Older workers benefit most from a modest health behavior program when it combines a web-based risk assessment with personal coaching.

University of Illinois at Chicago researchers conducted a randomized trial to evaluate two worksite wellness interventions assessing older workers' health behaviors and outcomes. The findings are available online and will be published in an upcoming issue of the American Journal of Public Health.

The health behaviors that were examined were physical activity, diet, stress reduction and smoking cessation, says Susan Hughes, professor of community health sciences, co-director of the UIC Center for Research on Health and Aging at the Institute for Health Research and Policy, and principal investigator of the study.

The researchers enrolled 423 participants into three study groups: the COACH intervention, a Web-based risk assessment with personal coaching support; the RealAge intervention, a Web-based risk assessment with behavior-specific online modules; and a control group that received printed health-promotion materials.

Participants ranged in age from 40 to 68 and were staff at UIC. Measures of healthy behaviors and weight, body mass index and waist circumference were assessed at baseline, six months after baseline and 12 months after baseline.

"What we found is that there were real differences in uptake between the two groups," Hughes said. "Ninety-five percent of people in the COACH program actually used the COACH intervention, as compared to 59 percent of people in the RealAge arm."

Both COACH and RealAge use websites to provide standardized risk assessments, develop risk appraisals, and give participants suggestions for pursing health-related behavior change. The COACH intervention also incorporates individualized counseling -- by phone and in person -- with a public health-educated coach to assist participants with their health-related goals.

RealAge participants were sent one email message to remind them to access the RealAge Web site, but it was up to the individual to stick with the program and determine how much interaction they would have with the website to meet their goals.

At six and 12 months, participants in the COACH program reported eating significantly more fruits and vegetables than the control group and also reported significantly more minutes of physical activity. They also reported a significant reduction in dietary fat intake at 12 months.

In contrast, the RealAge group experienced one significant outcome. They had a decline in waist circumference at six months that was maintained at 12 months.

The researchers are curious to understand how that happened. "That's another puzzle," Hughes said. "We have to go back and look at the data for an explanation of this interesting outcome."