Comparison of BMI changes in Japanese adults receiving face-to-face versus online counseling for specific health guidance: a noninferiority prospective observational study

Abstract

Objectives

This study aimed to evaluate the noninferiority of online counseling over face-to-face counseling for specific health guidance (SHG).

Methods

This prospective observational study was conducted using specific health checkup (SHC) and SHG data of individuals with health insurance in Japan. We analyzed data from 1431 participants who met the inclusion criteria, including those who underwent online or face-to-face counseling between April 1, 2020 and March 31, 2021, and received an SHC in the following year but no earlier than 90 days after their first counseling session. Assessed variables comprised demographics, counseling methods, and SHC results, including baseline questionnaire findings and body mass index (BMI) at follow-up. We performed inverse probability of treatment weighting (IPTW) using propensity scores, with changes in BMI as the objective variable and the counseling method as the explanatory variable. We set the noninferiority margin to 0.175, based on a previous study.

Results

The online and face-to-face counseling groups comprised 455 (31.8%) and 976 (68.2%) participants, respectively. The number of men and mean age were 214 (47.0%) and 49.9 years (SD: 6.9 years), respectively, in the online counseling group, and 491 (50.3%) and 51.1 years (SD: 7.6 years), respectively, in the face-to-face counseling group. IPTW using propensity scores revealed a regression coefficient of −0.014 (95% CI: −0.157 to 0.129) for the online group compared with the face-to-face group ( P = .847). The CI was within the noninferiority margin.

Conclusions

The effects of online counseling on BMI are likely noninferior to those of face-to-face counseling.

Abstract

What is already known on this topic.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in a swift surge in the use of online counseling as an alternative to traditional face-to-face counseling. Online counseling offers several benefits, such as heightened geographical inclusivity, facilitated participation for individuals facing travel constraints, and engagement with a broader spectrum of participants. Several previous studies have indicated that online counseling may be effective in improving overweight and obesity status.

What this study adds.

For specific health guidance in Japan, the potential effect of online counseling on BMI is expected to be comparable to that of face-to-face counseling.

How this study might affect research, practice, or policy.

As a practical implication, our results suggests that online counseling should be actively used when feasible. As a policy implication, our study indicates that the environment and system for online counseling should be improved, and that the skills of health professionals should be enhanced to develop effective online counseling.