与多发性硬化症患者开始和完成基于网络的生活方式教育计划相关的社会人口学、健康和生活方式相关特征：随机对照试验。

Sociodemographic, Health, and Lifestyle-Related Characteristics Associated With the Commencement and Completion of a Web-Based Lifestyle Educational Program for People With Multiple Sclerosis: Randomized Controlled Trial.

机构信息

Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.

Institute for Clinical and Translational Science, University of California, Irvine, CA, United States.

出版信息

J Med Internet Res. 2024 Aug 28;26:e58253. doi: 10.2196/58253.

DOI:10.2196/58253

PMID:39197163

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11391162/

Abstract

BACKGROUND

Digital health interventions increase access to multiple sclerosis (MS)-related knowledge for people living with MS; however, our understanding of factors associated with engagement in web-based learning is limited.

OBJECTIVE

This study aims to examine associations between participant sociodemographic, health, and lifestyle-related characteristics and the commencement and completion of the Multiple Sclerosis Online Course (MSOC) in a randomized controlled trial (RCT).

METHODS

An intervention course was developed based on the Overcoming MS Program-an evidence-based lifestyle modification program for MS, and a standard care course was developed based on international MS website information. An RCT was conducted to compare the effectiveness of the intervention course versus the standard care course in improving health outcomes in people living with MS. Participant data were collected from a baseline survey. Associations between baseline participant characteristics and MSOC commencement and completion, respectively, were assessed using multivariate log-binomial regression.

RESULTS

Overall, 1893 participants enrolled in the RCT, and 45.27% (n=857) completed the baseline survey: 23.5% (n=444) in the intervention course and 21.8% (n=413) in the standard care course. Of these 857 participants, 631 (73.6%) commenced the standard care course or intervention course, and 49.1% (218/444) and 54.2% (224/413) completed the intervention course and standard care course, respectively. University education, partnered relationship status, and higher mental and physical quality of life were associated with 19%, 12%, 20%, and 22% higher rates of course commencement, respectively. Clinically significant fatigue was associated with a 10% reduction in the likelihood of commencement. Strongest associations with intervention course completion included middle and older adulthood, male sex, fatigue, and preexisting adherence to a diet program, with 96%, 27%, 24%, and 19% higher rates of completion observed, respectively, whereas higher self-efficacy was associated with up to 35% lower intervention course completion. Associations with standard care course completion included practicing meditation (20% higher completion), whereas employment was associated with 22% lower completion.

CONCLUSIONS

Sociodemographic and clinical factors, as well as lifestyle-related factors, were important factors in MSOC commencement and completion. These data may help guide the design and enhancement of digital health interventions tailored for people living with MS.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12621001605886; https://tinyurl.com/2vyve9p9.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12883-023-03298-0.

摘要

背景

数字健康干预措施增加了多发性硬化症（MS）患者获取相关知识的途径；然而，我们对参与网络学习的相关因素的理解还很有限。

目的

本研究旨在探讨参与者的社会人口学、健康和生活方式相关特征与多发性硬化在线课程（MSOC）开始和完成之间的关联，这是一项随机对照试验（RCT）。

方法

基于克服多发性硬化症计划（一种针对多发性硬化症的基于循证的生活方式改变计划）开发了干预课程，并基于国际多发性硬化症网站信息开发了标准护理课程。进行了一项 RCT，比较了干预课程与标准护理课程在改善 MS 患者健康结果方面的有效性。从基线调查中收集参与者数据。使用多变量对数二项式回归评估基线参与者特征与 MSOC 开始和完成之间的关联。

结果

总体而言，1893 名参与者参加了 RCT，其中 45.27%（n=857）完成了基线调查：干预课程 23.5%（n=444）和标准护理课程 21.8%（n=413）。在这 857 名参与者中，631 名（73.6%）开始了标准护理课程或干预课程，其中 49.1%（218/444）和 54.2%（224/413）分别完成了干预课程和标准护理课程。接受过大学教育、伴侣关系状况、较高的心理和生理生活质量与课程开始的可能性分别增加 19%、12%、20%和 22%相关。临床显著疲劳与开始的可能性降低 10%相关。与干预课程完成最强相关的因素包括中年和老年、男性、疲劳和预先坚持饮食计划，完成率分别观察到 96%、27%、24%和 19%的增加，而自我效能感较高则与完成干预课程的可能性降低 35%相关。与标准护理课程完成相关的因素包括练习冥想（完成率增加 20%），而就业与完成率降低 22%相关。