Pro-Change Behavior Systems, Inc. recently completed a five year program of research funded by the National Heart, Lung, and Blood Institute (NHLBI) and led by Principal Investigator, Dr. Leanne Mauriello, to develop and test a multi-media obesity prevention program for adolescents. Health in Motion is a population-based program relevant for all teens that focuses on helping them adopt or maintain physical activity, fruit and vegetable consumption, and limiting television time according to national guidelines. Each of these behaviors is important for leading a healthy lifestyle and preventing overweight and obesity.
Health in Motion is a self-directed, computer-based program that can be easily delivered to adolescents across multiple settings. Once the teen logs on, the intervention administers on-screen assessments and offers immediate, tailored and stage-matched feedback based on the Transtheoretical Model of Behavior Change. Each intervention session is designed to be delivered within 30 minutes. A fully tailored intervention is offered for physical activity and optimally tailored sections are offered for fruit and vegetable consumption and TV viewing. Multimedia components, including audio, videos, animations, and interactive feedback screens, engage the users and help to relay important behavioral change strategies.
As part of a 14-month clinical effectiveness trial Health in Motion was delivered to 1800 students from 8 high schools across the country. The majority of students were White (71.5%), female (50.8%), of normal weight according to their body mass index (74.7%), and on average 16 years old. The treatment group received three intervention sessions and two follow-up assessments, while the control group received four assessment-only sessions. Results of the trial demonstrate the effectiveness of the program to initiate behavior change for all three behaviors and to treat multiple risks simultaneously.
At the end of the intervention, the treatment group increased their physical activity of at least 60 minutes by 1 additional day (while the control group increased that much activity by 1/3 of a day), increased their fruit and vegetable consumption by 1.5 servings per day (while the control group increased by ½ of a serving), and reduced their daily television viewing by 1 hour (while the control group reduced by ½ an hour). At the 12 month follow-up time point, the treatment group continued to outperform the control group on all three of these measures.
The intervention also was successful at moving treatment group participants from a pre-action stage (in which participants were not doing the target behavior) to the action or maintenance stages (in which participants had begun to do the target behavior), with 28.5% of the treatment group moving to action or maintenance for physical activity, 35.5% moving to action or maintenance for fruit and vegetable consumption, and 43% moving to action or maintenance for TV viewing. These effects were relatively stable for the treatment group out to the 12 month follow-up time point.
A noteworthy success of Health in Motion is its ability to treat multiple risks simultaneously. Among treatment group participants those students who progressed to action or maintenance for one behavior were 4.2 to 2.1 times more likely to make the same progress on another behavior. This finding was not found among control group participants. Findings also indicate the ability of the intervention to reduce the number of behavioral risks among treatment group participants. Among students with at least one behavioral risk at baseline, the treatment group reported fewer risks than the control group at the 2, 6, and 12 month time points. In addition, among those with zero behavioral risks at baseline, the control group reported significantly more risks at the 2, 6, and 12 month time points than the treatment group. These findings reflect the crux of treating multiple risks simultaneously. An intervention that can help students reduce multiple risks, help students adopt more than one healthy behavior, and prevent students from acquiring risks stretches the impact seen to date with single behavior interventions. Overall, these findings exemplify the ability of Health in Motion to promote the adoption of multiple health behaviors while also reducing relapse and risk acquisition.
The effectiveness of Health in Motion to help students who previously where not doing healthy lifestyle behaviors at recommended levels adopt the target behaviors to national guidelines, and help many of them continue doing the behaviors out to 12 months post intervention culminates this five year program of research and program development. Adoption and maintenance of these lifestyle behaviors particularly when promoted through a feasible and easily adoptable intervention strategy can lend greatly towards helping teens adopt healthy behaviors that may prevent the onset of adult obesity and the consequential health impacts that obesity bears to individuals, and society as a whole.
Over 10 presentations on this research have been made at several national conferences and three publications have resulted to date. Discussions with potential commercialization partners have ensued and elicited much enthusiasm for marketing Health in Motion to schools, youth organizations, health care providers, and to health promotion, disease management, and insurance benefit companies. Health in Motion is now available to license. Contact Janice M. Prochaska, President and CEO, at jmprochaska@prochange.com, for more information.