Bridging Health Disparities through Digital Health Coaching

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Bridging Health Disparities through Digital Health Coaching: Use and Outcome of the Online Losing Weight Coach in Individuals with Low, Middle and High Socio-economic Positions

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Bridging Health Disparities through Digital Health Coaching

  1. 1. Bridging Health Inequalitiesthrough Digital Health Coaching Use and Outcome of the Online Losing Weight Coach in Individuals with Low, Middle and High Socioeconomic Positions.<br />Dr. Claudia Put<br />Dr. LeentjeVervoort<br />InèsGaston-Echeverria<br />
  2. 2. SES-related health inequalities<br /><ul><li>socio-economicrelateddifferences in mortality
  3. 3. cancers, cardiovasculardiseases
  4. 4. mediated by higherprevalence of healthriskbehaviors
  5. 5. e.g. unhealthydiets, insufficientphysicalactivity or excercise, smoking, …</li></ul>Phelan, Link, & Tehranifar(2010). J of Health and Social Behavior<br />
  6. 6. health risk behaviors<br /><ul><li>higherprevalence in individualswithlower SES
  7. 7. e.g., smoking</li></ul>Stichting tegen Kanker, 2010<br />
  8. 8. health inequalities (HI)<br /><ul><li>mortality
  9. 9. lifeexpectancy
  10. 10. how oldwillyouget, givenyourgender and age?
  11. 11. expectedyears of healthy living
  12. 12. how manyyearswillyouremainhealthy, givenyourgenderand age?
  13. 13. healthdisparities are stillincreasing</li></ul>Koning Boudewijnstichting (2010). Tackling Health inequalities in Belgium<br />
  14. 14. life expectancy<br />Belgian man, 25<br />Koning Boudewijnstichting (2010). Tackling Health inequalities in Belgium<br />
  15. 15. expectedyears of healthy living<br />Belgian woman, 25<br />Koning Boudewijnstichting (2010). Tackling Health inequalities in Belgium<br />
  16. 16. SES as a fundamental cause of HI<br /><ul><li>influence on variousdiseases, e.g. cancer, CVD
  17. 17. through multiple riskbehaviors, e.g., smoking, unhealthydiet, …
  18. 18. differentaccess to ‘resources’ thatcanbeused to avoidrisks or treatproblems
  19. 19. ‘healthychoices’ egfood
  20. 20. treatment, therapy, intervention
  21. 21.  knowledge, money, social support, …</li></ul>Phelan, Link, & Tehranifar(2010). J of Health and Social Behavior<br />
  22. 22. reducing SES-related HI<br /><ul><li>healthinequalitiesbased on SES canbereduced by institutinghealth interventions thatautomaticallybenefitindividualsirrespective of theirownresources 
  23. 23.  affordable interventions
  24. 24.  easy-to-acces interventions
  25. 25.  easy-to-use interventions
  26. 26.  time-efficient interventions</li></ul>Phelan, Link, & Tehranifar(2010). J of Health and Social Behavior<br />
  27. 27. Digital health coaching<br /><ul><li>affordable interventions
  28. 28. easy-to-acces interventions
  29. 29. high internet use in Belgium: 76%, but withSES-differences
  30. 30. no-lowformaleducation: 65%
  31. 31. medium formaleducation: 86%
  32. 32. high formaleducation: 98%
  33. 33. ‘health-related issues’ are verypopular on the internet</li></li></ul><li>Digital health coaching<br /><ul><li>easy-to-use
  34. 34. daily e-mailtips right intoyourmailbox
  35. 35. clearlystructuredwebpages, easy to navigate
  36. 36. completelyautomated
  37. 37. time-efficient
  38. 38. at home, no need to go out or plan
  39. 39. accessible 24/7
  40. 40. atyourown pace</li></ul>Phelan, Link, & Tehranifar(2010). J of Health and Social Behavior<br />
