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A L ifestyle I ntervention V ia E mail. An intervention to improve Nutrition Physical Activity Developed by Block Dietary Data Systems * In collaboration with Kaiser Permanente of Northern California Division of Research
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An intervention to improve • Nutrition • Physical Activity • Developed by Block Dietary Data Systems* • In collaboration with Kaiser Permanente of Northern California Division of Research * Information about the developers of Alive may be found at the end of this presentation Block Dietary Data Systems. www.nutritionquest.com
Background • Americans have a high prevalence of “unhealthy” diets • 77% have fewer than five servings of fruits and vegetables each day • 77% have a fat intake greater than 30% of calories • Americans have a low level of physical activity • 51% fail to meet the recommended activity levels • 24% are at the “sedentary” level Block Dietary Data Systems. www.nutritionquest.com
Overview • 12 weekly or bi-weekly messages • Extensively tailored to individual characteristics • Based on established learning and behavior-change theories and principles • Available for groups reachable by email • Employees, group/organization members, HMO clients • Requires minimal organizational effort or expertise • Proven effective in a randomized controlled trial Block Dietary Data Systems. www.nutritionquest.com
Behavioral Goals • Increase physical activity • Decrease saturated and trans fats, decrease added sugars, increase good fats and carbs • Increase fruit and vegetable intake • Not a weight loss program • Can be adapted to other intervention outcomes Block Dietary Data Systems. www.nutritionquest.com
Behavior Change Principles • Maximizing individual relevance--through assessments, feedback and tailoring • Tailoring to stage-of-change, individual diet habits, exercise preferences • Goal setting • Small-steps toward new habits • Continued feedback and reinforcement • Increasing salience and motivation through health information, tips and reminders • Encouraging social support Block Dietary Data Systems. www.nutritionquest.com
Proven Effective • Randomized controlled trial • Funded by the Centers for Disease Control and Prevention • 797 employees of Kaiser Permanente of Northern California • Statistically significant increases • Physical activity, fruits and vegetables • Statistically significant decreases • Saturated fat, trans fats Block Dietary Data Systems. www.nutritionquest.com
Proven Effective • Randomized controlled trial results paper in preparation • Results reported in June 2007 in Oslo at the International Society of Behavioral Nutrition and Physical Activity • The Trial website contains much more information about Alive!, and about the randomized trial: • www.alive.kaiser.org Block Dietary Data Systems. www.nutritionquest.com
Components • Weekly messages contain • Suggested goals to try for the week, tailored to each individual • Tips for achieving the selected goals • Tips for overcoming barriers • Health information, information on nutrition and physical activity • Interactive tool to explore effects of specific changes • Links to other health/nutrition sites • Links to track diet and physical activity • More! Block Dietary Data Systems. www.nutritionquest.com
Some “Health Notes” Topics • Carbs and the Glycemic Index • Fruits, Veggies and Cancer • Physical Activity and Breast Cancer • Diet and Cognitive Function • Mood, Stress and Physical Activity • Components of Fitness • Trends in Physical Activity Programs • “Good” Fats, “Bad” Fats • and many others Block Dietary Data Systems. www.nutritionquest.com
How it works • Licensing agreement with Block Dietary Data Systems (BDDS) • Organization/company promotes program to employees or membership • Inform them that it’s approved • BDDS can provide some promotional material • BDDS sends invitation email to organization’s HR or other official • Organization’s official forwards email to employee/membership list Block Dietary Data Systems. www.nutritionquest.com
How the process begins • Email is sent by the organization or company • Batch email, to organization’s target group • Email message appears in employee’s or member’s email reader Block Dietary Data Systems. www.nutritionquest.com
Invitation Email • Appears in employee’s inbox Block Dietary Data Systems. www.nutritionquest.com
Employee ‘clicks to get started’ • This is just an opportunity to take a Health Risk Assessment and receive feedback • Then employee receives diet and physical activity assessment Block Dietary Data Systems. www.nutritionquest.com
Health Risk Assessments • Dietary and physical activity screener tools provide tailoring information Block Dietary Data Systems. www.nutritionquest.com
Diet and Physical Activity Screeners • Completed online in 15 minutes • Provide instant feedback on • Saturated fat intake • Trans fat intake • Added sugar intake • Health-related physical activity • Cardiovascular-related physical activity • Sedentary behavior • Available to all, free, whether they decide to participate or not Block Dietary Data Systems. www.nutritionquest.com
Instant Feedback • Instant feedback shows each individual how their own behavior could be improved, in relation to their current health habits Block Dietary Data Systems. www.nutritionquest.com
Instant Feedback • First example, person doing well in fats, less well in fruits and vegetables, so-so in physical activity Block Dietary Data Systems. www.nutritionquest.com
Instant Feedback • Second example, person doing poorly in diet and physical activity Block Dietary Data Systems. www.nutritionquest.com
After Giving Diet and Physical Activity Results: • Opportunity to participate in the Alive program Block Dietary Data Systems. www.nutritionquest.com
If persons choose to participate, they provide email to which Alive! emails will be sent. • May provide an alternate email if they want to participate from home as well. Block Dietary Data Systems. www.nutritionquest.com
Tailoring Questionnaire • Tailoring for diet is based partially on responses to diet questionnaire • E.g., if they report drinking whole milk, suggested goals will propose switching to lower-fat milk • All tailoring is based on responses to lifestyle/tailoring questionnaires • E.g., stage of change and preferences for structured or unstructured physical activity • Or whether they cook, eating-out habits, kids at home Block Dietary Data Systems. www.nutritionquest.com
Participant Chooses Big Goal to Work On • Will work on for next 12 weeks • Can change goal in first two weeks • By agreement, participant may rejoin at end of 12 weeks to work on same or different goal Block Dietary Data Systems. www.nutritionquest.com
Weekly email messages • Come directly to participant’s email inbox Block Dietary Data Systems. www.nutritionquest.com
Weekly email messages • Each week has a Health Notes (information about nutrition or physical activity and health), summarized in the weekly email by sidebar on the right • Each week has suggested small-step goals; participant commits to one or two to try for following week Block Dietary Data Systems. www.nutritionquest.com
Barriers are addressed • First weekly email lists common barriers to achieving diet (or physical activity goals) • Participant indicates which ones are barriers for him • Each week thereafter, tips for overcoming those particular barriers are suggested Block Dietary Data Systems. www.nutritionquest.com
Weekly email messages • When participant choose a goal to work on for the following week…. Block Dietary Data Systems. www.nutritionquest.com
