NutritionQuest

More About Alive!

The Alive! program is based on years of solid research and the expertise of a highly-qualified team of specialists, including:

• Dr. Gladys Block (Ph.D., Epidemiology, Johns Hopkins) — an internationally respected nutrition researcher on the faculty at the University of California at Berkeley.
• Clifford H. Block (Ph.D., Cognitive Psychology, Yale) — 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) — a nationally known researcher in physical activity.
• Torin Block — architect of the delivery method and innovative technical features of the Alive! program.

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Materials documenting the development and success of Alive!

• Journal of Medical Internet Research (2008)

  An article describing the development of Alive! and reporting Alive!'s effects on quality of life.

• The American Journal of Preventive Medicine (2009)

  An article describing primary results from the Alive! randomized controlled trial.

• Alive! PowerPoint Presentation (PowerPoint Presentation)

  A PowerPoint presentation illustrating the process and content of Alive!

• Kaiser Permanente Research Studies: Alive! (website)

  More information about Alive! and the randomized controlled trial.

The History of Alive!

Alive! is an enhancement of a successful prototype called Worksite Internet Nutrition (WIN). The WIN program was a 12-week program in which participants worked on reducing total fat or increasing intake of fruits and vegetables; it was delivered entirely via email. Development of WIN was supported in part by a grant from the California Department of Health Services, Cancer Research Program.

Alive! has improved on the original concept in WIN by:

• Adding a physical activity track.
• Changing the focus from total fat to saturated and trans fats.
• Adding an emphasis on reducing added sugars.
• Enabling participants to complete each of the three tracks over the course of a year.
• Providing tailored goal setting to create an individually-adapted change program.

An article describing the development and testing of WIN was published in 2004 in Preventing Chronic Disease, a journal of the U.S. Centers for Disease Control (CDC).

The Little-by-Little CD-ROM

Also a precursor to the development of Alive! , 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 Alive! multi-week process). 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 randomized placebo-controlled trial was conducted among low-income African American and White women, and it demonstrated statistically significant increased intake of fruits and vegetables.

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; and goal-setting. Brief dietary assessments are followed by immediate feedback on participants' intake in relation to recommendations, identification of 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, such as cost, time constraints, and children's preferences. 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 goals 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.

Little-by-Little is available as a CD-ROM at the cost of $15, as a service to researchers and public health.