Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 11, 2024
Date Accepted: Jul 2, 2024
Sociodemographic, health, and lifestyle-related characteristics associated with course commencement and completion of a web-based lifestyle educational program for people with multiple sclerosis: Randomized Controlled Trial
ABSTRACT
Background:
Digital health interventions increase access to multiple sclerosis (MS) related knowledge for people with MS, however our understanding of factors associated with engagement in online learning is limited.
Objective:
To examine associations between participant sociodemographic, health, and lifestyle-related characteristics with commencement and completion of the MS Online Course (MSOC) in a randomized controlled trial (RCT).
Methods:
The intervention course (IC), based on the Overcoming MS program, an evidence-based lifestyle modification program in MS, and a standard-care course (SCC), based on international MS websites’ information, were developed. An RCT was conducted to compare the effectiveness of the IC vs SCC at improving health outcomes. Participant data were collected from a baseline survey. Associations between baseline participant characteristics and MSOC commencement and completion were assessed utilizing multivariate log-binomial regression.
Results:
1,893 participants enrolled in the RCT, 857 (45%) completed the baseline survey, 444 (23%) in the IC and 413 (22%) in the SCC. Of these 857 participants, 74% commenced the SCC or IC, and 49% and 54% completed the IC and SCC, respectively. University education, partnered relationship status, higher mental and physical quality of life (QoL), and omega-3 supplementation were associated with 19%, 12%, 20%, 22% and 14% higher rates of course commencement, respectively. Clinically significant fatigue was associated with a 10% reduction in likelihood of commencement. Strongest associations with IC completion included middle adulthood (96%), male sex (27%) fatigue (24%), and pre-existing adherence to a diet program (19%) whereas higher self-efficacy was associated with up to 35% lower IC completion. Associations with SCC completion included practising meditation (20%), whereas employment was associated with 22% lower completion.
Conclusions:
Sociodemographic and clinical potentially lifestyle-related factors are important in participation and completion of the MSOC. These data may help guide the design and enhancement of digital health interventions tailored for people with MS. Clinical Trial: Australian and New Zealand Clinical Trials Registry: ACTRN: ACTRN12621001605886
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