Web-Based Risk Communication and Planning in an Obese Population: Exploratory Study

BACKGROUND: A healthy diet, low in saturated fat and high in fiber, is a popular medical recommendation in preventing cardiovascular disease (CVD). One approach to motivating healthier eating is to raise individuals’ awareness of their CVD risk and then help them form specific plans to change. OBJECTIVES: The aim was to explore the combined impact of a Web-based CVD risk message and a fully automated planning tool on risk perceptions, intentions, and saturated fat intake changes over 4 weeks. METHODS: Of the 1187 men and women recruited online, 781 were randomly allocated to one of four conditions: a CVD risk message, the same CVD risk message paired with planning, planning on its own, and a control group. All outcome measures were assessed by online self-reports. Generalized linear modeling was used to analyze the data. RESULTS: Self-perceived consumption of low saturated fat foods (odds ratio 11.40, 95% CI 1.86–69.68) and intentions to change diet (odds ratio 21.20, 95% CI 2.6–172.4) increased more in participants allocated to the planning than the control group. No difference was observed between the four conditions with regard to percentage saturated fat intake changes. Contrary to our expectations, there was no difference in perceived and percentage saturated fat intake change between the CVD risk message plus planning group and the control group. Risk perceptions among those receiving the CVD risk message changed to be more in line with their age (change in slope(individual) = 0.075, P = .01; change in slope(comparative) = 0.100, P = .001), whereas there was no change among those who did not receive the CVD risk message. CONCLUSION: There was no evidence that combining a CVD risk message with a planning tool reduces saturated fat intake more than either alone. Further research is required to identify ways in which matching motivational and volitional strategies can lead to greater behavior changes. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 91154001; http://www.controlled-trials.com/ISRCTN91154001 (Archived by WebCite at http://www.webcitation.org/62sBoGeOO)