title: Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.
abstract: BACKGROUND
  Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases.
  
  
  OBJECTIVE
  We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum cholesterol in patients at increased cardiovascular risk.
  
  
  METHODS
  We conducted a randomized controlled trial among patients with increased cardiovascular risk in Canadian family practices. During 8 months, patients in the intervention group and control groups received usual care. Patients in the intervention group also had access to a Web-based nutrition counselling and social support tool (Heartweb). Site use during the study was monitored. We measured social support, body mass index, waist/hip ratio, blood pressure, and cholesterol levels at baseline and at 4 and 8 months to assess the effectiveness of the intervention.
  
  
  RESULTS
  We randomized 146 patients into the Web-based intervention (n=73) or the control group (n=73). Within the Web-based intervention group, Heartweb was used by only 33% (24/73) of patients, with users being significantly younger than nonusers (P=.03). There were no statistically significant differences between the intervention group and the control group in changes in social support, anthropometry, blood pressure, and serum cholesterol levels.
  
  
  CONCLUSIONS
  Uptake of the Web-based intervention was low. This study showed no favourable effects of a Web-based nutrition counselling and social support intervention on social support, anthropometry, blood pressure, and serum cholesterol. Improvements in reach and frequency of site use are needed to increase the effectiveness of Web-based interventions.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. M.Verheijden@arbeid.tno.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Verheijden
authors.forename: J Carel
authors.initials: JC
authors.lastname: Bakx
authors.forename: Reinier
authors.initials: R
authors.lastname: Akkermans
authors.forename: Henk
authors.initials: H
authors.lastname: van den Hoogen
authors.forename: N Marshall
authors.initials: NM
authors.lastname: Godwin
authors.forename: Walter
authors.initials: W
authors.lastname: Rosser
authors.forename: Wija
authors.initials: W
authors.lastname: van Staveren
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
mesh_terms: D000886:Anthropometry; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D003376:Counseling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications; D005194:Family Practice / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000150:complications; D020407:Internet; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods*; D009864:Ontario; D017063:Outcome Assessment, Health Care; D012944:Social Support
chemical_list: D002784:Cholesterol