Published: 02/12/2004, Volume II4, No. 5934 Page 29

Behavioural change programmes are a popular way to combat obesity, improve smoking cessation levels and help manage care for conditions such as diabetes. But justifying the cost, finding the staff to deliver it and measuring results can be difficult.

US healthcare provider Kaiser Permanente has recently started to use a behavioural change product that appears to offer a solution.

The system is predominantly internetbased and comes from Michigan-based HealthMedia (www.healthmedia. com), a company which has also provided the 'click-toquit' online programmes used by GlaxoSmithKline to support its smoking cessation products.

The technology claims to design individualised behaviour change programmes based on, initially, a standardised online questionnaire, the answers to which can be 'tuned' for a specific user.

HealthMedia chief executive Ted Dacko says: 'Our approach began with an online interview, with 30-35 questions. We used the data from that to draft programmes specifically prepared for each Kaiser member in the study - approximately half of a 5,000-member trial.

'Within the interview, we were looking not just at dietary behaviour, but also clinical information and emotional elements.

So we were asking when did the subject overeat and why.' The personalised plan would then be delivered either online or in print.

More recent versions are even quizzing subjects on their hobbies to provide still stronger links to health information and encourage behavioural change.

The questionnaire is akin to the kind of profiling - or customer relationship management, to use the jargon - that a supermarket might use based on information from loyalty cards.

Mr Dacko says: 'They went back and studied the participants at three, six, nine and 12 months, and after 12 months there was almost a doubling in the weight loss achieved for the HealthMedia sample against those on the traditional Kaiser information.' It also showed people taking part were on average visiting their doctor 1.1 fewer times a year.

A factor analysis of the fall in doctor visits suggested users were not simply replacing their GP with the plan and online resources, but taking more responsibility for their own health.

HealthMedia's deal with Kaiser will cover a whole range of such conditions such as diabetes, hypertension, arthritis, back pain, teen health, smoking cessation, nutrition, weight management and stress management.