Diffusion of computer-tailored behavior change programs through the Health Monitor System.

Smoking, unhealthy eating habits, inactivity and excessive alcohol consumption
are important determinants of disease and mortality, such as diabetes type II,
cardiovascular diseases and cancer. Recently several effective new approaches
have been developed using computer tailored (CT) programs to motivate people to
change their health behaviors. In the Netherlands, many programs that use CT
techniques have shown to be successful for quitting smoking, increasing fruits
and vegetable consumption, increasing physical activity and reducing alcohol
consumption in adults.
The present study is aimed at successful diffusion of a combination of
several CT programs (focused on physical activity, fruit and vegetable
consumption, smoking and alcohol consumption) using Internet. In particular,
the combined CT program will be integrated in the Adult Health Monitor
(www.monitorgezondheid.nl) service of the Regional Health Authority (RHA). This
integration will result in an E-Health Passport people can turn to in order to
obtain not only detailed and personalized information regarding their current
health status and potential risk associated with this status, but also
personalized advice on how to positively change their health by focusing on
five key behaviors (physical activity, fruit and vegetable consumption, smoking
and alcohol consumption).

This project aims to disseminate current CT programs on smoking, fruits and
vegetables consumption, physical activity and alcohol consumption to the
general public within one generic E-Health Passport that integrates the
information of the health monitor with existing computer tailored programs. In
order to study the diffusion of the new service, it is important to assess the
level of adoption, the characteristics of adopters and non-adopters and
satisfaction of adopters with the new service in order to obtain a good
adoption profile (study 1). Due to the fact that program impact largely depends
on level of use and especially the sustainability of use, it is important to
design and test strategies that increase and maintain level of use. Therefore,
in study 2 the efficacy of a pro-active approach using prompts in order to
attract sufficient attention in users to maintain interest and use will be
studied.

Study 1:
Longitudinaal design (3 months)
Study 2:
Randomized control trial (RCT), with four measurements: baseline, 6, 12 and 18
months.

Study 1:
No intervention.
Study 2:
The CT intervention will target five health behaviors; physical activity, fruit
and vegetable intake, smoking and alcohol consumption. The program will provide
people with feedback regarding their current health status, the health risks
associated with this status, suggestions to change health behaviors once Dutch
norms regarding these behaviors are not being complied with and relevant
computer tailored advice to promote changing these behaviors. Participants have
an opportunity to visit and use the CT program as often as they like and
receive feedback on behavior changes or problems.
This intervention will be offered pro-actively to participants in the
experimental condition, meaning that they will receive prompts every three
months reminding them to use the CT program. A reactive approach will be used
for participants in the control group, implying that they will not receive any
additional prompts.

To our knowledge no risks are associated with participation in the current
study.