Background:

 Virtual programs grounded in evidence-based health behavior strategies can provide effective between-visit care to improve health outcomes for individuals with cardiometabolic disease risk. Personalization may promote compassionate and engaging patient-centered care in these programs. We evaluated the impact on program engagement of providing members enrolled in a virtual lifestyle prevention program (Omada for Prevention) the opportunity to make a guided decision about the theme of the curriculum they receive vs providing content in a standardized order

Methods:

The intervention group consisted of members who indicated managing food cravings as a barrier to engaging in healthy lifestyle behaviors in a survey at program baseline. They were given the opportunity to select their “learning paths” at baseline and again at week 4. Paths are 3-4 week focus areas of content around specific health behavior topics surfaced based on member inputs and core curriculum needs. The usual care group was identified using 1:1 propensity score matching to members who indicated other food and drink related barriers and received standardized curriculum without the opportunity to select their learning paths. Member engagement metrics were compared through the first 7 program weeks, which included the first 2 learning paths. Chi-squared tests were used to evaluate categorical variable differences and t-tests were used to evaluate mean differences in continuous variables.

Results:

Members were 72% female, 72% white, and had an average baseline BMI of 34.7 with no significant differences between the intervention (n=1373) and usual care (n=1436) groups. During the first 4-week path, intervention members were 9% more likely to establish rapport (i.e. send a message in response to outreach) with their care team and 4.5% more likely to set goals (both p<.01) compared to the usual care group. After 7 weeks, the intervention group had sent 20% more messages per week to the care team (p<.01), set 13% more goals (p<.01), and had 6% more physically active days (p=0.05) compared to the usual care group. 

Conclusion:

Virtual prevention program members who had the opportunity to choose their learning paths engaged with the program significantly more in a number of meaningful ways than members who were not given the option to choose. Results suggest that empowering members with moments of guided choice could meaningfully support the uptake of health behavior change strategies.