While nothing can beat in-person counseling or coaching to promote healthy behaviors, that approach is often too expensive or otherwise not feasible. Wellness coordinators generally rely on brochures or videotapes to provide commonly-needed information, but interactive multimedia (IMM) approaches are rapidly gaining favor. Weíve used this approach successfully for both behavior change interventions and work-skills training. To describe it from the user's perspective, IMM is a computer program with good-looking graphics that can play video, run animations, and maybe have interesting sound effects. It can be delivered via the Internet, corporate intranet, kiosks, workstations, or CD-ROM. Depending on the circumstances, an employee may be able to access IMM programs from his or her desk, in a clinic waiting room, at a learning center, from home, or while on the road. Perhaps most appealing to busy workers, this resource is available on demand, 24/7.
Employees are usually interacting from the moment the program begins: making choices, trying out skills, and maybe testing their knowledge as they move through the program. The IMM user experiences a visually-rich environment that is responsive to his or her interests, time constraints, and learning style. Available topics are varied. For instance, worker programs that weíve tested include: health risk appraisal, smoking cessation, healthy eating, exercise, stress reduction, family and professional eldercare, and workplace training for nurse assistants and food handlers. Many IMM programs offer each user the opportunity to input demographic and assessment information, which is immediately processed to tailor the video presentations to that specific user. This approach has been shown to be highly effective with an Internet smoking cessation program that our center recently tested in a full-scale trial in worksites nationwide .
Well-designed IMM programs are attractive to employees because they are easy (even fun) to use. As appropriate, programs can be made navigable by mouse-point-and-click, making them accessible to workers with minimal computer experience. Text and graphics can be supplemented by narration and video modeling scenes, which assists employees who donít read well. Overall, IMM allows individuals to absorb and review content at an individually appropriate pace. Moving into the future, a research team at our center is exploring voice recognition technology, which could allow workers to respond to the program simply by speaking.
Each of our wellness intervention programs on smoking, exercise, and eating habits offers coaching across multiple visits. For example, the first visit to the programs leads the user step-by-step through the process of making a personalized behavior change plan. At return visits, the employee reports in and the program assesses the report, responding with encouraging feedback and tailored suggestions for sticking with or adjusting the plan.
The work-skills training programs can take a mastery learning approach. For example, this strategy proved successful in a field-test of a CD-ROM to train nurse assistants to better communicate with residents with dementia. Through video narration and the use of video-modeling of the skills in action, the program presented the material to be learned, tested the user's comprehension, and reviewed and re-tested as individually needed. This IMM program proved superior in all comparisons to a videotape program of the same content. Interactive multimedia has arrived!
Although this is still a budding area of study, research supports the use of this new technology for both personal behavior change and work-skills training. IMM programs have proven to offer significant advantages over non-interactive formats, including efficiency, ease of use, and the tailoring of materials to individual users (Kreuter, Farrell, Olevitch, & Warnecke, 2000; Revere & Dunbar, 2001). Our work, funded by the National Institutes of Health, has involved development of IMM programs or websites, with randomized testing in real-world conditions (e.g., with employees at companies such as American Airlines, Centura Health Systems, Hallmark Cards, Home Shopping Network, Hewlett-Packard, Lockheed-Martin, and Nalco Chemical). Across the board, the results have been promising, and we have multiple research papers either in press, submitted, or in preparation.
In sum, both research and common sense support the use of new technology to improve health communication. As increasingly more powerful (yet less expensive) computers, become commonplace in worksites, IMM programs will provide the standard for modern support of workplace health promotion nationwide.
The Oregon Center for Applied Science welcomes interest by companies that might want to serve as no-cost test sites (employees get paid to participate on their own time). Please contact the author at (888) 349-5472 or at email@example.com.
Revere, D. & Dunbar, P.J. (2001). Review of computer-generated outpatient health behavior interventions: clinical encounters "in absentia." Journal of American Medical Informantics Association, 8(1), 62-79.