Interactive communication strategies

Abstract

Abstract: Physical inactivity is a recognized independent risk factor for the development of cardiovascular disease. However, a large proportion of the U.S. population does not participate in regular physical activity, and research has shown that without intervention, most people remain sedentary. Thus, an urgent need exists for developing effective interventions to promote physical-activity adoption and maintenance. Additionally, it is important that these interventions can be disseminated to the large population of sedentary individuals. To be disseminable, physical-activity interventions must move beyond reliance on strictly face-to-face modes and begin to more fully use newer technologies, such as the Internet. This article summarizes the progress made in promoting physical activity with interactive communications. We also delineate areas for future research.

Introduction

T he American Heart Association (AHA) has recognized physical inactivity as an independent risk factor for the development of cardiovascular disease.1 Physical activity is one of the ten leading national health indicators for the next decade.2 The American College of Sports Medicine (ACSM) and the Centers for Disease Control and Prevention (CDC) have developed guidelines to quantify the amount of physical activity required for health benefits.3 For healthy individuals with no known cardiovascular disease, the guidelines recommend that individuals accumulate at least 30 minutes of moderate intensity physical activity on most, preferably all, days of the week, recognizing that some physical activity is better than none and that increased physical activity is associated with greater benefits.3 The U.S. Surgeon General has also endorsed these recommendations.4

Despite these recommendations, a large proportion of the U.S. population does not participate in regular physical activity.4 Research has shown that without intervention, most people remain sedentary.5 Therefore, the need is great for developing effective interventions to promote physical-activity adoption and maintenance. Also, it is critical that these interventions be disseminable to the 75% of the population who are sedentary or insufficiently active.3 To achieve this goal, physical-activity interventions must move beyond reliance on face-to-face and other downstream approaches toward more midstream and upstream approaches that can more fully use newer technologies, such as the Internet.6, 7

Using technology can be an ideal medium to effect behavior change because technology is becoming integrated into virtually all aspects of society. Specifically, recent advances in information technologies have greatly altered society, as highlighted in a recent science panel on interactive communication and health.8 By 1997, the information technology industry had become the largest industry in the United States in terms of sales.9, 10 The percentage of U.S. households with personal computers has increased radically, from only 8% in 1984 to 45% in 1998.11, 12 So much information is now available on the World Wide Web that only about one quarter of it can be cataloged by even the best search engines.13 As of 1998, more than 70 million U.S. adults actively used the Internet, and the numbers are increasing rapidly in the United States and other countries.14, 15 One half of all U.S. Internet users have used the Internet to obtain health information,16 which makes the Internet an ideal avenue for tailored, interactive intervention delivery. To date, no studies have been published on the use of the Internet to promote physical activity. To capitalize on using the Internet for physical-activity promotion, interventions using this medium need to be developed.