A Web-Based Lifestyle-Related Course for People Living With Multiple Sclerosis: Quantitative Evaluation of Course Completion, Satisfaction, and Lifestyle Changes Among Participants Enrolled in a Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Web-based health courses providing lifestyle-related information can potentially increase knowledge, facilitate behavior change, and improve health outcomes for people living with multiple sclerosis (MS). Despite the low engagement with web-based programs by this population, few studies have evaluated factors influencing engagement. This study evaluated engagement with our 6-week lifestyle-related course (Multiple Sclerosis Online Course; MSOC) by participants enrolled in a large, international randomized controlled trial, as well as preliminary outcomes. OBJECTIVE: This study aimed to quantitatively assess engagement with the MSOC (the intervention course [IC] and standard-care course [SCC]), motivators of and barriers to participants' course completion, course satisfaction, engagement with the community forum, and intentions to implement lifestyle changes. METHODS: We collected data via a baseline survey before course commencement and an evaluation survey 1 month after the 6-week course. Course completers were queried on motivators of completion, course satisfaction, previous knowledge, forum participation, and intentions to adopt lifestyle changes. Noncompleters were queried on barriers to course completion. Differences between the 2 study arms were examined using chi-square and 2-tailed t tests. Multivariable linear regression models assessed factors (sociodemographic and course and health related) associated with participants' intentions to adopt lifestyle changes adjusting for baseline lifestyle factors. Moderation analyses were conducted to test group differences. RESULTS: Of the 857 participants, 442 (51.6%) completed the MSOC (IC: n=218, 49.3%; SCC: n=224, 50.7%), and 291 (34%) completed the evaluation survey (n=254, 87.3% course completers; n=37, 12.7% noncompleters). Key motivators of course completion included an interest in participating in MS research, optimizing health, course flexibility, and relevant and useful course content. Barriers to course completion included time constraints and technical issues. Most course completers rated the MSOC as "excellent/very good" (IC: 92/126, 73%; SCC: 78/128, 60.9%; P=.17). Engagement with the facilitator-led community forum was higher in the IC than in the SCC (56/126, 44.4% vs 32/128, 25%; P=.003). More IC completers versus SCC completers expressed their intention to adopt dietary changes (89/125, 71.2% vs 74/127, 58.3%; P=.04), increase their sun exposure (82/124, 66.1% vs 62/124, 50%; P=.01), supplement with omega-3 (84/125, 67.2% vs 60/126, 47.6%; P=.004), and practice meditation (85/124, 68.5% vs 66/126, 52.4%; P=.009). Forum engagement, course satisfaction, new course content, and an interest in receiving additional course content were associated with intentions to adopt lifestyle changes across both study arms. CONCLUSIONS: The web-based lifestyle IC provided new and satisfactory content and facilitated intentions to adopt lifestyle changes. Positive associations between engagement with the community forum and intentions to implement lifestyle changes and identifying barriers to completion such as time constraints provide important insights to inform the design of future digital health interventions for people living with MS and possibly other chronic conditions. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001605886; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382778&isReview=true.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".