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Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study
  1. Carl Joakim Brandt1,2,
  2. Jane Clemensen2,3,
  3. Jesper Bo Nielsen1,
  4. Jens Søndergaard1
  1. 1 Research Unit of General Practice, Department for Public Health, University of Southern Denmark, Odense, Denmark
  2. 2 CIMT - Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denamrk
  3. 3 Hans Christian Andersen’s Childrens Hospital, Odense University Hospital, Odense, Denmark
  1. Correspondence to Dr Carl Joakim Brandt; cbrandt{at}


Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool, including the support of peers and healthcare professionals.

Setting General practice clinics in the Region of Southern Denmark.

Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight.

Results The main themes identified were facilitators, barriers and support from family and peers. Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance. It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person. Often, significant life events were identified as catalysts for successful long-term lifestyle changes. Dominant barriers to change were perception of insurmountable obstacles, experience of lack of self-efficacy and excess eating of high-calorie food. Finally, experiencing of trustworthy person-to-person forums, need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change.

Conclusion The most important driver in long-term weight loss was a strong relationship with a healthcare professional. Collaborative e-health tools can support the relationship and behavioural changes through monitoring and providing relevant feedback. The support from family and peers also matters, and long-term success depends on the ability to establish strong, positive support on a day-to-day basis.

  • behavioral outcome
  • weight loss
  • behavioral change support system
  • telemedicine
  • lifestyle change
  • obesity

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors CJB, JC, JBN and JS have all contributed substantially to the conception and the design of the work, and analysis and interpretation of data. CJB, JC, JBN and JS have all been involved in drafting and revising the article critically for important intellectual content. CJB, JC, JBN and JS have all approved the final version attached, will approve the final published version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The study has been partly funded by The Region of Southern Denmark, KEU project 07/10.

  • Competing interests CJB owns stock in LIVA Healthcare ApS, the company that has developed parts of the technical platform used by the patients in the pilot study.

  • Patient consent Obtained.

  • Ethics approval The Regional Committees on Health Research Ethics for Southern Denmark.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All 10 interviews can be provided in Danish on request.

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