Online Forums Increase Participation in Walking Program

13 Sep

My wife, Dr. Caroline Richardson, has for many years been developing and testing an Internet-mediated walking program, called Stepping Up to Health, with various populations. Participants get an uploading pedometer and interact with a website that graphs progress, automatically increments daily walking goals as people become more fit, and provides personally tailored tips. It’s been pretty effective. But it’s been purely an individual activity: there was no interaction among participants. We wondered if some interpersonal interaction might make it even more effective.

We started just by adding online forums, without deep integration of social features. Remarkably, in a randomized controlled trial, we found that just the forums were enough to cause more people to stick with the program. In the arm of the trial with no online community, 66% of people completed the 16-week program (meaning they uploaded steps for 20 days in the last month). In the arm with an online community, 79% completed. In other words, about a third of those who would have been expected to drop out didn’t.

Among those who completed the program, both arms had similar step count increases. Pooling across the two arms, participants who completed the program walked an average of 4468 steps per day in their baseline week (before their first upload and before randomization to one of the two arms). At the end of the study, they averaged a 6948 steps per day, an increase of about a mile per day.

The fact that step count increases were just as big for the treatment group,  but with more of them completing, suggests that the online forums may have helped people to walk more, not just keep them using the program which got them to walk more. The logic here is that the people who were “saved” from dropping out were probably less enthusiastic about the program and less successful at increasing their walking; including those people, however, did not reduce the average step count improvement. In any case, even if the social feature just helped people to keep participating in the program, which had other active ingredients that got them to walk more, that is a significant finding.

If just forums can help in this way, would integration of other social features be even better? I think so, but I don’t have any data to report about that.

Details about the study can be found in this journal article, accessible online. For a sense of what people actually talked about in the forums, and all the staff effort that was needed to keep the forums going, check out the companion article.

Richardson CR, Buis LR, Janney AW, Goodrich DE, Sen A, Hess ML, Mehari KS, Fortlage LA, Resnick PJ, Zikmund-Fisher BJ, Strecher VJ, Piette JD
An Online Community Improves Adherence in an Internet-Mediated Walking Program. Part 1: Results of a Randomized Controlled Trial
J Med Internet Res 2010;12(4):e71

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