Bridging Health Disparities through Digital Health Coaching: Use and Outcome of the Online Losing Weight Coach in Individuals with Low, Middle and High Socioeconomic Positions.
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Abstract
BACKGROUND. Health risk behaviors related to lifestyle-related diseases differ between socioeconomic position (SEP) groups. For example, obesity and physical inactivity are found to be more prevalent in low-SEP groups compared to high-SEP groups.
Internet-delivered behavioral change programs aimed at improving health behaviors are found to decrease behavioral health risks . As such, they might be potentially promising tools in the battle against health disparities. However, the health gap between high and low-SEP groups is mirrored in a digital gap. Although the digital divide in computer and Internet access diminished over time, low-SEP groups still show less digital skills. This might negatively influence the beneficiary impact of digital health coaches.
OBJECTIVE. The present paper describes an observational study examining the role of educational level and occupational status (as indices of SEP) on the use and outcome of an online behavioral intervention aimed at increasing health behaviors related to a healthy diet and physical activity.
METHODS. We analyzed the association between users’ SEP (characterized by educational level and occupational status) and the use of the Losing Weight Coach, a web-based health behavior change program. In addition to examining number of visits and duration of activity on the website, we studied various process variables (e.g. activation of daily e-mail tips, use of diary, etc.). Furthermore, we described the relation between SEP and program outcome.
OUTCOME. Most users of the Losing Weight Coach were from the high SEP-group. Outcome of the behavioral change program (weight loss, behavior change) did not differ between educational level or occupational status.
CONLUSION. Online behavioral change programs mainly reach higher SEP-people. Nonetheless, they are as effective in low SEP-groups as they are in high SEP-groups in changing behavior. These results illustrate the potential benefits of digital health coaching in overcoming health disparities between low and high SEP-groups. However, additional efforts are needed to promote and disseminate digital health coaches in lower educated and occupationally inactive people.
Internet-delivered behavioral change programs aimed at improving health behaviors are found to decrease behavioral health risks . As such, they might be potentially promising tools in the battle against health disparities. However, the health gap between high and low-SEP groups is mirrored in a digital gap. Although the digital divide in computer and Internet access diminished over time, low-SEP groups still show less digital skills. This might negatively influence the beneficiary impact of digital health coaches.
OBJECTIVE. The present paper describes an observational study examining the role of educational level and occupational status (as indices of SEP) on the use and outcome of an online behavioral intervention aimed at increasing health behaviors related to a healthy diet and physical activity.
METHODS. We analyzed the association between users’ SEP (characterized by educational level and occupational status) and the use of the Losing Weight Coach, a web-based health behavior change program. In addition to examining number of visits and duration of activity on the website, we studied various process variables (e.g. activation of daily e-mail tips, use of diary, etc.). Furthermore, we described the relation between SEP and program outcome.
OUTCOME. Most users of the Losing Weight Coach were from the high SEP-group. Outcome of the behavioral change program (weight loss, behavior change) did not differ between educational level or occupational status.
CONLUSION. Online behavioral change programs mainly reach higher SEP-people. Nonetheless, they are as effective in low SEP-groups as they are in high SEP-groups in changing behavior. These results illustrate the potential benefits of digital health coaching in overcoming health disparities between low and high SEP-groups. However, additional efforts are needed to promote and disseminate digital health coaches in lower educated and occupationally inactive people.
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