Saturday, February 23, 2008

How to get people to actually visit efficacious tailored health education websites, and what is needed for such education to be effective?

Last month a paper appeared in the journal Health Education that I co-authored, based on as study by Rick Crutzen, from Maastricht University. Rick and Wendy Brouwers from Erasmus University Medical Centre both work on their PhD’s based on research into why people do or do not visit, access, and stay long enough to complete e-health promotion interventions on the web. Research has indicated that so-called computer-tailored health education is more likely to result in health behaviour change than generic health education. In computer-tailoring people receive personalized feedback and advice, based on a personal assessment of the health behaviour and behavioural determinants. The web is regarded as a very promising channel to distribute such tailored advice, but studies comparing web-based and print computer-tailored intervention indicate that print-delivered versions may be more effective. One reason is that people do not visit the relevant website, or do not stay long enough to really go through the diagnosis and advice. Rick and Wendy’s studies explore why that is the case and what might make people more attentive to web-based tailored interventions.

The purpose of Rick Crutzen’s paper was to gain first insight into factors which might be associated with exposure to internet-delivered interventions. He conducted semi-structured focus group interviews with five groups of Dutch adolescents, aged 12-17 years. Several aspects of exposure, e.g. a first visit, staying long enough actually to use and process the information; and revisiting the intervention, were explored. The results indicate that word-of-mouth ‘marketing’, social comparison information, and regular reminders may help to increase exposure to web-based e-health interventions among adolescents. Further research will be conducted to test these and other issues to improve exposure.

Willemieke Kroeze recently published a paper in Health Education Research ( looking into what is needed for computer-tailored nutrition education to be effective. She compared three different versions of the education. A first version provided respondents with feedback about their behaviour compared to recommended intake levels, a second version provided additional feedback about the respondent’s intake compared to that of peers, and the third version also gave so-called action feedback: practical tailored information on how to make dietary changes. The results showed that the most extensive feedback was the only version that was better than non-tailored, generic nutrition information.

For abstracts of relevant papers, please see

Thursday, February 21, 2008

A three-country meeting on behavioural nutrition and physical activity

On Tuesday February 19 researchers from Cambridge, Ghent and the EMGO Institute came together in Amsterdam for a one-day meeting. This has grown into a yearly event, and this week was the fourth time these research groups met.

The three groups are interested in and have research programs on behavioural nutrition and physical activity research. The annual meetings were organised because of great similarities in research interests and ongoing studies.

During the morning program presentations by Sanne de Vries and Nannah Tak from the EMGO Institute, Kirstin Corder from Cambridge, and Leen Haerens and Benedicte Deforche from Ghent gave presentations on ongoing research on compliance to physical activity recommendations among youth and effects of school-based interventions to promote healthful behaviours among children and adolescents.

In the afternoon, research leaders from the three groups, Nick Wareham, Willem van Mechelen and Ilse de Bourdeaudhuij provided short introductions to inform discussions in smaller groups about future collaborations in research on measurement of physical activity, dietary behaviours and potential determinants, environmental determinants of physical activity and diet, computer-tailored health promotion.

One of the photos showes some good intentions that were made for further collaboration.

Sunday, February 17, 2008

The development of a cancer rehabilitation research program

Last Friday we had a meeting with representatives of a number of health care and research organisations to bring the Alp d’Huzes Cancer Rehabilitation (A-CaRe) program further towards completion. Researchers from the VU, the Amsterdam and Utrecht University Medical Centres, the Netherlands Cancer Institute, the Telematica Institute, and the Veldhoven Hospital met at our VUmc campus to discuss progress and to plan the completion of the program proposal. I have reported on the Alp d’Huzes program initiative here before. Alp d-Huzes is a foundation to raise money for cancer research, The main or at least most striking activity of Alp D’Huzes is a yearly sponsored cycling even at the famous Alp d’Huez mountain (see ).
The A-CaRe program will focus on investigating cancer rehabilitation programs for different groups of cancer patients, based on physical training, including strength training and endurance training to fight fatigue, improve functioning and quality of life. The A-Care will exist of a clinical research track with four trials to develop and evaluate different interventions, an implementation and patient facilitation track to explore and promote opportunities for larger scale dissemination of interventions that have proven effective, and a public relation track to communicate about the progress and merits of the project to patients, health professionals and the general public.
We are now in the later stages of completion of the proposal, seeking adjustment between the different tracks and trials, agreement on the main outcome parameters and measurement instruments, and a good system to communicate between partners within this comprehensive program.
We aim at starting this program within the next few months.