Effectiveness and Cost-effectiveness of a Web-based Tailored Multiple Behavior Change Intervention

Abstract

Background: We tested two computer tailored lifestyle programs, one inviting people to change unhealthy behavior one at a time (sequentially), and the other inviting people to change all unhealthy behaviors (simultaneously). We compared the results with those from a comparison group receiving only lifestyle feedback. Methods: In a 2-year RCT, all respondents (N=5055) received feedback about their compliance with the guidelines for physical activity, vegetable and fruit consumption, alcohol intake and smoking. The experimental groups also received motivational feedback–based on the I-Change Model to change during via 4 steps. Mixed model, cost-effectiveness and cost-utility analyses were performed. Findings: After 1 year, the sequential condition was most effective (ES=0.28). After 2 years, the simultaneous condition was most effective (ES=0.18). Both interventions were cost-effective for changing lifestyles. Discussion: Nation-wide implementation of both interventions is recommended given their effectiveness and cost-effectiveness. A combination of both tailoring strategies may be most suitable for multiple behavior change.