The University of Michigan's Health Media Research Laboratory, in collaboration with Henry Ford Health System, is evaluating the impact of a longitudinal computer-based tailored print intervention and complementary web-based tailored telecounseling intervention among 3,000 HMO enrollees. Through a randomized, 2x2 factorial trial, we are determining effectiveness of the interventions, both individually and in combination, in achieving behavior change in three targeted health risk behaviors: low vegetable consumption, cigarette smoking, and sedentary behavior. Three- and twelve-month behavioral effects of the individual and combined treatments are being evaluated. Features of the project include: (1) use of multiple eHealth strategies, including the web, computer-tailored print, and the electronic medical record; (2) interaction of eHealth tools with a trained health specialist; and (3) implementation in a realistic, generalizable setting. Current follow-up data provide sufficient power to examine intervention effects on vegetable consumption. Tailored print materials resulted in a .41 serving improvement in vegetable consumption three months after baseline assessment versus a .08 serving improvement among those not receiving tailored print (p=.02). This difference was greater among African American subjects (.61 versus -.16 serving improvement; p=.02). At this intermediate stage of the trial, the telecounseling intervention has not demonstrated a significantly effect on vegetable consumption.

Learning Objectives:

• How different e-Health tools and strategies can be synchronized in a managed care setting;
• How e-Health tools can be integrated with human interaction in a managed care setting;
• The outcomes of e-Health tools, integrated with human interaction, in a managed care setting.