title: Optimizing diffusion of an online computer tailored lifestyle program: a study protocol.
abstract: BACKGROUND
  Although the Internet is a promising medium to offer lifestyle interventions to large amounts of people at relatively low costs and effort, actual exposure rates of these interventions fail to meet the high expectations. Since public health impact of interventions is determined by intervention efficacy and level of exposure to the intervention, it is imperative to put effort in optimal dissemination. The present project attempts to optimize the dissemination process of a new online computer tailored generic lifestyle program by carefully studying the adoption process and developing a strategy to achieve sustained use of the program.
  
  
  METHODS
  A prospective study will be conducted to yield relevant information concerning the adoption process by studying the level of adoption of the program, determinants involved in adoption and characteristics of adopters and non-adopters as well as satisfied and unsatisfied users. Furthermore, a randomized control trial will be conducted to the test the effectiveness of a proactive strategy using periodic e-mail prompts in optimizing sustained use of the new program.
  
  
  CONCLUSIONS
  Closely mapping the adoption process will gain insight in characteristics of adopters and non-adopters and satisfied and unsatisfied users. This insight can be used to further optimize the program by making it more suitable for a wider range of users, or to develop adjusted interventions to attract subgroups of users that are not reached or satisfied with the initial intervention. Furthermore, by studying the effect of a proactive strategy using period prompts compared to a reactive strategy to stimulate sustained use of the intervention and, possibly, behaviour change, specific recommendations on the use and the application of prompts in online lifestyle interventions can be developed.
  
  
  BACKGROUND
  Dutch Trial Register NTR1786 and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016).
authors.affiliation: CAPHRI/Department of Health Promotion, Maastricht University, P,O, Box 616, 6200 MD Maastricht, the Netherlands. francine.schneider@maastrichtuniversity.nl
authors.forename: Francine
authors.initials: F
authors.lastname: Schneider
authors.forename: Liesbeth A D M
authors.initials: LA
authors.lastname: van Osch
authors.forename: Stef P J
authors.initials: SP
authors.lastname: Kremers
authors.forename: Daniela N
authors.initials: DN
authors.lastname: Schulz
authors.forename: Mathieu J G
authors.initials: MJ
authors.lastname: van Adrichem
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003258:Consumer Behavior; D004059:Diffusion of Innovation; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D014584:User-Computer Interface; D055815:Young Adult