In a recent study published in the Journal of Medical Internet Research, researchers explored the effectiveness of a novel web-based health behavior tool integrated into services provided by certified exercise practitioners (CEPs). The study aimed to assess changes in health behaviors among older adults over a 12-week period.
The background of the study highlights the importance of healthy lifestyle behaviors, such as balanced diet, regular physical activity, adequate sleep, and stress management, in reducing chronic disease risk and enhancing overall well-being. Digital interventions have emerged as cost-effective methods to promote these behaviors, yet few have been integrated into CEP services.
Study Objective
The primary objective of this randomized controlled trial was to examine changes in health behaviors during the implementation of the Food, Exercise, Sleep, and Stress (FESS) web-based questionnaire. This tool served as an adjunct to traditional face-to-face services provided by CEPs.
Methods
The study utilized a two-arm, randomized pre-post intervention design involving 41 participants, predominantly women, with a median age of 65 years. Participants were randomly assigned to complete the FESS questionnaire either three times per week or daily for 12 weeks. The questionnaire tracked health behaviors across four domains and provided health tips.
Outcomes were assessed using the FESS questionnaire at baseline, 6 weeks, and 12 weeks. Changes in questionnaire responses were analyzed using Friedman ANOVA and Wilcoxon signed-rank post hoc tests. Group differences were assessed using the Mann-Whitney U test. Compliance was measured by the proportion of completed questionnaires relative to the total prescribed.
Results
The findings revealed positive or no changes in most health behaviors, with significant improvements noted in vegetable consumption, water intake, stress management, and sleep quality. Notably, the group completing the questionnaire daily exhibited larger changes in stress and sleep behaviors, while the three-day group demonstrated higher compliance rates.
However, compliance declined over time in both groups. Additionally, validation of the exercise domain through accelerometer data indicated low rates of overreporting exercise and underreporting sedentary behavior.
Conclusions
The study concluded that the FESS questionnaire is feasible and can lead to observed changes in health behaviors, particularly in diet, stress, and sleep, when integrated into CEP services. While daily use was associated with greater changes, the decline in compliance over time raises important considerations for future interventions.
What this study does not show
This study does not establish a direct causal relationship between the use of the FESS questionnaire and long-term health outcomes, nor does it provide evidence of sustained behavior change beyond the intervention period.
Evidence scorecard
- Analytic validity: established
- Clinical validity: established
- Clinical utility: established