Women using a web‐based digital health coaching programme for stress management: stress sources, symptoms and soping strategies

Researchers have proposed and tested many theories to understand gender differences in stress experiences. However, little research has identified differences between subgroups of women in terms of stress sources, symptoms, coping strategies and help‐seeking behaviour. The purpose of this study was to examine these characteristics of women seeking help for stress management through a digital health coaching programme. We examined cross‐sectional data from 63,690 women between the ages of 18 and 59 years who participated in the stress management programme from 2001 to 2008. We divided the sample into age groups to identify developmental patterns in their stress characteristics. Work , time demands and psychological reactions to stress were consistent concerns, whereas between‐group comparisons indicated diverse stress characteristics by age group. Importantly, women at all ages reported being uncomfortable asking for help. The findings suggest that technology‐based solutions like digital health coaching may reach women who may not otherwise seek or receive help for stress management. The results also emphasize the importance of considering the unique characteristics of women when providing them stress management interventions. Copyright © 2011 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87059/1/smi1389.pd

Reach, Engagement, and Retention in an Internet-Based Weight Loss Program in a Multi-Site Randomized Controlled Trial

Reviewer: Christensen, Helen[This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2007/2/e11/ ] Background: Research increasingly supports the conclusion that well-designed programs delivered over the Internet can produce significant weight loss compared to randomized controlled conditions. Much less is known about four important issues addressed in this study: (1) which recruitment methods produce higher eHealth participation rates, (2) which patient characteristics are related to enrollment, (3) which characteristics are related to level of user engagement in the program, and (4) which characteristics are related to continued participation in project assessments. Methods: We recruited overweight members of three health maintenance organizations (HMOs) to participate in an entirely Internet-mediated weight loss program developed by HealthMedia, Inc. Two different recruitment methods were used: personal letters from prevention directors in each HMO, and general notices in member newsletters. The personal letters were sent to members diagnosed with diabetes or heart disease and, in one HMO, to a general membership sample in a particular geographic location. Data were collected in the context of a 2×2 randomized controlled trial, with participants assigned to receive or not receive a goal setting intervention and a nutrition education intervention in addition to the basic program. Results: A total of 2311 members enrolled. Bivariate analyses on aggregate data revealed that personalized mailings produced higher enrollment rates than member newsletters and that members with diabetes or heart disease were more likely to enroll than those without these diagnoses. In addition, males, those over age 60, smokers, and those estimated to have higher medical expenses were less likely to enroll (all P < .001). Males and those in the combined intervention were less likely to engage initially, or to continue to be engaged with their Web program, than other participants. In terms of retention, multiple logistic regressions revealed that enrollees under age 60 (P < .001) and those with higher baseline self-efficacy were less likely to participate in the 12-month follow-up (P = .03), but with these exceptions, those participating were very similar to those not participating in the follow-up. Conclusions: A single personalized mailing increases enrollment in Internet-based weight loss. eHealth programs offer great potential for recruiting large numbers of participants, but they may not reach those at highest risk. Patient characteristics related to each of these important factors may be different, and more comprehensive analyses of determinants of enrollment, engagement, and retention in eHealth programs are needed