Interactive web-based lifestyle intervention and metabolic syndrome: findings from the Red Ruby (a randomized controlled trial)

Abstract

BackgroundMetabolic syndrome is a growing public health problem worldwide. Several interventions have been proposed to specifically target the problem. This study evaluated the effectiveness of an interactive web-based lifestyle for management of metabolic syndrome.MethodsThis randomized controlled trial was conducted from June through August 2012 in Tehran, Iran. Participants were individuals with metabolic syndrome who had registered on the study website. Interested eligible participants were invited for a free clinic visit and clinical assessment. They were randomly assigned to the intervention (n = 80) or control (n = 80) group. The intervention group received an interactive web-based program called the Healthy Heart Profile and were followed for 6 months. The control group received general information on metabolic syndrome. Anthropometric measures, glycemic status, and lipid profile were evaluated at baseline, and at 3- and 6-month follow-up assessments. Metabolic syndrome was defined according to The National Cholesterol Education Program Adult Treatment Panel (ATP) III report except for waist circumference, which was modified to ≥90 cm for both genders for the Iranian population.ResultsIn total, 1,437 individuals registered on the study website. The mean age of participants was 44.2 years (SD = 10.0). There were no significant differences between the intervention and control groups on any baseline variable except that participants in the intervention group recorded higher levels of LDL. The results showed a decrease in metabolic syndrome in both groups. These reductions were significantly greater in the intervention group at the 3- and 6-month follow-ups. The intervention group showed significantly greater decreases (P < 0.05) over the control group for, respectively, systolic blood pressure (3-month: −10 versus −6 mmHg; 6-month: −11 versus −8 mmHg), diastolic blood pressure (3-month: −10 versus −4 mmHg; 6-month: −11 versus −6 mmHg), weight (3-month: −2 versus −1 kg; 6-month: −4 versus −1 kg), body mass index (3-month: −0.5 versus −0.2 kg/m2; 6-month: −1.1 versus −0.4 kg/m2) and improvement in HDL (3-month: 2 versus 0.64 mg/dl; 6-month: 6 versus 4 mg/dl).ConclusionThe findings suggest that the web-based interactive program was beneficial for individuals with metabolic syndrome. Comprehensive interactive web-based prevention programs are promising to help involve patients in improving management of metabolic syndrome and adopting a healthy lifestyle.Trial registrationIRCT201111198132N1. Registered 27 May 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0950-4) contains supplementary material, which is available to authorized users.

The EMPOWER-SUSTAIN e-Health Intervention to improve patient activation and self-management behaviours among individuals with Metabolic Syndrome in primary care: study protocol for a pilot randomised controlled trial

“…Development of an e-health intervention to support patients' self-management requires careful planning and the use of theory-based strategies to increase the probability of effectiveness, programme adoption and implementation [34][35][36][37]. Therefore, the EMPOWER-SUST AIN self-management mobile app is developed using the persuasive technology theory [39].…”

“…To meet the growing demands of the younger generation, efforts have been made to develop web or mobile applications for self-management of multiple CV risk factors [34][35][36][37][38]. To ensure sustainability, the application should be developed using an evidence-based approach such as persuasive technology [39].…”

The EMPOWER-SUSTAIN e-Health Intervention to improve patient activation and self-management behaviours among individuals with Metabolic Syndrome in primary care: study protocol for a pilot randomised controlled trial

“…Development of an e-health intervention to support patients' self-management requires careful planning and the use of theory-based strategies to increase the probability of effectiveness, programme adoption and implementation [34][35][36][37]. Therefore, the EMPOWER-SUSTAIN selfmanagement mobile app © is developed using the persuasive technology theory [39].…”

“…Therefore, the EMPOWER-SUSTAIN selfmanagement mobile app © is developed using the persuasive technology theory [39]. It consists of evidence-based content presented in a user friendly interface, with incorporation of interactivity, reward system, problem-solving assistance, patient-physician collaboration and regular reinforcement to ensure sustainability [34][35][36][37][78][79][80][81]. It is designed to aid and motivate people to adopt positive attitude and behaviour change through persuasion and social influence [39].…”

“…To meet the growing demands of the younger generation, efforts have been made to develop web or mobile applications for self-management of multiple CV risk factors [34][35][36][37][38]. To ensure sustainability, the application should be developed using evidence-based approach such as the persuasive technology [39].…”