Exercise :: Log-on to shape-up

The Internet can be an effective tool in helping inactive adults to get moving, a new study suggests. Researchers at The Miriam Hospital and The Warren Alpert Medical School of Brown University found that web-based intervention programs aimed at changing the behavior of sedentary adults were just as effective as traditional, print-based programs.

The research was published in the May 14 issue of the Archives of Internal Medicine.

“The findings are important because they provide evidence that different channels of delivery can provide equally effective results,” says lead author Bess Marcus, PhD, with The Miriam Hospital?s Centers for Behavioral and Preventive Medicine and professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University

“Non face-to-face methods, such as the mail and the Internet, can reduce potential barriers, such as lack of access to fitness facilities and time constraints,” explains Marcus.

Marcus and her team decided to study the effectiveness of web-based channels because of their potential to be available to larger populations at minimal cost.

Prior studies have shown that direct mail programs geared at changing behavior in order to boost a person?s physical activity can work, but come with built-in drawbacks, including the lack of immediate feedback (due to the delay in mailing), lack of immediate interactivity, and even the cost of postage.

Researchers studied 249 healthy, sedentary, adults from Rhode Island and Pittsburgh. Participants were randomly assigned to one of three physical activity interventions: tailored Internet, standard Internet and tailored print.

Those in the tailored Internet group were asked to log on to a website designed by the researchers that included educational materials, tips for adopting and maintaining physical activity, and goal setting functions. They completed daily physical activity logs online, were emailed monthly questionnaires, and received immediate feedback according to their responses. Individuals in the tailored print group received the same information as those in the tailored Internet group, but the materials, including feedback, were delivered through the mail.

Participants in the standard Internet group were provided links to six pre-selected physical activity websites available to the general public, but not customized by the researchers. They were asked to complete physical activity logs and monthly questionnaires online, but did not receive tailored feedback reports.

After six months, participants in the tailored Internet group reported approximately 120 minutes of physical activity per week, the tailored print group 112.5 minutes per week, and the standard Internet group 90 minutes. After 12 months ? weekly activity reported was 90, 90 and 80 minutes respectively, showing no significant difference between the programs over time.

“We found that the online interventions worked just as well as the more expensive printed materials,” says Marcus.

All of the interventions, both print and Internet-based proved effective. The authors cite that overall, participants exhibited a 5.2 percent improvement in fitness from baseline to six months, and 5.9 percent improvement from baseline to12 months. The most commonly reported type of activity was walking.

In addition, the results indicate no difference between the tailored and standard programs, which was “an unexpected finding” the authors note.

“Because the largest public health benefit in physical activity interventions comes from having populations of sedentary persons become more active rather than already active persons becoming more active, the interventions, if widely implemented, could create substantial public health benefits,” says Marcus.

According to Marcus, “In 2006, 147 million American adults were internet users. If sedentary individuals are at least as likely as active individuals to use the Internet, this means roughly 80 million under-active adults are online and might be reached via web-based interventions.”

The researchers suggest that future studies examine the effectiveness of tailored Internet interventions disseminated in “real world” settings that are void of the research components present in the current trial.

Physical inactivity and dietary patterns are second only to tobacco use as a leading cause of preventable death in the United States. Despite the multiple health benefits that physical activity is associated with, less than half of Americans engage in the recommended physical activity levels.

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