Sociodemographic, Health, and Lifestyle-Related CharacteristicsAssociated With the Commencement and Completion of aWeb-Based Lifestyle Educational Program for People With MultipleSclerosis:Randomized Controlled Trial

Background: Digital health interventions increase access to multiple sclerosis (MS)-related knowledge for people living withMS; however, our understanding of factors associated with engagement in web-based learning is limited.Objective: This study aims to examine associations between participant sociodemographic, health, and lifestyle-relatedcharacteristics and the commencement and completion of the Multiple Sclerosis Online Course (MSOC) in a randomized controlledtrial (RCT).Methods: An intervention course was developed based on the Overcoming MS Program-an evidence-based lifestyle modificationprogram for MS, and a standard care course was developed based on international MS website information. An RCT was conductedto compare the effectiveness of the intervention course versus the standard care course in improving health outcomes in peopleliving with MS. Participant data were collected from a baseline survey. Associations between baseline participant characteristicsand MSOC commencement and completion, respectively, were assessed using multivariate log-binomial regression.Results: Overall, 1893 participants enrolled in the RCT, and 45.27% (n=857) completed the baseline survey: 23.5% (n=444)in the intervention course and 21.8% (n=413) in the standard care course. Of these 857 participants, 631 (73.6%) commencedthe standard care course or intervention course, and 49.1% (218/444) and 54.2% (224/413) completed the intervention courseand standard care course, respectively. University education, partnered relationship status, and higher mental and physical qualityof life were associated with 19%, 12%, 20%, and 22% higher rates of course commencement, respectively. Clinically significantfatigue was associated with a 10% reduction in the likelihood of commencement. Strongest associations with intervention coursecompletion included middle and older adulthood, male sex, fatigue, and preexisting adherence to a diet program, with 96%, 27%,24%, and 19% higher rates of completion observed, respectively, whereas higher self-efficacy was associated with up to 35%lower intervention course completion. Associations with standard care course completion included practicing meditation (20%higher completion), whereas employment was associated with 22% lower completion. Conclusions: Sociodemographic and clinical factors, as well as lifestyle-related factors, were important factors in MSOCcommencement and completion. These data may help guide the design and enhancement of digital health interventions tailoredfor people living with MS.