Evidence map›Paper›PMID 34668165›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

Engagement and Adherence with a Web-Based Prehabilitation Program for Patients Awaiting Abdominal Colorectal Surgery.

Elizabeth Shelton, Nicolas B Barreto, Serena Bidwell, Margaret Folk-Tolbert, Andrew Shelton, Amber W Trickey, Cindy J Kin

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. [App-based prehabilitation: implementation and adherence].Chirurgie (Heidelberg, Germany) · 2025
    Review
  7. Article
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  9. Environmental impact of the enhanced recovery pathway in colorectal surgery: A simulation study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
    Article
  10. Review
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elizabeth SheltonDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Nicolas B BarretoDepartment of Surgery, Stanford-Surgery Policy Improvement Research and Education (SSPIRE), Palo Alto, CA, USA.
Serena BidwellDepartment of Surgery, Stanford-Surgery Policy Improvement Research and Education (SSPIRE), Palo Alto, CA, USA.
Margaret Folk-TolbertStanford Health Care, Palo Alto, CA, USA.
Andrew SheltonDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Amber W TrickeyDepartment of Surgery, Stanford-Surgery Policy Improvement Research and Education (SSPIRE), Palo Alto, CA, USA.
Cindy J KinDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA. cindykin@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderstanding the drivers of patient engagement and adherence is critical to developing and implementing preoperative optimization programs. The aim of this project is to determine whether existing health beliefs are associated with engagement and adherence in a home-based online prehabilitation program.

methodsPatients undergoing abdominal colorectal operations were enrolled in an online nutrition and exercise program. We collected baseline health beliefs and mindsets, daily exercises, and weekly diet recalls. Multivariable binary logistic regression predicted engagement, multivariable ordinary least squares regression predicted diet adherence, and generalized linear models with a binomial distribution predicted engagement and exercise adherence.

resultsOf the 227 patients who agreed to participate, 75% activated their accounts; of those, 75% used the program. Engagement with the program was unrelated to health beliefs or mindsets. Positive diet-related health beliefs and a growth mindset were associated with positive diet behaviors and inversely associated with negative diet behaviors. Exercise-related health beliefs and mindsets were not associated with exercise adherence. Patients enrolled within 4 weeks of surgery used the program more than those enrolled more than 4 weeks from surgery.

conclusionsThis app-based prehabilitation program demonstrated moderate acceptability, engagement, and adherence. Addressing health beliefs and mindsets may be an effective way of increasing adherence to diet recommendations. To increase adherence to exercise recommendations, further assessment of potential barriers is critical. While an online platform is a highly promising scalable strategy, more customization and user engagement are necessary to make it an effective way of delivering a preoperative health behavior change intervention.

Indexed as

Colorectal SurgeryDigestive System Surgical ProceduresHumansInternetPreoperative CarePreoperative ExerciseHealth behavior adherenceHealth beliefsOnline health coachingPatient engagementPrehabilitation

Identifiers

PMID34668165

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.