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

Background: The aim of this study was to determine adherence and attrition rates in a lifestyle intervention for people with metabolic syndrome. Methods: 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. Results: 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: 0.450.85, P=0.033) were more likely to stay in the study. Conclusion: 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.