Adherence and Attrition in a Web-Based Lifestyle Intervention for People with Metabolic Syndrome.

Leila Jahangiry, Davoud Shojaeizadeh, Ali Montazeri, Mahdi Najafi, Kazem Mohammad, Mehdi Yaseri
Author Information
  1. Leila Jahangiry: 1. Dept. of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences , Tabriz, Iran.
  2. Davoud Shojaeizadeh: 2. Dept. of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.
  3. Ali Montazeri: 3. Mental Health Research Group, Health Metrics Research Center, Iranian Institutesfor Health Sciences Research, ACECR , Tehran, Iran.
  4. Mahdi Najafi: 4. Tehran Heart Center, Tehran University of Medical Sciences , Tehran, Iran.
  5. Kazem Mohammad: 5. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.
  6. Mehdi Yaseri: 5. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.

Abstract

BACKGROUND: The aim of this study was to determine adherence and attrition rates in a lifestyle intervention for people with metabolic syndrome.
METHODS: Adherence and attrition data from a randomized controlled trial were collected. Participants were classified as adherence group if they completed assessments at 3 and 6 months follow-up and as attrition group if they did not. Physical activity and quality of life was measured using the International Physical Activity Questionnaire (IPAQ) and the Short Form Health Survey (SF-36). Generalized Estimating Equations (GEE) was used to explore predictors of attrition.
RESULTS: The mean age of participants (n=160) was 44.1 years. Attrition rate in the intervention and control groups at first follow-up were the same (20%). However, the control group had significantly higher attrition rate (%33.7) compared to the intervention group (%20) at 6 months follow up. Results showed that low educated participants were more likely to not stay in the study than better educated participants (OR=2.95,CI:1.39-6.33,P=0.05). According with length of the study, attrition was decreased at six month (OR=0.66,CI:0.52-0.83,P<0.001). Also, some aspects of health-related quality of life contributed to the attrition rate. Those who had higher scores on general health (OR=0.66,CI:0.54-0.97,P=0.023), social functioning (OR=0.44,CI:0.40-0.76,P=0.032), role emotional (OR=0.74,CI:0.54-0.98,P=0.18), vitality (OR=0.55,CI:0.38-0.90,P=0.015) and mental health (OR=0.63,CI:0.45-0.85,P=0.033) were more likely to stay in the study.
CONCLUSION: It remains a concern that Web-based lifestyle programs may fail to reach those who need it most. Participant in the study generally had better quality of life than those who were lost to follow up.

Keywords

References

  1. Circulation. 2002 Dec 17;106(25):3143-421 [PMID: 12485966]
  2. BMC Public Health. 2014 Jul 24;14:748 [PMID: 25059121]
  3. J Med Internet Res. 2010 Feb 17;12(1):e4 [PMID: 20164043]
  4. J Med Internet Res. 2006 Sep 29;8(3):e20; author reply e21 [PMID: 17032636]
  5. Ageing Res Rev. 2011 Sep;10(4):487-97 [PMID: 21628005]
  6. Arch Iran Med. 2010 May;13(3):243-4 [PMID: 20433230]
  7. J Med Internet Res. 2007 May 09;9(2):e11 [PMID: 17513282]
  8. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004274 [PMID: 16235356]
  9. Rev Endocr Metab Disord. 2013 Sep;14(3):241-54 [PMID: 23943309]
  10. Diabet Med. 2009 Jul;26(7):745-6 [PMID: 19573127]
  11. J Med Internet Res. 2007 Jan 22;9(1):e1 [PMID: 17478410]
  12. Obesity (Silver Spring). 2006 Mar;14(3):377-82 [PMID: 16648607]
  13. JAMA. 2003 Apr 23-30;289(16):2083-93 [PMID: 12709466]
  14. J Med Internet Res. 2009 Apr 24;11(2):e13 [PMID: 19403466]
  15. Arterioscler Thromb Vasc Biol. 2004 Feb;24(2):e13-8 [PMID: 14766739]
  16. Diabetes Care. 2009 Jun;32(6):1092-7 [PMID: 19279302]
  17. J Am Coll Cardiol. 2010 Sep 28;56(14):1113-32 [PMID: 20863953]
  18. J Med Internet Res. 2011 Feb 14;13(1):e17 [PMID: 21320854]
  19. Am J Prev Med. 2007 Jul;33(1):54-64 [PMID: 17572313]
  20. J Med Internet Res. 2011 Jan 06;13(1):e2 [PMID: 21212045]
  21. J Med Internet Res. 2004 May 28;6(2):e15 [PMID: 15249264]
  22. Br J Psychiatry. 2008 Sep;193(3):181-4 [PMID: 18757972]
  23. J Med Internet Res. 2005 Mar 31;7(1):e11 [PMID: 15829473]
  24. Patient Prefer Adherence. 2008 Feb 02;2:57-65 [PMID: 19920945]
  25. J Gen Intern Med. 2007 Dec;22(12):1695-703 [PMID: 17922167]
  26. Health Technol Assess. 2007 Nov;11(48):iii, ix-105 [PMID: 17999843]
  27. J Med Internet Res. 2002 Dec;4(3):E17 [PMID: 12554548]
  28. Diabet Med. 2006 May;23(5):469-80 [PMID: 16681555]
  29. Qual Life Res. 2005 Apr;14(3):875-82 [PMID: 16022079]
  30. Lancet. 2005 Apr 16-22;365(9468):1415-28 [PMID: 15836891]
  31. J Med Internet Res. 2011 Dec 27;13(4):e117 [PMID: 22201703]