Dissemination strategies and adherence predictors for web-based interventions—how efficient are patient education sessions and email reminders?

Abstract

The Internet offers the potential to efficaciously deliver health interventions at a low cost and with a low threshold across any distance. However, since many web-based interventions are confronted with low use and adherence, proactive dissemination strategies are needed. We, therefore, tested the efficacy of a 1-h patient education session as part of a rehabilitation program and an email reminder 4 weeks later on the publicity and use of a web-based intervention aimed at lifestyle changes in patients with either coronary heart disease or chronic back pain (CBP) and examined adherence predictors. The website www.lebensstil-aendern.de is a cost-free, German-language website providing more than 1000 patient narratives about successful lifestyle changes. To test the efficacy of the dissemination strategies and to examine adherence predictors, we conducted a sequential controlled trial with heart and CBP patients recruited from German inpatient rehabilitation centers. The dissemination strategies were found to be efficient. Use rates, however, remained low. The email reminder and internal health locus of control emerged as notable factors in motivating patients to participate in the web-based intervention. Other factors that have been suggested to be related to nonuse, e.g. sociodemographic characteristics and medical condition, did not predict use or adherence.

Online-based interventions for sexual health among individuals with cancer: a systematic review

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“…The efficacy of patient education programmes on the uptake and use of web-based, digital health interventions has indeed been shown previously in cardiovascular disease patients. 58 Digital health programme components should be developed applying a user-centric approach and taking into account user (i.e. patient) needs and preferences from the first prototype to the final end-product stage.…”

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“…Future investigation should focus on confirming the causes of the identified discrepancies in rehabilitation compliance, then developing methods to decrease these disparities across the patient population. Prior studies in other patient populations have found that patient motivation can increase rehabilitation compliance, 6 with preoperative educational classes 19 and reminder 1,3,7,24 services displaying similar effects of increasing compliance in various clinical settings.…”