Testing an Internet-based Lifestyle Approach

Cardiovascular diseases and cancer are two major health problems in the Netherlands. Lifestyle risk behaviors associated with these problems are smoking, bad nutritional habits, inactivity, and excessive alcohol consumption. These risk behaviors have been found to be more prominent in people with a low educational level. Computer tailored health education promotes the adoption of health behaviors in groups with both a high and low educational level. The first generation methods mostly focused on a single behavior. Recently new second-generation studies started to include multiple behaviors. However, it is not clear how to best offer health information about lifestyles to the public. It is conceivable that some people are ready to change several behaviors at the same time, whereas others might be only prepared to change a limited cluster of behaviors, or to change only one specific behavior. Recent Dutch studies suggest that a focus on clusters may be more acceptable for some people, since a previous overall lifestyle tailoring approach did result in changes in both activity and nutritional patterns, but not in smoking behavior. Internet-based health education has become popular but few were tested in a RCT to analyze effects on multiple behaviors. Our goal is to test and analyze the effects of different ways of delivering tailored feedback using an Internet-based approach by comparing a single behavior approach, a cluster approach and a generic approach, and to compare effects with those of a control group. We hypothesize that the effectiveness of the experimental conditions will depend on the motivational characteristics of the person. Potential differences in appreciation and effectiveness of the interventions for subgroups (SES, age, gender) will be described as well. The intervention will be offered to inhabitants of two provinces of the Netherlands (Zeeland and Brabant) as part of an additional service to their regular health monitoring questionnaires by the Regional Health Authorities (RHA) of these provinces (Dutch: GGD's).