Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, United States.
Department of Psychology, University of South Carolina, Columbia, SC, United States.
J Med Internet Res. 2023 Apr 12;25:e42581. doi: 10.2196/42581.
Web-based tailored interventions offer rich opportunities for improved access to and personalization of behavioral interventions. However, despite the promise of this approach, the engagement and underrepresentation of minority groups remain major issues.
This study evaluated whether engagement (log-in status and log-in duration) with different types of tailored behavioral content from the Families Improving Together for weight loss web-based intervention was associated with changes in moderate to vigorous physical activity (MVPA) among African American families with overweight or obesity.
Parent-adolescent dyads were randomized to a web-based tailored intervention or web-based health education comparison program. The web-based intervention (N=119) was completed by parents and targeted 6 weight-related behaviors to support their adolescent children's weight loss goals (session contents included energy balance, fast food, fruits and vegetables, physical activity [PA], sedentary behavior, and sweetened beverages). MVPA was measured using accelerometers at baseline and after the intervention.
Using a hierarchical approach, the log-in status and duration for each web-based session were used to evaluate the additive effects of engagement with different types of tailored behavioral content on MVPA after the web-based intervention. Among parents, logging in to the PA session was not associated with greater MVPA (B=-12.561, 95% CI -18.759 to -6.367), but MVPA increased with greater log-in duration for the PA (B=0.008, 95% CI 0.004-0.012) and sedentary behavior (B= 0.008, 95% CI 0.004-0.012) sessions. These results suggest that parents who logged in to the PA session had lower MVPA, but MVPA increased with greater log-in duration for the PA and sedentary behavior sessions. These associations remained even after accounting for engagement with other content sessions. However, these engagement effects did not translate to the adolescents.
The results of this study highlight the need to disentangle the impact of engagement with different tailored content to improve the efficacy of tailored web-based interventions, especially for promoting PA in African American families.
ClinicalTrials.gov NCT01796067; https://clinicaltrials.gov/ct2/show/NCT01796067.
基于网络的定制干预为改善行为干预的可及性和个性化提供了丰富的机会。然而，尽管这种方法有很大的前景，但少数民族群体的参与度和代表性仍然是主要问题。
本研究评估了在超重或肥胖的非裔美国家庭中，参与 Families Improving Together 减肥网络定制干预的不同类型定制行为内容（登录状态和登录持续时间）是否与中度至剧烈体力活动（MVPA）的变化相关。
家长-青少年对子被随机分配到基于网络的定制干预或基于网络的健康教育比较方案中。基于网络的干预（N=119）由父母完成，针对 6 种与体重相关的行为，以支持他们青少年孩子的减肥目标（课程内容包括能量平衡、快餐、水果和蔬菜、体力活动[PA]、久坐行为和含糖饮料）。在干预前后使用加速度计测量 MVPA。
使用分层方法，根据每个基于网络的课程的登录状态和持续时间，评估参与不同类型的定制行为内容对基于网络干预后 MVPA 的附加影响。在父母中，登录 PA 课程与更高的 MVPA 无关（B=-12.561，95%CI-18.759 至-6.367），但 PA 和久坐行为课程的登录持续时间增加与更高的 MVPA 相关（B=0.008，95%CI 0.004-0.012）。这些结果表明，登录 PA 课程的父母 MVPA 较低，但 PA 和久坐行为课程的登录持续时间增加与更高的 MVPA 相关。即使考虑到与其他内容课程的参与度，这些关联仍然存在。然而，这些参与效果并没有转化为青少年。
本研究结果强调需要解开不同定制内容参与的影响，以提高定制网络干预的效果，特别是在促进非裔美国家庭的 PA 方面。
ClinicalTrials.gov NCT01796067；https://clinicaltrials.gov/ct2/show/NCT01796067。
