Web-based education on Metabolism and Obesity is associated with improved lifestyle and health behaviours among Brazilian school teachers

Background: Obesity is a major global public health challenge, and teachers play a critical role in school-based health promotion. This study examined the perceived impact of a web-based educational program on metabolism and obesity delivered to Brazilian school teachers. Methods: This analytical cross-sectional study included 217 teachers who responded to the evaluation questionnaire after attending the course between 2017 and 2022. Statistical analyses included logistic regression and chi-square tests. Findings: Course completion rate was 81.98%, substantially exceeding the 5-15% typical of global MOOCs. However, ethnic disparities were observed: White respondents were 4.95 times more likely to complete the course than Black respondents (p=0.00097) and Brown respondents were 3.05 times more likely (p=0.0268) than Black respondents. Among non-completers, lack of time (64.7%) was the primary barrier. Participation was concentrated in Sao Paulo (77%), with no respondents from three northern states. Perceived difficulty showed a non-significant trend (p=0.0893) where by Black respondents had the lowest predicted difficulty; the most challenging course material was Scientific Content/Reading papers (50%). Completion was strongly associated with applying learned activities in teaching (p<2.2x10-16); 57.1% of completers implemented health-promoting activities, most commonly games, healthy eating, and combined diet-physical activity habits. Completers also reported significant improvements in lifestyle decisions (p=1.76x10-21) and healthy habits (p=9.35x10-77), including better diet and increased physical activity. Conclusion and interpretation: Course completion was associated with reported improvements in diet, physical activity, nutrition knowledge, and teaching practices among Brazilian teachers. However, marked ethnic and regional disparities were observed. White teachers were nearly five times more likely to complete the course than Black teachers. The absence of respondents from northern states reveals that scalability without equity widens existing gaps. Online access to free courses alone does not democratize education; mitigating ethnic and regional disparities must be a priority for digital health interventions.