ABSTRACT
Background: Adults with metabolic syndrome and obesity who participate in intensive lifestyle Interventions (ILIs) often achieve significant weight loss (>5%), improve activity levels and dietary quality, and reduce their risk for diabetes. STRIDES, the ILI at our safety-net county health system, was delivered in group classes until March 2020, when, due to COVID-19, classes pivoted to a web-based format. STRIDES serves an ethnically and economically diverse population. This project compared participant outcomes and staff work between in-person and web-based STRIDES. Methods: Using the STRIDES program data base, attendance, weight loss, and staff work were evaluated for two in-person class cohorts (2018, 2019) and the web-based class cohort (2020). Attendance at weekly group classes and weight loss were compared for in-person participants to web-based participants. who had monthly in-person weigh-ins. Repeated measures ANOVA was used to test for differences in weight loss over time between the three cohorts after adjusting for baseline weight. Results: The 278 (89, 91,98) participants in three cohorts had: a mean age of 56 yrs.and mean BMI of 41%, and were 90% female and 41% AA.Mean number of classes attended were: 8, 13, and 17 at 3, 6, and 12 months. Dropout, low, medium, and high attendance was 2%, 9%, 23%, and 66% respectively and did not differ between in-person and web-based cohorts. Participant weight loss was 6.3% at 6 mo. with 50% achieving >5% weight loss and did not differ between cohorts. New staff web-based work included: technology on-boarding for participants;>1400 coaching calls/year;set-up/ invites for sessions;delivery of participant materials;monthly in-person weigh-ins;and ongoing log-in support during class. Participants satisfaction with the web-based format was 'good' or 'very good' for 95% and 92% plan to parcticipate again. Conclusions: Diverse ILI participants in the 2020 web-based class format had attendance and weight loss comparable to two prior in-person group class years. Participant satisfaction was high in the web-based format, but may not persist after pandemic conditions. Program delivery required additional work compared to the in-person format. Web-based ILI is promising to improve accessibility to programs that improve cardiometabolic risk, but may have increased costs compared to the in-person format.