Communication Interactive Health Communication and Work Site Health Promotion Robin G. Molella, MD, Candace K. Kolars, PhD, MPH, Neil R. Sullivan, MPH, and Philip T. Hagen, MD

There has been significant interest on the part of employers in using the Internet as a tool for promoting employee health. This interest has been fueled by the realization that improved employee health correlates with both increased worker productivity and decreased health care expenditures.

A health promotion web site has been designed to improve the health status of employees. It includes health information, a health risk assessment, self-care information and modules focused on healthy behaviors and disease management. The site is based on behavioral theory and uses tailored messages to motivate and re-engage site users in the behavior change process. Additional messages address barriers to behavior change.

Over the course of 2 years the site has been available to employees of a number of large corporations. Usage trends were followed by collection of data from the Internet site. The results were reviewed and adjusted for issues such as double registration. Forty-three percent of the registrants were female. The average age was 42.6 years.

Comment: In the above data, men are well represented and often outnumber women. This is somewhat at odds with data presented by the Pew Internet and American Life Project which reports women seek Internet information more commonly than men. If this observed difference is true and not merely related to denominator issues, then the question is why. Are men more likely to seek health promotion information in the work place? Can we utilize work place interventions to encourage use of Internet health promotion programming?

Peak Usage: 8am-6pm CST (usage starts at 7am and is high until 8pm reflecting the other time zones) Average session length: 12.5 minutes Average page-views/session: 12 Note: Session length is timed from the first page viewed to the last page viewed and so underestimates the amount of time spent on the site.

The health risk appraisal was completed by 26 percent of registered users revealing that 15 percent were at high risk. The most popular areas of the site are exercise, healthy weight, self-care, nutrition and depression.

Web Research Challenges   While web site databases collect profuse amounts of data, finding meaningful data from site usage logs is not always simple.   Things such as multiple registrations by the same user may contaminate data.

Web Research Challenges Web Research Challenges   Site logs and data points are created as a result of the conveniences of engineering unless researchers and developers give specific guidance at the time of design. Data obtained after the fact may not provide answers to key questions.

Web Research Challenges Web Research Challenges   A body of research regarding usability, accessibility, graphic design and program design needs to be compiled as part of efficacy and outcomes research.

Web Research Challenges   Site usage data gives important hints to how individuals are using web based health promotion information but fails to answer important questions regarding those who do not use the programs who might be at highest risk of the conditions we seek to prevent.   In addition site usage data does not answer questions regarding usability issues which might have caused individuals to leave the site or fail to return.

Web Research Challenges   Future research in Web based health promotion, in addition to focusing on outcomes, needs to focus on how to integrate Web based programs into the existing health promotion infrastructure. How can these programs be used to complement more traditional interventions?

Conclusions Individuals regardless of age and gender are willing to seek out health promotion information on the Internet. Studies are needed to define the web designs, which maximize program participation and behavior change. Research goals should be incorporated at the time of web design to facilitate further investigation of these issues

Robin G. Molella, MD 1, Candace K. Kolars, PhD, MPH 2, Neil R. Sullivan, MPH 3, and Philip T. Hagen, MD 1 (1) Preventive and Occupational Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, , (2) Mayo Foundation, Mayo Medical Ventures, 200 1st St. SW, Rochester, MN 55905, (3) Mayo Clinic Health Management Resources, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905