%0 Journal Article
%@ 1438-8871
%I JMIR Publications Inc.
%V 17
%N 7
%P e177
%T Effect of a Web-Based Behavior Change Program on Weight Loss and Cardiovascular Risk Factors in Overweight and Obese Adults at High Risk of Developing Cardiovascular Disease: Randomized Controlled Trial
%A Watson,Sinead
%A Woodside,Jayne V
%A Ware,Lisa J
%A Hunter,Steven J
%A McGrath,Alanna
%A Cardwell,Christopher R
%A Appleton,Katherine M
%A Young,Ian S
%A McKinley,Michelle C
%+ Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Institute of Clinical Science Block B, Grosvenor Road, Belfast, BT12 6BJ, United Kingdom, 44 (0)28 9063 2685, m.mckinley@qub.ac.uk
%K Internet
%K randomized controlled trial
%K health behavior
%K weight loss
%K overweight
%K obesity
%D 2015
%7 16.07.2015
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Web-based programs are a potential medium for supporting weight loss because of their accessibility and wide reach. Research is warranted to determine the shorter- and longer-term effects of these programs in relation to weight loss and other health outcomes. Objective: The aim was to evaluate the effects of a Web-based component of a weight loss service (Imperative Health) in an overweight/obese population at risk of cardiovascular disease (CVD) using a randomized controlled design and a true control group. Methods: A total of 65 overweight/obese adults at high risk of CVD were randomly allocated to 1 of 2 groups. Group 1 (n=32) was provided with the Web-based program, which supported positive dietary and physical activity changes and assisted in managing weight. Group 2 continued with their usual self-care (n=33). Assessments were conducted face-to-face. The primary outcome was between-group change in weight at 3 months. Secondary outcomes included between-group change in anthropometric measurements, blood pressure, lipid measurements, physical activity, and energy intake at 3, 6, and 12 months. Interviews were conducted to explore participants’ views of the Web-based program. Results: Retention rates for the intervention and control groups at 3 months were 78% (25/32) vs 97% (32/33), at 6 months were 66% (21/32) vs 94% (31/33), and at 12 months were 53% (17/32) vs 88% (29/33). Intention-to-treat analysis, using baseline observation carried forward imputation method, revealed that the intervention group lost more weight relative to the control group at 3 months (mean –3.41, 95% CI –4.70 to –2.13 kg vs mean –0.52, 95% CI –1.55 to 0.52 kg, P<.001), at 6 months (mean –3.47, 95% CI –4.95 to –1.98 kg vs mean –0.81, 95% CI –2.23 to 0.61 kg, P=.02), but not at 12 months (mean –2.38, 95% CI –3.48 to –0.97 kg vs mean –1.80, 95% CI –3.15 to –0.44 kg, P=.77). More intervention group participants lost ≥5% of their baseline body weight at 3 months (34%, 11/32 vs 3%, 1/33, P<.001) and 6 months (41%, 13/32 vs 18%, 6/33, P=.047), but not at 12 months (22%, 7/32 vs 21%, 7/33, P=.95) versus control group. The intervention group showed improvements in total cholesterol, triglycerides, and adopted more positive dietary and physical activity behaviors for up to 3 months verus control; however, these improvements were not sustained. Conclusions: Although the intervention group had high attrition levels, this study provides evidence that this Web-based program can be used to initiate clinically relevant weight loss and lower CVD risk up to 3-6 months based on the proportion of intervention group participants losing ≥5% of their body weight versus control group. It also highlights a need for augmenting Web-based programs with further interventions, such as in-person support to enhance engagement and maintain these changes. Trial Registration: ClinicalTrials.gov NCT01472276; http://clinicaltrials.gov/ct2/show/study/NCT01472276 (Archived by Webcite at http://www.webcitation.org/6Z9lfj8nD). 
%M 26183659
%R 10.2196/jmir.3828
%U http://www.jmir.org/2015/7/e177/
%U https://doi.org/10.2196/jmir.3828
%U http://www.ncbi.nlm.nih.gov/pubmed/26183659