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Why are evidence-based interventions important?

The U.S. Task Force on Community Preventive Services "strongly recommends" evidence-based, "individually-adapted health behavior change programs."

Alive! is just such a program. It is extensively tailored to account for individual differences, and it has been proven effective in a randomized trial. The program has also been updated and expanded with funding from the National Institutes of Health; a second trial is set to begin Spring 2010.

Alive! was developed by research scientists and other public health experts to impact and improve the behaviors associated with long term health.

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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.

First you complete an online questionnaire to assess your current physical activity level and typical diet. This takes around 10-15 minutes.
You are immediately provided with detailed feedback about your current diet and physical activity. If you decide to participate in the program, you can easily sign up by providing your name and email address. This information is kept confidential.
After you sign up, you will complete a brief questionnaire about your lifestyle. This information will help tailor the program particular to your individual lifestyle.
You are now ready to decide which Big Goal you would like to concentrate on for the next 12 weeks. Perhaps you discovered that you are not getting enough exercise? Or you are eating too much saturated fat and sugar. Or perhaps you ought to be eating more fruits and vegetables each day? You can choose which big goal you would like to work on first.
Each week you will receive a messages in your email box where we will suggest several small-step goals you could work on in the coming week. For example, "For lunch, I will add a salad on at least 2 days". These small-step goals are designed just for you, base on the responses you provided to the diet, activity and lifestyle questionnaires. Each small-step goal will move you closer to your Big Goal. We also address barriers that may arise, and suggest tips with your lifestyle in mind.
In the course of the week, we will send you an email reminder about your small step goal for the week.
Every week you will keep track of your progress for each small-step goal you set and make a new small-step goal for the coming week. Along the way, Alive! will provide you with tips for achieving the small changes you have set goals for.
Your Progress Tracker will record all the small-step goals you have accomplished.
Every week, Alive! will provide new Health Notes about important health research related to your Big Goal. Research has found that being informed is an empowering and motivating tool for change.
Your Health Note Library stores all the Health Notes you have received each week and is always available for your review.
The "What If..." Simulator tool is an interactive program inside Alive that allows you to understand the impact that small changes can have to your overall diet and activity levels.
When you have completed the 12 weeks, you may then decide to pursue a new Big Goal.