Effects of a tailored follow-up intervention on health behaviors, beliefs, and attitudes.
BACKGROUND
The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers.


METHODS
Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program at local North Carolina health departments. During the year after the behavior change program, intervention participants were mailed six sets of computer-tailored health messages and received two computer-tailored telephone counseling sessions. Main outcomes of dietary and physical activity behaviors, beliefs, and attitudes were measured.


RESULTS
Intervention participants were more likely to move forward into more advanced stages of physical activity change (p = 0.02); control participants were more likely to increase their level of dietary social support at follow-up (p = 0.05). Both groups maintained low levels of reported saturated fat and cholesterol intake at follow-up. No changes were seen in physical activity in either group.


CONCLUSIONS
Mailed computer-tailored health messages and telephone counseling calls favorably modified forward physical activity stage movement but did not appreciably affect any other psychosocial or behavioral outcomes.
Jacobs
Alissa D
AD
Department of Nutrition, University of North Carolina at Chapel Hill, 27599, USA.
Ammerman
Alice S
AS
Ennett
Susan T
ST
Campbell
Marci K
MK
Tawney
Katherine W
KW
Aytur
Semra A
SA
Marshall
Stephen W
SW
Will
Julie C
JC
Rosamond
Wayne D
WD
D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000592:standards; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009043:Motor Activity; D009657:North Carolina / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000592:standards; D011203:Poverty / Q000706:statistics & numerical data*; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016387:Women's Health