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

Abstract

This study aimed to evaluate the non-inferiority of online counseling over face-to-face counseling for specific health guidance (SHG). 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 1,431 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 non-inferiority margin to 0.175, based on a previous study. 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 (standard deviation: 6.9 years), respectively, in the online counseling group and 491 (50.3%) and 51.1 years (7.6 years), respectively, in the face-to-face counseling group. IPTW using propensity scores revealed a regression coefficient (95% confidence interval) of -0.014 (-0.157, 0.129) for the online group compared to the face-to-face group (p=.847). The confidence interval was within the non-inferiority margin. The effects of online counseling on BMI are likely non-inferior to those of face-to-face counseling.