title: Associations of internet website use with weight change in a long-term weight loss maintenance program.
abstract: BACKGROUND
  The Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss.
  
  
  OBJECTIVE
  This paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance.
  
  
  METHODS
  Adults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal.
  
  
  RESULTS
  Participants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002).
  
  
  CONCLUSIONS
  Participants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss.
  
  
  BACKGROUND
  NCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue).
authors.affiliation: Kaiser Permanente, Center for Health Research, Portland, USA. kristine.funk@kpchr.org
authors.forename: Kristine L
authors.initials: KL
authors.lastname: Funk
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.forename: Alan
authors.initials: A
authors.lastname: Bauck
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Brantley
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Champagne
authors.forename: Janelle
authors.initials: J
authors.lastname: Coughlin
authors.forename: Arlene T
authors.initials: AT
authors.lastname: Dalcin
authors.forename: Jean
authors.initials: J
authors.lastname: Harvey-Berino
authors.forename: Jack F
authors.initials: JF
authors.lastname: Hollis
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Jerome
authors.forename: Betty M
authors.initials: BM
authors.lastname: Kennedy
authors.forename: Lillian F
authors.initials: LF
authors.lastname: Lien
authors.forename: Valerie H
authors.initials: VH
authors.lastname: Myers
authors.forename: Carmen
authors.initials: C
authors.lastname: Samuel-Hodge
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation*; D018579:Patient Selection; D010809:Physical Fitness; D012648:Self Care; D015430:Weight Gain; D015431:Weight Loss