The Alive! Diet and Physical Activity Intervention Program
NEWS (June 4, 2009): The Alive! program is featured in a new TIME magazine article written by Dr. Sanjay Gupta. The Alive! program is available to individuals, and to worksites and other large organizations.
Individual users: Please click here to sign up for Alive!
Worksites and other large organizations: Please contact us for group pricing.
Alive! (A Lifestyle Intervention Via Email)* is an effective behavior-change intervention to improve participants ’ physical activity, ‘bad’ fats and carbs, and fruits and vegetables. These are all factors that are proven to be related to heart disease, blood pressure, even stress. It has been proven effective. In a randomized controlled trial, Alive! produced statistically significant increases in physical activity and fruit and vegetable intake, and significant decreases in saturated and trans fats!
Alive! can reach 100s or 1000s, inexpensively, many more than typically participate in a wellness program. It is delivered actively, directly to participants' email inbox, rather than being a passive website necessitating participant initiative. Alive! is a turn-key system designed for serving large groups such as employees or members of an organization. It requires almost no administrative support, personnel time or expertise on the part of the employer or organization. Assessment, tailoring and delivery of messages are fully automated.
Alive! begins with a baseline questionnaire, a Health Risk Assessment focused on diet and physical activity. This provides immediate feedback about the individual's diet and physical activity levels. So whether or not they participate in the full intervention, everyone receives information about their own health behaviors. This can be a motivation to change, all by itself!
If they sign up, Alive! gives them a weekly email program tailored to their own lifestyle and preferences. A key component is weekly goal-setting. Alive! suggests small weekly achievable goals to choose. These goals, and tips for achieving them, are tailored to the individual's eating habits and physical activity level and preferences. Each message also provides information on the relationship between diet, physical activity and health, and interactive tools.
Alive! participants can choose among three alternative paths to healthier behavior:
- Increase physical activity
- Increase fruit and vegetable consumption
- Decrease saturated and trans fats, decrease added sugars, increase good fats and whole grains
Each 12-week program focuses on one of these three paths. Participants may choose to participate in only one 12-week segment, or may choose to continue, covering two or even all three topics over the course of a year.
In addition to the primary intervention effects on diet and physical activity, Alive! was also shown in the randomized trial to produce significant improvements in health-related quality of life and in presenteeism.
To view examples of Alive! program materials: http://www.nutritionquest.com/products/Alive_program_samples.html
What makes Alive! unique?
Alive! Is proven effective in a randomized controlled trial.
Alive! brings messages directly to the individual – no active information seeking is required.
Alive! Is based on solid behavioral theory.
Alive! is interactive. Participants provide input on their own diet and physical activity patterns. Then, based on their own perceived needs and readiness for change, participants engage in a process of weekly goal setting and tracking.
Alive! is tailored. Participants receive only the information and small steps relevant to their needs and lifestyle.
How to get started with Alive!
Alive! is available to employers or other organizations under a licensing agreement based on the number of potential participants to whom it is offered. We can work with you to meet your needs and resources.
We have found that the highest participation is achieved when people are sent individual invitations through email. With this approach, Alive! enrollment materials are sent to you, the employer or organization, via email. You then forward an "invitation email" to your employees or members. They complete the dietary and physical activity questionnaire, and receive instant feedback on their nutritional and activity level, regardless of whether they enroll or not. After that, if they choose to enroll, employees/members enter their email address. Subsequent program messages are sent via email from the NutritionQuest server.
Alternatively, potential participants may be informed about Alive! through brochures or other promotions. A URL specific to your organization would be provided, through which individuals could complete the assessments and enrollment. Some recruitment materials are available.
Other information about Alive!
- An article describing the development of Alive, and reporting Alive's effects on quality of life was published in the Journal of Medical Internet Research. See http://www.jmir.org/2008/4/e43/HTML .
- An article describing primary results from the Alive randomized controlled trial is available in the June, 2009 issue of the American Journal of Preventive Medicine. See http://www.ajpm-online.net/article/S0749-3797(09)00150-0/abstract .
- Download a Powerpoint presentation illustrating the process and content of Alive!: http://www.nutritionquest.com/products/ALIVE_program_overview.ppt
- View examples of Alive! program materials: http://www.nutritionquest.com/products/Alive_program_samples.html
- Visit the website for the randomized trial of Alive!. This provides more information about both Alive! and the randomized trial:
http://www.alive.kaiser.org/
- By arrangement, we would be glad to lead a 'webinar', in which we walk you through Alive!. This would enable you and your group to see the invitational email, baseline assessments, and weekly messages, from a remote setting.
- A demo version of Alive! is available, that permits you to experience Alive! directly, by fast-forwarding through all weeks. Contact Block Dietary Data Systems.
