Effectiveness of User and Expert Driven Internet-based Lifestyle Interventions on Hypertension Control
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      Hypertension is a leading risk factor for cardiovascular disease and mortality. Lifestyle
      counseling is recommended as a first line therapy for reducing blood pressure (BP) and risk
      for cardiovascular events. Recent studies suggest that e-based lifestyle interventions are
      effective in evoking therapeutic change in BP1. However, BP response and adherence to
      exercise and diet behavior varies significantly after e-based interventions due to variations
      in treatment methodologies. Consensus is not yet established for a standardized e-counseling
      protocol for hypertension. As noted in our systematic review, the two dominant models of
      e-counseling procedures are expert-driven (protocol driven, prescriptive) and user-driven
      (self-guided, collaborative). Expert-driven programs prescribe specific changes for lifestyle
      behavior which are intended to facilitate compliance to behavioral change. In contrast, the
      user-driven method actively involves the subject in goal-setting and/or the selection of the
      intervention used to reach the behavioral goal. One conclusion from the systematic review is
      that these models are used indiscriminately in e-counseling programs. There is currently
      inadequate data to determine the efficacy of programs that are expert-driven vs. user-driven
      in reducing BP while modifying lifestyle behaviour. It is possible that a combination of
      expert-driven and user-driven features for lifestyle e-counseling is most effective. However,
      before these two approaches can be combined, it is essential to establish the strengths and
      limitations of each model.
    

Detailed description: 
      This study will use a 3-parallel group, randomized controlled design: 3 (Groups: Control,
      expert-driven, and user-driven e-Counselling) by 2 (Assessments: baseline, 4-month). Controls
      will receive general e-information on BP management. The expert-driven e-Counselling group
      will provide a prescribed exercise and a diet plan. The user-driven e-Counselling group will
      a program that enables the patient to choose areas of focus. All subjects will be sent 16
      e-messages on a weekly schedule.
    

Intervention name(s): Control Group; Expert-Driven Group; User-driven group
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Received general information about blood pressure control. All subjects will be sent 16 e-messages on a weekly schedule.; The user-driven e-Counselling group will receive a lifestyle program where the user are able to choose areas of focus. All subjects will be sent 16 e-messages on a weekly schedule.; The user-driven e-Counselling group will receive a lifestyle program where the user are able to choose areas of focus. All subjects will be sent 16 e-messages on a weekly schedule.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention