title: Rates and determinants of uptake and use of an internet physical activity and weight management program in office and manufacturing work sites in England: cohort study.
abstract: BACKGROUND
  Internet-based physical activity (PA) and weight management programs have the potential to improve employees' health in large occupational health settings. To be successful, the program must engage a wide range of employees, especially those at risk of weight gain or ill health.
  
  
  OBJECTIVE
  The aim of the study was to assess the use and nonuse (user attrition) of a Web-based and monitoring device-based PA and weight management program in a range of employees and to determine if engagement with the program was related to the employees' baseline characteristics or measured outcomes.
  
  
  METHODS
  Longitudinal observational study of a cohort of employees having access to the MiLife Web-based automated behavior change system. Employees were recruited from manufacturing and office sites in the North West and the South of England. Baseline health data were collected, and participants were given devices to monitor their weight and PA via data upload to the website. Website use, PA, and weight data were collected throughout the 12-week program.
  
  
  RESULTS
  Overall, 12% of employees at the four sites (265/2302) agreed to participate in the program, with 130 men (49%) and 135 women (51%), and of these, 233 went on to start the program. During the program, the dropout rate was 5% (11/233). Of the remaining 222 Web program users, 173 (78%) were using the program at the end of the 12 weeks, with 69% (153/222) continuing after this period. Engagement with the program varied by site but was not significantly different between the office and factory sites. During the first 2 weeks, participants used the website, on average, 6 times per week, suggesting an initial learning period after which the frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight (-2.6 kg, SD 3.2, P< .001). The reduction in weight was largest for employees using the program's weight loss mode (-3.4 kg, SD 3.5). Mean PA level recorded throughout the program was 173 minutes (SE 12.8) of moderate/high intensity PA per week. Website interaction time was higher and attrition rates were lower (OR 1.38, P= .03) in those individuals with the greatest weight loss.
  
  
  CONCLUSIONS
  This Web-based PA and weight management program showed high levels of engagement across a wide range of employees, including overweight or obese workers, shift workers, and those who do not work with computers. Weight loss was observed at both office and manufacturing sites. The use of monitoring devices to capture and send data to the automated Web-based coaching program may have influenced the high levels of engagement observed in this study. When combined with objective monitoring devices for PA and weight, both use of the website and outcomes can be tracked, allowing the online coaching program to become more personalized to the individual.
authors.affiliation: MiLife Coaching Ltd, Colworth Science Park, Sharnbrook, Bedford MK44 1LQ, UK. lisa.ware@milife.com
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Ware
authors.forename: Robert
authors.initials: R
authors.lastname: Hurling
authors.forename: Ogi
authors.initials: O
authors.lastname: Bataveljic
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Fairley
authors.forename: Tina L
authors.initials: TL
authors.lastname: Hurst
authors.forename: Peter
authors.initials: P
authors.lastname: Murray
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Rennie
authors.forename: Chris E
authors.initials: CE
authors.lastname: Tomkins
authors.forename: Anne
authors.initials: A
authors.lastname: Finn
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cobain
authors.forename: Dympna A
authors.initials: DA
authors.lastname: Pearson
authors.forename: John P
authors.initials: JP
authors.lastname: Foreyt
mesh_terms: D001835:Body Weight; D015331:Cohort Studies; D034742:Electronic Mail; D004739:England; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D007858:Learning; D008137:Longitudinal Studies; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D009043:Motor Activity; D016272:Occupational Health; D009862:Online Systems; D010353:Patient Education as Topic; D010358:Patient Participation; D018579:Patient Selection; D012648:Self Care; D012984:Software; D015431:Weight Loss