title: The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  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, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. francine.schneider@maastrichtuniversity.nl
authors.forename: Francine
authors.initials: F
authors.lastname: Schneider
authors.forename: Daniela N
authors.initials: DN
authors.lastname: Schulz
authors.forename: Loes H L
authors.initials: LH
authors.lastname: Pouwels
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.forename: Liesbeth  A D M
authors.initials: L
authors.lastname: van Osch
mesh_terms: D000328:Adult; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D012923:Social Class; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000706:statistics & numerical data*
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