CAPHRI / Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
BMC Public Health. 2013 Aug 5;13:721. doi: 10.1186/1471-2458-13-721.
The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands.
The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors.
A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate.
With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive dissemination strategy succeeded in ensuring relatively high levels of reach. Reach among at-risk individuals (e.g. low socioeconomic status and unhealthy lifestyle) was modest. It is therefore essential to further optimize reach by putting additional effort into increasing interest in the lifestyle intervention among at-risk individuals and to encourage them to actually use the intervention.
Dutch Trial Register (NTR1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016).
为了扩大有效互联网生活方式干预措施的受众范围，采用反应性策略进行推广。这凸显了投资于主动策略，为目标人群提供这些干预措施的必要性。本研究通过将干预措施嵌入荷兰地区公共卫生服务的现有在线健康监测系统，采用主动策略来增加互联网提供的多组件计算机定制干预措施的覆盖范围。
研究人群包括荷兰成年人，他们受邀参加地区公共卫生服务提供的成人健康监测（N=96388）。该监测由在线或书面问卷组成。采用前瞻性设计，通过关注生活方式干预的实际参与情况，确定覆盖范围的水平。此外，通过构建干预使用者的详细档案，评估目标人群的覆盖范围是否充分。参与者的特征，如人口统计学、行为和心理健康状况以及生活质量，被纳入模型作为预测因素。
共有 41155 人（43%）参加了成人健康监测，其中 41%（n=16940）填写了在线版本。超过一半的在线参与者表示有兴趣（n=9169；54%）参加计算机定制干预，5168 名参与者（31%）实际参加了互联网提供的计算机定制干预。男性、年龄较大的受访者和教育程度较高的个体更有可能参加干预。此外，结果表明，生活方式相对健康且 BMI 健康的参与者更有可能参加。
在参加在线成人健康监测的三分之一参与者中，实际上有 1 人参加了计算机定制的生活方式干预，所采用的主动传播策略成功地确保了相对较高的覆盖范围。在高风险人群（例如，社会经济地位较低和生活方式不健康）中的覆盖范围适度。因此，通过进一步努力提高高风险人群对生活方式干预的兴趣，并鼓励他们实际使用干预措施，提高覆盖范围至关重要。
荷兰试验注册处（NTR1786）和马斯特里赫特大学和马斯特里赫特大学医院的医学伦理委员会（NL2723506809/MEC0903016）。
