Effect of Using an Exercise and Nutrition Secure Email Message on the Implementation of Health Promotion in a Large Health Care System

Background and Program: Secure email messaging is used to provide timely communication between healthcare providers and patients with medical information and education. There have been increasing rates of overweight and obesity among military healthcare patients. To address this issue, we utilized a secure email messaging system that is primarily used for medication refills. This commentary demonstrates the extent to which the message was viewed and how much the message was liked. Preliminary Results: Of the 16,020 individuals emailed, 7,011 participants (43.8%) opened the email, and 1,023 patients (14.6% of those who opened it) completed the survey. Satisfaction rate for the health promotion message was 77.2%. Participants reported an intent to eat more fruit and vegetables (49.6%), decrease portion sizes (38.8%), and increase physical activity (51.1%), while 33.6% reported having no intent to change. Conclusion: The majority were satisfied with the health promotion message. This email method enables a single provider to have increased contact with patients. It is unknown if this message reached higher risk or harder to reach participants, a patient subset that could benefit most from this type of communication. This study is unique in that to our knowledge it is the first one to use secure email messaging in the military healthcare system for health promotion.

149 Satisfaction with Food-Related Life Of Irish Adults Older Than 55 Years

Background Food is an important part of older people’s life contributing to their physiological and mental well-being and to their satisfaction with life. The aim of this study was to investigate the factors that contribute to the satisfaction with food-related life of Irish community-dwelling adults older than 55 years. Methods A mixed methods approach was employed. Quantitative data were collected through a survey which tested how socio-demographic characteristics, food habits, mood and self-perceived health were correlated (Spearman correlation) with the 5 items from the satisfaction with food-related life (SWFL) questionnaire. Qualitative data were collected through open-ended questions which investigated the factors determining food satisfaction levels of the 81 adults (54 women) older than 55 years who participated in the study. Results The highest score (4.3/5) was given to the item from the SWFL questionnaire: “Food and meals are very important elements in my life”, and was regardless of gender, age and marital status of the participants. In contrast, the lowest score (3.9/5) was given to the item “My life in relation to food and meals is ideal”. Spearman’s correlation revealed that fruit consumption was positively correlated “With regard to food, the conditions of my life are excellent” (rho=0.29, p<0.05). The open-ended questions showed that sensory appeal was the most popular term related to food satisfaction levels. Conclusion Meals and food play an important role in older adults’ life; however, participants did not consider their life in relation to meals and food as ideal. Therefore, strategies need to be employed to improve food and meal experience for community-dwelling older adults to keep them healthy for longer. Food industry should focus on developing nutritious and sensory-appealing food for the older consumers. Finally, the finding that consumption of fruit leads to satisfaction with food-related life could be used as a health promotion message to change eating behaviour.

Recalling and Intending to Enact Health Recommendations: Optimal Number of Prescribed Behaviors in Multibehavior Messages

Two experiments investigated the effects of the number of health recommendations (e.g., quit smoking; relax for a day) contained in a health-promotion message on recommendation recall and intentions to enact the recommendations. We hypothesized that if recommendations are stored individually, a higher number of presented recommendations will increase the number of recalled recommendations. As the number of recommendations increases, however, recipients are likely to summarize more recommendations as part of a single, more general theme (or header), resulting in a decrease in the proportion of recalled recommendations. Two experiments ( N = 193 and N = 266) found that the total number of recalled recommendations increased and the proportion of recalled recommendations decreased with the number of presented recommendations. Experiment 2 replicated the findings with the number and the proportion of intended behaviors. The implications of these findings for future behavioral health interventions are discussed.

Effects of Environmental Changes in a Stair Climbing Intervention: Generalization to Stair Descent

Purpose. Visual improvements have been shown to encourage stair use in worksites independently of written prompts. This study examined whether visual modifications alone can influence behavior in a shopping mall. Climbing one flight of stairs, however, will not confer health benefits. Therefore, this study also assessed whether exposure to the intervention encouraged subsequent stair use. Design. Interrupted time-series design. Settings. Escalators flanked by a staircase on either side. Subjects. Ascending and descending pedestrians (N = 81,948). Interventions. Following baseline monitoring, a colorful design was introduced on the stair risers of one staircase (the target staircase). A health promotion message was superimposed later on top. The intervention was visible only to ascending pedestrians. Thus, any rise in descending stair use would indicate increased intention to use stairs, which endured after initial exposure to the intervention. Measures. Observers inconspicuously coded pedestrians' means of ascent/descent and demographic characteristics. Results. The design alone had no meaningful impact. Addition of the message, however, increased stair climbing at the target and nontarget staircases by 190% and 52%, respectively. The message also produced a modest increase in stair descent at the target (25%) and nontarget (9%) staircases. Conclusions. In public venues, a message component is critical to the success of interventions. In addition, it appears that exposure to an intervention can encourage pedestrians to use stairs on a subsequent occasion.