title: The Effect of Tailored Web-Based Feedback and Optional Telephone Coaching on Health Improvements: A Randomized Intervention Among Employees in the Transport Service Industry.
abstract: Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches.
  
  
  
  To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index-BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching.
  
  
  
  Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants' reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used.
  
  
  
  Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m(2)) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47.8%, and 165 of 324 participants, 50.9%, for groups B and C, respectively) and physical activity habits (181 of 301 participants, 60.1%, and 207 of 324 participants, 63.9%, for B and C, respectively) compared with the control group A (122 of 356 participants, 34.3%, for diet and 177 of 356 participants, 49.7%, for physical activity). At follow-up, the intervention groups had significantly decreased motivation (group B: P<.001 for change in diet; P<.001 for change in physical activity; group C: P=.007 for change in diet; P<.001 for change in physical activity), whereas the control group reported significantly increased motivation to change diet and physical activity (P<.001 for change in diet; P<.001 for change in physical activity).
  
  
  
  Tailored Web-based health feedback and the offering of optional telephone coaching did not have a positive health effect on employees in the transport services. However, our findings suggest an increased short-term motivation to change health behaviors related to diet and physical activity among those receiving tailored Web-based health feedback.
authors: Karolinska Institutet, Department of Medicine, Clinical Epidemiology Unit, Stockholm, Sweden. Madeleine.Solenhill@hh.se.
authors: Madeleine
authors: 0000-0002-4144-4877
authors: M
authors: Solenhill
authors: Alessandra
authors: 0000-0002-5116-7180
authors: A
authors: Grotta
authors: Elena
authors: 0000-0001-5534-7245
authors: E
authors: Pasquali
authors: Linda
authors: 0000-0001-5743-0923
authors: L
authors: Bakkman
authors: Rino
authors: 0000-0002-2538-0287
authors: R
authors: Bellocco
authors: Ylva
authors: 0000-0001-6816-7577
authors: Y
authors: Trolle Lagerros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005246:Feedback; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013689:Telephone; D014186:Transportation; D000078329:Workforce; D055815:Young Adult
keywords: Internet; diet; exercise; intervention studies; lifestyle; motivation; occupational health; questionnaires; randomized