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Social media–delivered lifestyle interventions have shown promising outcomes, often generating modest but significant weight loss. Participant engagement appears to be an important predictor of weight loss outcomes; however, engagement generally declines over time and is highly variable both within and across studies. Research on factors that influence participant engagement remains scant in the context of social media–delivered lifestyle interventions.

This study aimed to identify predictors of participant engagement from the content generated during a social media–delivered lifestyle intervention, including characteristics of the posts, the conversation that followed the post, and participants’ previous engagement patterns.

We performed secondary analyses using data from a pilot randomized trial that delivered 2 lifestyle interventions via Facebook. We analyzed 80 participants’ engagement data over a 16-week intervention period and linked them to predictors, including characteristics of the posts, conversations that followed the post, and participants’ previous engagement, using a mixed-effects model. We also performed machine learning–based classification to confirm the importance of the significant predictors previously identified and explore how well these measures can predict whether participants will engage with a specific post.

The probability of participants’ engagement with each post decreased by 0.28% each week (P<.001; 95% CI 0.16%-0.4%). The probability of participants engaging with posts generated by …