Development of Alive!
Alive! is an enhancement of a successful prototype, WIN (Worksite Internet Nutrition). See description of WIN, below.
Alive! is based on solid research. Dr. Gladys Block (Ph.D., Epidemiology, Johns Hopkins) is an internationally respected nutrition researcher, on the faculty at the University of California at Berkeley. Clifford H. Block (Ph.D., Cognitive Psychology, Yale) has been the architect of many large-scale programs in health social marketing, education, and the application of new technologies to achieve innovations in education and health behavior change. Dr. Barbara Sternfeld (Ph.D., Epidemiology, University of California at Berkeley) is a nationally known researcher in physical activity. Torin Block conceived the delivery method and innovative technical features.
Two journal articles have been submitted for publication, and another is in preparation. The first describes the randomized trial results on the effects of Alive! on the diet and physical activity outcomes. The second describes in detail the components of Alive! and the behavioral principles underlying it, and describes the effects on health-related quality of life and presenteeism. The third examines goals that were chosen by randomized trial participants, and the relation between number of goals chosen and diet and physical activity outcomes.
For more information about Alive!
Contact sales@NutritionQuest.com or phone usat 510-704-8514
The Little-by-Little CD-ROM
Little-by-Little is a behavioral intervention designed to help individuals make dietary changes to eat more fruits and vegetables and reduce fat intake. It was developed at the University of California, Berkeley, by Dr. Gladys Block and colleagues. Little-by-Little is primarily intended to be used as a one-time educational or behavior-change experience (as opposed to the multi-week programs described above.) In the randomized trial in which it was tested and found to be effective, participants interacted with the CD-ROM in a single sitting.
The program content is guided by behavior-change principles: nutrition screening and feedback; tailoring based on readiness for change and participant lifestyle; flexibility and individual choice; goal-setting. Brief dietary assessments are followed by immediate feedback on participants’ intake in relation to recommendations, identification the top sources of fat in the participant’s diet, and suggestions for lower-fat alternatives. A food sufficiency question can identify persons in need, who in turn are given the phone number of a local Food Stamps office (entered by an administrator during initial set-up.) Participants choose which dietary area to focus on, and within each dietary area may explore topics of particular concern to themselves, such as cost, time constraints, children’s preferences, and so forth. After completing either the fruit/vegetable module or the fat-reduction module, participants are presented with a list of possible goals. The goals offered are guided in part by the options that the user has chosen during the CD-ROM exploration, and emphasize small achievable goals. Users are encouraged to choose one or two, to try for two weeks. If a printer is available, a certificate can be printed, showing the goals chosen and providing a place to sign a commitment.
The development and initial testing were described in reference #1 below. A randomized placebo-controlled trial was conducted among low-income African American and White women, and demonstrated statistically significant increased intake of fruits and vegetables (reference #2).
Nutritionquest makes Little-by-Little available at minimal cost ($15), as a service to researchers and public health.
References related to the Little-by-Little program:
1. Block G, Miller M, Harnack L, Kayman S, Mandel S, Cristofar S. An interactive CD-ROM for nutrition screening and counseling. American Journal of Public Health 2000;90:781-785.
2. Block G, Wakimoto P, Metz D, Fujii ML, Feldman N, Mandel R, Sutherland B. A Randomized Trial of the Little-by-Little CD-ROM: Demonstrated Effectiveness in Increasing Fruit and Vegetable Intake in a Low-Income Population. Preventing Chronic Disease (serial online) 2004 Jul. http://www.cdc.gov/pcd/issues/2004/jul/04_0016.htm.
In addition to the named authors, Dr. Clifford H. Block of Block Dietary Data Systems was a major contributor to the behavioral aspects of Little-by-Little.
The WIN Program
The WIN (Worksite Internet Nutrition) program was a 12-week program delivered entirely by e-mail, designed to improve individuals’ dietary intake. Development of WIN was supported in part by a grant from the California Department of Health Services, Cancer Research Program. A paper describing the development and testing of WIN can be found in the in CDC’s online journal Preventing Chronic Dieisease; see http://www.cdc.gov/pcd/issues/2004/oct/04_0034.htm.
WIN is the prototype for Alive! (described above). It differed from Alive! in the following ways:
Alive! added a physical activity track.
Alive! changed the focus from total fat to saturated and trans fats.
Alive! added an emphasis on reducing added sugars.
Alive! permits participants to complete each of the three tracks over the course of a year. WIN consists of a single 12-week program, during which the participant works on either total fat or fruits and vegetables.
* Copyright and service mark notice: "Alive!" and "A Lifestyle Intervention Via Email" are Copyrighted, and are Service Marks of NutritionQuest.
