Influence of Health Characteristics on Reported Adherence to Lifestyle Change Advice from an Electronic Health Management Tool
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Abstract
Background: Western societies are confronted with a worrisome increase in chronic disorders such as cardiovascular disease (CVD), diabetes, and chronic respiratory illness. These diseases are linked by common risk factors such as physical inactivity, smoking, excessive alcohol intake and unhealthy diet, providing opportunities for early diagnosis and prevention. The broad availability of internet and low-cost medical devices for home measurement provide increasing opportunities for web-based, personal health advice and lifestyle counselling.
Objective: To investigate the relationship between health characteristics and reported adherence to lifestyle change advice from a web-based, personal health management tool.
Methods: Employees of five Dutch companies were invited to use the Prevention Compass, a web-based health management service based on electronic questionnaires, biometric evaluation, and laboratory testing at a regional laboratory. It allows individuals to assess their personal risk profile for a broad set of chronic diseases and provides a tailored health plan for risk reduction generated by web-based knowledge technology. Lifestyle advices within the health plan target physical activity, smoking cessation, dietary habits, stress management and alcohol intake. On demand, participants could schedule a health counselling session with an occupational physician after receiving the health plan. For participants at high risk the health plans include referral to primary or secondary care for further evaluation and treatment. Four weeks after receiving their health plans, participants were asked to complete a second questionnaire regarding health behaviour change actions on the same lifestyle items as measured in the Prevention Compass questionnaire.
Results: A total of 6790 people were invited, of which 2295 (33%) used the Prevention Compass. From these, 638 (28%) completed the survey. Compared to people with a normal risk on CVD, participants with a high risk on CVD more frequently reported an increase in physical activity (odds ratio (OR) 3.36, p=0.003) and a reduction in alcohol consumption (OR 3.31; p=0.024). Participants with an intermediate CVD risk more often reported to have taken overall health action (OR 1.71, p=0.035). Independently, participants with overweight (OR 1.63, p=0.024) and obesity (OR 3.45, p<0.001) more frequently reported to have increased physical activity. Participants with obesity also more often indicated to have changed their diet (OR 3.63, p=0.002), while participants with overweight more frequently reported to have taken overall health action (OR 1.61, p=0.012) and reduced their alcohol consumption (OR 1.90, p=0.050). People with excessive alcohol consumption (OR 4.24, p=0.047) reported to have quit smoking more often, and the same was true for physically active people (OR 3.45, p=0.048). Participants with excessive alcohol consumption also indicated to have reduced this alcohol consumption (OR 6.98, p<0.001).
Conclusion: The adherence to web-based lifestyle change advice is related to health characteristics, with those at higher risk more frequently reporting adherence. This indicates that lifestyle change advice should be tailored to the health characteristics of the person receiving it.
Objective: To investigate the relationship between health characteristics and reported adherence to lifestyle change advice from a web-based, personal health management tool.
Methods: Employees of five Dutch companies were invited to use the Prevention Compass, a web-based health management service based on electronic questionnaires, biometric evaluation, and laboratory testing at a regional laboratory. It allows individuals to assess their personal risk profile for a broad set of chronic diseases and provides a tailored health plan for risk reduction generated by web-based knowledge technology. Lifestyle advices within the health plan target physical activity, smoking cessation, dietary habits, stress management and alcohol intake. On demand, participants could schedule a health counselling session with an occupational physician after receiving the health plan. For participants at high risk the health plans include referral to primary or secondary care for further evaluation and treatment. Four weeks after receiving their health plans, participants were asked to complete a second questionnaire regarding health behaviour change actions on the same lifestyle items as measured in the Prevention Compass questionnaire.
Results: A total of 6790 people were invited, of which 2295 (33%) used the Prevention Compass. From these, 638 (28%) completed the survey. Compared to people with a normal risk on CVD, participants with a high risk on CVD more frequently reported an increase in physical activity (odds ratio (OR) 3.36, p=0.003) and a reduction in alcohol consumption (OR 3.31; p=0.024). Participants with an intermediate CVD risk more often reported to have taken overall health action (OR 1.71, p=0.035). Independently, participants with overweight (OR 1.63, p=0.024) and obesity (OR 3.45, p<0.001) more frequently reported to have increased physical activity. Participants with obesity also more often indicated to have changed their diet (OR 3.63, p=0.002), while participants with overweight more frequently reported to have taken overall health action (OR 1.61, p=0.012) and reduced their alcohol consumption (OR 1.90, p=0.050). People with excessive alcohol consumption (OR 4.24, p=0.047) reported to have quit smoking more often, and the same was true for physically active people (OR 3.45, p=0.048). Participants with excessive alcohol consumption also indicated to have reduced this alcohol consumption (OR 6.98, p<0.001).
Conclusion: The adherence to web-based lifestyle change advice is related to health characteristics, with those at higher risk more frequently reporting adherence. This indicates that lifestyle change advice should be tailored to the health characteristics of the person receiving it.
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