Greaney Mary L, Puleo Elaine, Bennett Gary G, Haines Jess, Viswanath K, Gillman Matthew W, Sprunck-Harrild Kim, Coeling Molly, Rusinak Donna, Emmons Karen M
1Dana-Farber Cancer Institute, Boston, MA, USA.
Health Educ Behav. 2014 Feb;41(1):52-62. doi: 10.1177/1090198113486803. Epub 2013 May 29.
Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics around distribution. Web-based interventions offer more interactivity but may not be accessible to all. Healthy Directions 2 was a primary care-based cluster randomized controlled trial designed to improve five behavioral cancer risk factors among a diverse sample of adults (n = 2,440) in metropolitan Boston. Intervention materials were available via print or the web. Purpose. To (a) describe the Healthy Directions 2 study design and (b) identify baseline factors associated with whether participants opted for print or web-based materials.
Hierarchical regression models corrected for clustering by physician were built to examine factors associated with choice of intervention modality.
At baseline, just 4.0% of participants met all behavioral recommendations. Nearly equivalent numbers of intervention participants opted for print and web-based materials (44.6% vs. 55.4%). Participants choosing web-based materials were younger, and reported having a better financial status, better perceived health, greater computer comfort, and more frequent Internet use (p < .05) than those opting for print. In addition, Whites were more likely to pick web-based material than Black participants.
Interventions addressing multiple behaviors are needed in the primary care setting, but they should be available in web and print formats as nearly equal number of participants chose each option, and there are significant differences in the population groups using each modality.
许多美国成年人存在多种行为风险因素，因此需要有效的、可扩展的干预措施来促进人群健康。在医疗保健环境中，干预措施通常以印刷品形式提供，虽然几乎人人都能获取，但篇幅简短（如宣传册），缺乏互动性，且在分发方面需要一些后勤工作。基于网络的干预措施提供了更多互动性，但并非所有人都能使用。健康指导2是一项基于初级保健的整群随机对照试验，旨在改善大波士顿地区不同成年人群体（n = 2440）中的五种行为性癌症风险因素。干预材料可通过印刷品或网络获取。目的：（a）描述健康指导2研究设计，（b）确定与参与者选择印刷品或网络材料相关的基线因素。
构建经医生聚类校正的分层回归模型，以检验与干预方式选择相关的因素。
在基线时，只有4.0%的参与者符合所有行为建议。选择印刷品和网络材料的干预参与者数量几乎相同（44.6%对55.4%）。选择网络材料的参与者比选择印刷品的参与者更年轻，报告的经济状况更好，自我感觉健康状况更好，对电脑更适应，且上网频率更高（p < 0.05）。此外，白人比黑人参与者更有可能选择网络材料。
在初级保健环境中需要针对多种行为的干预措施，但应同时提供网络和印刷两种形式，因为选择每种形式的参与者数量几乎相同，而且使用每种形式的人群存在显著差异。
