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Volume 36, Issue 6, Pages 475-483 (June 2009)


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Improving Diet and Physical Activity with ALIVE: A Worksite Randomized Trial

Barbara Sternfeld, PhDaCorresponding Author Informationemail address, Clifford Block, PhDb, Charles P. Quesenberry Jr, PhDa, Torin J. Block, BAb, Gail Husson, MPHa, Jean C. Norris, DrPHb, Melissa Nelson, MA, MPHa, Gladys Block, PhDb

Context

Healthy diets and regular physical activity confer many health benefits, but the prevalence of these behaviors is relatively low.

Background

Cost-effective strategies are needed to increase healthy eating and physical activity in the population.

Design

An RCT, conducted in 2006, of a 16-week e-mail program offered individually tailored, small-step goals; a personal homepage with tips; educational materials; and tracking and simulation tools.

Setting/population

Seven hundred eighty-seven employees in the administrative offices of a large healthcare organization volunteered to participate.

Main outcome measures

Changes were self-reported for total physical activity; moderate physical activity (MPA); vigorous physical activity (VPA); walking; sedentary behavior; and intake of fruits and vegetables, saturated and trans fats, and added sugars in the intervention group compared to the control group.

Results

In intent-to-treat analyses (conducted in 2007 and 2008) that set change in nonresponders to the follow-up questionnaire to zero, the intervention group reported increases of 28.0 minutes/week (min/wk) of MPA (SE=7.4, p=0.0002); 12.5 min/wk of VPA (SE=5.7, p=0.03); and 21.5 min/wk of walking (SE=5.5, p=0.0003) relative to the control group. Intake of both saturated and trans fats (grams/day [g/day]) declined (β=–0.95, SE=0.36, p=0.01; β=–0.29, SE=0.12, p=0.02, respectively). The consumption of fruits and vegetables increased significantly (p=0.03), and the consumption of added sugars decreased marginally (p=0.08). The largest changes were in participants who did not meet behavioral recommendations at baseline (increase of 55.4 min/wk of MPA and decrease of 1.15 g/day of trans fats, relative to the control group). Differences between the intervention and control groups were still observed 4 months after the intervention ended.

Conclusions

ALIVE is an effective program for achieving significant improvement in diet and physical activity.

Trial registration

NCT00607009.

a Division of Research, Kaiser Permanente, Oakland, California

b NutritionQuest, Inc., Berkeley, California

Corresponding Author InformationAddress correspondence and reprint requests to: Barbara Sternfeld, PhD, Division of Research, Kaiser Permanente, 2000 Broadway, Oakland CA 94612

PII: S0749-3797(09)00150-0

doi:10.1016/j.amepre.2009.01.036


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