for why many people may not take up the opportunity for human support.
Integrating findings from both our qualitative and quantitative studies provided far richer insights than would have been gained using only a single method of inquiry. Further research should investigate the optimum delivery of human support needed to maximize sustainable weight loss in online interventions. Statement of contribution What is already known on this subject? There is evidence that human support may increase the effectiveness of e-health interventions. It is unclear what level of human support might be optimal or how human support improves effectiveness. Triangulation of quantitative and qualitative methods can be used to inform the design and implementation of interventions What does this study add? This paper demonstrates the value of a mixed methods approach when developing and evaluating an intervention. Qualitative methods provided complementary insights into the optimal level of human support. Brief human support is valued by some and may enhance usage and outcomes of an e-health intervention for weight loss.
本文阐述了混合方法在积极在线减重（POWeR）计划的开发与评估中的应用，该计划是一项旨在支持可持续减重的电子健康干预措施。所概述的研究还探讨了人力支持如何能够提高干预措施的使用率以及促进减重。
采用混合方法来开发和评估POWeR。在开发阶段，我们利用定量和定性研究结果来规划干预措施并获取反馈。接下来，进行了一项可行性试验，并嵌套了定性研究，以探究何种程度的人力支持可能带来最可持续的减重效果。最后，开展了一项基于社区的大型POWeR试验，并嵌套了定性研究，以探究增加简短电话指导是否能提高使用率。
研究结果表明POWeR是可接受的且可能有效。在我们的试验中，提供人力支持提高了使用率，但并非毫无问题。有趣的是，有迹象表明，相较于更常规的支持，更基础（简短）的人力支持可能会产生更可持续的减重效果。定性访谈表明，更常规的支持可能会助长依赖心理，这意味着当支持结束时，患者无法维持减重效果。社区试验中的定性研究结果还对许多人可能不利用人力支持机会的原因给出了解释。
整合定性和定量研究的结果所提供的见解远比仅使用单一探究方法所获得的见解丰富得多。进一步的研究应调查在在线干预中为实现最大程度的可持续减重所需的人力支持的最佳提供方式。贡献声明 关于该主题已知的信息有哪些？有证据表明人力支持可能会提高电子健康干预措施的有效性。目前尚不清楚何种程度的人力支持可能是最佳的，也不清楚人力支持如何提高有效性。定量和定性方法的三角互证可用于为干预措施的设计和实施提供信息 本研究增加了什么内容？本文展示了混合方法在开发和评估一项干预措施时的价值。定性方法为人力支持的最佳水平提供了补充见解。一些人重视简短的人力支持，这可能会提高一项减重电子健康干预措施的使用率和效果。
