The Feasibility of a Web-Based Educational Lifestyle Program for People With Multiple Sclerosis: A Randomized Controlled Trial

Abstract

BackgroundModifiable lifestyle factors are important to aid people with multiple sclerosis in the self-management of their disease. Current self-management programs are limited by their face-to-face mode of delivery but there is immense potential with the internet to deliver these programs effectively.ObjectiveThe aims of this study are to assess the feasibility of a digitalized educational lifestyle self-management program for people with MS.MethodsIn this randomized controlled trial, people with MS were randomly allocated to participate in a 6-week tailored web-based educational lifestyle program or 6-week generic standard-care educational course, and were blinded to their allocation. Participants were recruited through multiple sclerosis (MS) Societies in four countries: Australia, New Zealand, Canada, and the United States. The primary outcome was to assess acceptability of the program defined as percentage completion of all modules at 6-weeks post-course commencement. Secondary outcomes included evaluating participant responses to the follow-up survey across three domains: accessibility, learnability, and desirability.ResultsThirty-five participants from Australia, Canada, New Zealand, and the US completed the baseline survey and were randomized. Four participants were deemed ineligible due to incomplete baseline data; therefore, nine out of 15 and eight out of 16 participants completed 100% of the course in the intervention and standard-care arm courses, respectively.ConclusionsThis study found that this web-based educational lifestyle program is a feasible means of delivering educational content to people with MS via the internet according to our a priori targets of >40% of participants in the intervention arm, and >25% in the control arm to completing 100% of the course. It is therefore appropriate to evaluate this intervention further in a large, randomized controlled trial.Trial registrationThis study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ID: ACTRN12621000245897).

Study protocol for an online lifestyle modification education course for people living with multiple sclerosis: the multiple sclerosis online course (MSOC)

“…After development of the MSOC, the pilot feasibility study (MSOC-Feasibility RCT) was conducted to quantitatively assess the feasibility of the MSOC using Likert scales [ 39 ] and found the MSOC performed well in accessibility, learnability, and desirability domains. Analysis of the primary outcome of feasibility (whether plwMS completed the MSOC) found 59% completion rates in the IC arm vs. 50% in the SCC arm, which confirmed course feasibility.…”

Acceptability of a digital health application to empower persons with multiple sclerosis with moderate to severe disability: single-arm prospective pilot study

“…In addition, the programme completion rate of 47% indicates an acceptable adherence to the intervention. Bevens et al (2022) declared a feasibility threshold of 40% programme completion for their web-based educational lifestyle programme for pwMS, which we successfully surpassed [ 28 ]. While we did not prespecify a certain percentage of programme completion as necessary for success, we consider a programme completion of 40% as a reasonable benchmark.…”

“…Some early work has also been performed to stimulate physical activity [ 27 ]. While there are some digital educational interventions available providing evidence-based information on relevant health behaviours in MS [ 28 , 29 ], we are not aware of programmatic digital health applications combining evidence-based patient information (EBPI) with cognitive behavioural therapy (CBT) and behaviour change techniques (BCTs) for all major health behaviour areas such as physical activity, psychological stress, sleep, and diet in MS. Against this background, a comprehensive internet-based health behaviour change intervention termed “levidex” was developed and is currently being evaluated in two randomised controlled trials (RCTs) [ 30 , 31 ]. Nevertheless, more evidence is needed to examine the effectiveness of levidex for pwMS.…”

Web-Based Health Information Seeking by People Living With Multiple Sclerosis: Qualitative Investigation of the Multiple Sclerosis Online Course

“…We developed 2 courses in conjunction with people living with MS: the standard care course (SCC) based on the information from MS websites and the intervention course (IC) based on the Overcoming MS program. The content and format of the Overcoming MS program have been described comprehensively elsewhere [18]; however, briefly, it is a lifestyle management program recommending a plant-based wholefood diet, exercise and stress reduction activities, sunlight exposure, and vitamin D consumption. The 7 modules of the first round of the MSOC were delivered across 6 weeks from August to September 2022.…”