JMIR Publications

ABSTRACT

Background:

Web-based health/lifestyle-related courses have the potential to increase disease-related knowledge and facilitate lifestyle changes in people living with multiple sclerosis (plwMS). However, a limited number of studies have evaluated engagement with online learning by plwMS and factors influencing this engagement. The present study assessed the effectiveness of a novel 6-week web-based lifestyle-related course (the Multiple Sclerosis Online Course [MSOC]) for improving health outcomes in plwMS as part of a large, international randomised controlled trial (RCT). In the present study, we evaluated participant engagement with the MSOC and preliminary outcomes.

Objective:

To quantitatively assess course engagement, motivators, and barriers to course completion, satisfaction levels, forum engagement, and intentions for lifestyle change among MSOC participants as part of the larger RCT.

Methods:

Sociodemographic and health data were collected in a baseline survey completed prior to course commencement. Summary statistics were used to examine the following in course completers: motivators to course completion, course satisfaction, prior knowledge of the course, participation in a facilitated forum, and intentions to adopt lifestyle changes and in course non-completers: barriers to course completion. Chi-square and t-tests were utilised to examine differences between the two study arms – the MSOC intervention course (IC) and standard-care course (SCC). Multivariate linear regression models assessed the course-, sociodemographic-, and health-related factors associated with participants’ intentions for lifestyle change, adjusting for baseline lifestyle behaviours. Additionally, moderation analyses were undertaken to explore potential effects of study arm allocation. possible effects of study arm.

Results:

Of 857 participants enrolled in the RCT who completed the baseline survey, 442 (51.6%) completed the MSOC (218 IC, 224 SCC). Of these, 291 completed the evaluation survey; 88% (254/291) were course completers and 12% (37/291) were non-completers. Primary motivating factors underlying course completion included: the desire to participate in MS research, to optimise health, course flexibility (self-paced learning), and the perception of course content as relevant and useful. Primary barriers to course completion included personal time constraints and technical issues. The majority of course completers rated the MSOC as “excellent/very good” (73% IC and 61% SCC; p=0.17). Many engaged with the facilitator-led community forum (44% IC and 25% SCC; p=0.003). Preliminary effectiveness was evidenced by a significant proportion of course completers expressing their intentions to adopt lifestyle changes as a result of the course. In particular, more IC-completers expressed intentions to alter their diet (71% vs 58%, p=0.036), and increase sun exposure (66% vs 50%, p=0.014), supplement with omega-3 (67% vs 48%; p=0.004), and practice meditation (69% vs 52%, p=0.009). High course satisfaction, engagement with a facilitated forum, new course content, and expressing an interest in seeking additional information were associated with intentions to adopt lifestyle changes across study arms.

Conclusions:

Findings support the utility of this web-based lifestyle intervention for providing MS-related knowledge and encouraging lifestyle changes among plwMS.Insights into the factors influencing course completion and lifestyle change identified in the current study such a facilitated forum may guide the development of future online health interventions for plwMS. Clinical Trial: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001605886