Adherence and Attrition in a Web-Based Lifestyle Intervention for People with Metabolic Syndrome

The aim of this study was to determine adherence and attrition rates in a lifestyle intervention for people with metabolic syndrome.

Adherence and attrition data from a randomized controlled trial were collected. Participants were classified as adherence group if they completed assessments at 3 and 6 months follow-up and as attrition group if they did not. Physical activity and quality of life was measured using the International Physical Activity Questionnaire (IPAQ) and the Short Form Health Survey (SF-36). Generalized Estimating Equations (GEE) was used to explore predictors of attrition.

The mean age of participants (n=160) was 44.1 years. Attrition rate in the intervention and control groups at first follow-up were the same (20%). However, the control group had significantly higher attrition rate (%33.7) compared to the intervention group (%20) at 6 months follow up. Results showed that low educated participants were more likely to not stay in the study than better educated participants (OR=2.95,CI:1.39-6.33,P=0.05). According with length of the study, attrition was decreased at six month (OR=0.66,CI:0.52-0.83,P<0.001). Also, some aspects of health-related quality of life contributed to the attrition rate. Those who had higher scores on general health (OR=0.66,CI:0.54-0.97,P=0.023), social functioning (OR=0.44,CI:0.40-0.76,P=0.032), role emotional (OR=0.74,CI:0.54-0.98,P=0.18), vitality (OR=0.55,CI:0.38-0.90,P=0.015) and mental health (OR=0.63,CI:0.45-0.85,P=0.033) were more likely to stay in the study.

It remains a concern that Web-based lifestyle programs may fail to reach those who need it most. Participant in the study generally had better quality of life than those who were lost to follow up.