Web-Based Risk Communication and Planning in an Obese Population: Exploratory Study

Abstract

BackgroundA healthy diet, low in saturated fat and high in fiber, is a popular medical recommendation in preventing cardiovascular disease (CVD). One approach to motivating healthier eating is to raise individuals’ awareness of their CVD risk and then help them form specific plans to change.ObjectivesThe aim was to explore the combined impact of a Web-based CVD risk message and a fully automated planning tool on risk perceptions, intentions, and saturated fat intake changes over 4 weeks.MethodsOf the 1187 men and women recruited online, 781 were randomly allocated to one of four conditions: a CVD risk message, the same CVD risk message paired with planning, planning on its own, and a control group. All outcome measures were assessed by online self-reports. Generalized linear modeling was used to analyze the data.ResultsSelf-perceived consumption of low saturated fat foods (odds ratio 11.40, 95% CI 1.86–69.68) and intentions to change diet (odds ratio 21.20, 95% CI 2.6–172.4) increased more in participants allocated to the planning than the control group. No difference was observed between the four conditions with regard to percentage saturated fat intake changes. Contrary to our expectations, there was no difference in perceived and percentage saturated fat intake change between the CVD risk message plus planning group and the control group. Risk perceptions among those receiving the CVD risk message changed to be more in line with their age (change in slopeindividual = 0.075, P = .01; change in slopecomparative = 0.100, P = .001), whereas there was no change among those who did not receive the CVD risk message.ConclusionThere was no evidence that combining a CVD risk message with a planning tool reduces saturated fat intake more than either alone. Further research is required to identify ways in which matching motivational and volitional strategies can lead to greater behavior changes.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 91154001; http://www.controlled-trials.com/ISRCTN91154001 (Archived by WebCite at http://www.webcitation.org/62sBoGeOO)

Web-Based Self-Assessment Health Tools: Who Are the Users and What Is the Impact of Missing Input Information?

“…This is of particular interest for younger people where a low absolute 10-year CVD risk can be falsely reassuring [ 37 - 40 ], especially in the presence of multiple raised risk factors. Heart Age was shown to be more likely perceived as a wake-up call among younger (30-45 year old) smokers and/or obese users [ 41 ]. Previous studies also showed that Heart Age motivated people to make healthy behavior changes or had an emotional impact [ 7 , 42 , 43 ], and led to greater reductions in cholesterol, blood pressure, and CVD risk than when a percentage for 10-year CVD risk was provided [ 42 ].…”

“…Precautionary measures to restrict extreme outcomes of Web-based health assessment tools may generally be useful to limit large inaccuracies in predicted disease risk. Withholding people who have incomplete risk factor information from accessing Web-based self-assessment tools may be a missed opportunity as the Heart Age tool has been shown to motivate women to get their cholesterol tested [ 41 ].…”

Exploratory Study of Web-Based Planning and Mobile Text Reminders in an Overweight Population

“…The i f statements are purported to increase the accessibility of critical situations to a person, while the then component of the plan creates a stronger link between the situational cue and the goal-directed response. Promising results of this format have been reported in several health-related behaviors [ 9 - 12 ].…”

“…Most of the studies on implementation intentions have used face-to-face communication. These studies showed a reliable effect on diet, physical activity, and smoking cessation [ 5 , 8 - 11 ], whereas evidence from the two studies on the effects of Web-based interventions was mixed [ 12 , 13 ]. In a study conducted in an occupational setting, use of Web-based implementation intentions backfired, such that participants who did not form an implementation intention exercised significantly more than participants who formed an implementation intention [ 13 ].…”

“…In a study conducted in an occupational setting, use of Web-based implementation intentions backfired, such that participants who did not form an implementation intention exercised significantly more than participants who formed an implementation intention [ 13 ]. In a recent dietary intervention, participants allocated to a Web-based implementation intention condition reported a reduction in their self-reported saturated fat intake [ 12 ].…”