The Effectiveness of an Internet-based Nutrition and Fitness Education Program for Senior Military Officers

Abstract

PURPOSE: To evaluate the effectiveness of a 6-month Internet-based nutrition and fitness education program on promoting positive health outcomes among senior military officers. METHODS: Participants were randomly assigned to either a treatment group (n=39) that had access to the Internet-based intervention or a control group (n=39) that did not have access to the program, which was based on the Stages of Change Model for behavior change. Physiological (lipids, glucose, weight, BMI, percent body fat) and behavioral (physical activity readiness questionnaire, food frequency questionnaire, eating habits) measurements were collected at baseline and 6 months after completion of the intervention. Participants in the treatment group were required to log on to the website at least once each month. Participants completed monthly questionnaires to assess stage of change for diet (consumption of ≥5 servings of fruits/vegetables daily) and exercise (≥ 30 minutes of moderate activity on ≥ 3 days/week) to receive appropriate stage-matched education. RESULTS: Stage progression for diet was statistically significant from month 1 to 6 (p < .0005) in the treatment group as participants moved from pre-action stages to action and maintenance stages. However, stage of change was also significant (p = .004) for diet during the 6-month period after the intervention as participants relapsed. There were no significant changes in stage distribution for exercise during the study. Analysis of covariance revealed no significant improvement in behavioral and physiological measurements of the treatment group as compared to the control group. Participants in the action stage spent the most amount of time on the website (mean = 25 min/month) while precontemplators spent the least amount of time (6 min/month). As a group, participants spent the least amount of time on the fitness information. Eighty-five percent of participants would recommend this type of program to others in the military. CONCLUSION: The study findings are not sufficiently conclusive to suggest that an educational intervention based on the Stages of Change Model would be effective in improving eating and exercise behaviors of senior military officers, although participants progressed through the stages of change for consumption of fruits and vegetables. These findings suggest that the Internet is a promising and viable medium for delivering education to military personnel stationed and/or deployed around the world. Future research should focus on program content, factors that initiate and sustain behavior change, and possible use of email and other technology to deliver education to a military population.