  41. 41. The Online LosingWeight Coach<br /><ul><li>free of charge, providedby a largeBelgian</li></ul>healthinsurancecompany (CM)<br /><ul><li> online sincejanuary 2009
  42. 42. 65.792 users
  43. 43. completelyautomated, online interactiveapp
  44. 44. basedoncognitive & behavioraltechniques
  45. 45. goal is behavioralchange</li></li></ul><li>Start = questionnaire (eatingbehavior, physicalactivity, calory control, weight, motivation, self-efficacy)<br />
  46. 46. Tailoredindividual feedback <br />
  47. 47. Social comparison, in terms of motivation and behavior<br />
  48. 48. start of the coaching proces<br /><ul><li>Access to 3 programs
  49. 49. user chooseswhich one to startwith, otherremain accessible</li></li></ul><li>Example: program forbalancedeating<br />Per program acces to:<br /><ul><li>advice
  50. 50. strategies
  51. 51. Interactive tools: tests, feedback tools, …
  52. 52. Library</li></li></ul><li>Simple, attractive interactive tools<br />
  53. 53. Diary and graphicaloverviews<br />Registration & evolution of behaviorand appliedtechniques<br /><ul><li>Only the essence
  54. 54. Simple</li></ul> A tailoredpersonalmonthly report<br />
  55. 55. Daily e-mailtips<br /><ul><li>built up of a proces
  56. 56. triggers & engages
  57. 57. Controllable</li></li></ul><li>Only live-element: ask the expert + forum<br />
  58. 58. The Online Losing Weight Coach<br /><ul><li> n = 2785
  59. 59. 83% women, 17% man
  60. 60. age: M = 45, SD = 12
  61. 61. weight: M = 78.29 kg, SD = 14.05
  62. 62. underweight: 0.1%
  63. 63. normalweight: 29.7%
  64. 64. overweight: 43.5%
  65. 65. obesitas: 26.1%
  66. 66. pre- and post assessmenthealthbehavior questionnaire</li></li></ul><li>SES of Online Weight Coach Users<br />
  67. 67. weight of Online Weight Coach Users<br />
  68. 68. behavioral changes<br /><ul><li>behavior
  69. 69. related to food pattern, physicalactivity, calorie control
  70. 70. measured on a scalefrom 0 to 100
  71. 71. higher score = more healthybehavior</li></li></ul><li>behavioral changes: balancedeating<br /><ul><li>increase in eatingbehavior scores
  72. 72. M = 5.85, SD=18.00, F(1,2782)=106.03, p<.001
  73. 73. no significant interaction effectwith SES
  74. 74. F(2,2782)= 1.38, p=.25</li></li></ul><li>behavioral changes: physical activity<br />0<br /><ul><li>increase in physicalactivity scores
  75. 75. M = 10.71, SD=35.07, F(1,2782)=63.83, p<.001
  76. 76. no significant interaction effectwith SES
  77. 77. F(2,2782)= 1.61, p=.20</li></li></ul><li>behavioral changes: calorie control<br />0<br /><ul><li>increase in calorie control scores
  78. 78. M = 7.68, SD=19.76, F(1,2782)=102.00, p<.001
  79. 79. no significant interaction effectwith SES
  80. 80. F(2,2782)= 0.66, p=.25</li></li></ul><li>weight loss<br /><ul><li>weightloss
  81. 81. M = 1.73, SD=4.92, F(1,2782)=138.46, p<.001
  82. 82. no significant interaction effectwith SES
  83. 83. F(2,2782)= 2.22, p=.11</li></li></ul><li>conclusion<br /><ul><li>effect of online intervention: irrespective of SES
  84. 84.  potential for reducing SES-related HI
  85. 85. but: lower participation level in lower SES</li></ul> need for adequate communication<br /><ul><li>Message: focus barriers, prejudices
  86. 86. Channel: workplace, unemploymentagencies</li></li></ul><li>Thankyouforyourattention<br /> Contact: <br />claudia@brandnewday.eu<br />www.brandnewday.eu<br />

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