Adding an interactive online community to an Internet-based walking program can significantly decrease the number of participants who drop out, according to research conducted at the University of Michigan Medical School.
In the study, lead author Caroline Richardson, MD, associate professor of family medicine, and colleagues found that 79% of participants who used online forums to motivate each other stuck with the 16-week program, while only 66% of those who used a version of the site without the social components completed the program. Still, both groups saw equal improvements of about one mile per day in how much they walked while using the program’s web interface to track their progress.
The findings, scheduled to be published this month in the Journal of Medical Internet Research
, show that adding community features to online health programs can be a powerful tool for reducing attrition, according to Richardson. The approach can also potentially produce significant savings compared to traditional interventions, such as face-to-face coaching, which can be expensive to implement on a large scale.
“Brick by brick we have been building a model of how to change health behaviors using online tools,” said Richardson in a statement
. “We can see that social components can help to mitigate the big downside that Internet-mediated programs have had in the past, namely attrition.”
For health programs with a national or international scope, even small reductions in attrition could lead to positive health outcomes for large numbers of people and significant system-wide cost savings.
While one-on-one interventions can cost hundreds or thousands of dollars, the web-based approach has the potential to deliver similar results at a much lower cost. The pedometers used in Richardson’s program cost $34 each. A website like the one they used is somewhat expensive to set up, but becomes cheaper on a per-person basis over time and as the size of the program increases. Plus, much of the content is provided for free by participants as they share tips and encouragement.
“There’s already a huge demand for change that we’re not meeting in the health system,” she said, adding that many people want to change their lifestyle, but lack “the necessary behavioral skills or support that will allow them to be successful. That’s where these types of programs fit in.”
A second, complementary study analyzed which strategies were most successful at garnering social interaction. Among the recommendations based on the findings:
Use a small number of conversation spaces rather than many specialized ones;
Have staff respond to user posts when other users don’t and post new topics when there is a lull in the conversation;
Conduct contests with small prizes.
“We know from this study that online communities can help to keep people engaged,” said Paul Resnick, PhD, a professor at the University of Michigan School of Information and the study’s lead author. “But it can be hard to build a critical mass of participation. We found that with the right kinds of staff participation, it’s possible even within a small population to get the conversations going.”