DESCRIPTION (provided by applicant): The specific aims of this research project are (1) to replicate one of the most effective approaches to behavioral
intervention, a series of expert system interventions, for both smoking
cessation and reduction of dietary fat on a national sample; (2) to extend the
intervention to the reduction of sedentary life style; (3) to develop and
assess the effectiveness of an innovative automated counseling intervention,
the TLC telecommunications system, applied to the same 3 behavioral risk
factors; (4) to compare the effectiveness of the current modular expert system
approach with an integrated expert system intervention, and (5) to determine
the cost-effectiveness of each of the 3 interventions. All subjects will be at
risk for all 3 risk factors and all interventions would intervene on all 3 risk
factors simultaneously. The modular expert system intervention involves 3
assessments, each followed by 3 separate feedback reports at 6-month intervals
for each of the risk factors. The telecommunications system involves briefer
assessments on each risk factor and counseling luring regular telephone
contacts over a 12-month period. The integrated expert system intervention
involves a single assessment on 3 occasions of all 3 risk factors followed by
intervention on all 3 risk factors simultaneously in an attempt to increase
efficiency and capitalize on the covariance between the behaviors. All 3
interventions are based on the Transtheoretical Model. The national sample
would be 1600 subjects recruited throughout the continental United States using
random digit dial telephone methodology. All interventions are designed to
impact on a total population and a proactive recruitment procedure will be
employed to recruit more than 75 percent of the eligible sample. The design is
a 4-group (Control, Modular Expert System intervention, Telecommunications
Intervention, Integrated Expert System Intervention) x 3 occasions (0, 12, and
24 months). Each behavioral risk factor will be intervened upon for 12 months
and the 3 risk factors will be related simultaneously. The 3 interventions
evaluated in this project have the potential to be easily disseminated at low
costs to entire populations of at-risk individuals.
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