BACKGROUND:Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet. OBJECTIVE:The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity. METHODS:Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests. RESULTS:Retention rates were good for both groups-85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F(1,415) = 7.104, P = .008) and Dietary Stage of Change (F(1,408) = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F(2,203) = 5.270, P = .003), Attitudes Toward a Healthful Diet (F(2,204) = 2.585, P = .045), and Dietary Stage of Change (F(2,200) = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F(1,410) = 9.808, P = .002). CONCLUSIONS:The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition.

译文

背景:大多数工作场所都参与某种形式的健康促进计划,旨在改善工人的健康状况并降低医疗成本。尽管这些程序通常是通过研讨会和印刷材料的组合来交付的,但越来越多的工作场所健康促进程序是通过Internet交付的。
目的:本研究的目的是评估针对工作场所的基于Web的多媒体健康促进计划的有效性,该计划旨在改善饮食习惯,减轻压力并增加体育锻炼。
方法:使用随机对照试验设计,在每个组中进行前测后测比较,将419名人力资源公司的员工随机分配到基于Web的条件或提供相同主题印刷材料的条件。通过在线问卷对所有受试者进行测试前和测试后评估,该问卷包含健康行为和态度的多种测量。测试期为3个月。问卷数据主要通过协方差分析和t检验进行分析。
结果:两组的保留率均良好,基于Web的组为85%,而印刷组为87%。使用基于Web的程序的受试者的表现要明显优于印刷组的“健康饮食态度(F(1,415)= 7.104,P = .008)和饮食变化阶段(F(1,408)= 6.487,P = 0.01)”。 ),但其他五种饮食措施之间没有显着的群体差异。正如显着的t检验所示,两组在大多数饮食措施上均显示从测试前到测试后的改善。在基于网络的小组中,剂量分析显示受试者访问该计划的次数对饮食自我效能的测量具有显着影响(F(2,203)= 5.270,P = .003),对健康饮食的态度(F (2,204)= 2.585,P = .045)和饮食变化阶段(F(2,200)= 4.627,P = .005)。两组在压力或身体活动的测量方法上没有发现显着差异,尽管前测-后测变化的t检验表明,两组在其中一些测量方法上均有改善。在所有健康主题及其总体评估中,基于网络的小组对计划材料的评分均比印刷小组高得多(F(1,410)= 9.808,P = .002)。
结论:基于Web的程序在饮食和营养方面的改进比印刷材料更有效,但在减轻压力或增加体育锻炼方面却没有更有效。基于Web的程序获得的较高评级表明,工人更喜欢它而不是印刷材料。两组在所有健康主题上均表现出无数的测试前-测试后改善,尽管这种改善可能部分归因于霍桑效应。结果表明,基于多媒体Web的程序可能是向员工提供健康促进材料的一种有前途的手段,特别是在饮食和营养领域。

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