Randomized Trial of a “Talking Computer” to Improve Adults' Eating Habits

Abstract

Purpose.: To assess efficacy of an intervention delivered by an interactive, computer-controlled telephone system to improve individuals' diets. Design.: Randomized controlled trial. Setting.: Large multispecialty group practice. Subjects.: Two hundred ninety-eight adults who were both sedentary and had suboptimal diet quality. Intervention.: Weekly communication for 6 months via a totally automated, computer-based voice system. Among intervention group subjects, the system monitored dietary habits and provided educational feedback, advice, and behavioral counseling. Control group subjects received physical activity promotion counseling. Measures.: Daily intake of fruits, vegetables, red and processed meats, whole fat dairy foods, and whole grain foods estimated from a food frequency questionnaire. Results.: Mean age 45.9 years, 72 % women, 45 % white, and 45 % African-American. Among participants who completed diet assessments, compared with the control group, the intervention raised fruit intake a mean of 1.1 servings per day (95 % confidence interval [CI] .4, 1. 7). On a 0 to 100 global diet quality score combining all five food groups, intervention participants improved their mean score 9 (95 % 4 CI 13) points more than in the control group. The intervention also raised dietary fiber intake 4.0 g/d (95 % CI .1, 7.8) and decreased saturated fat, as a proportion of energy intake, by 1.7% (95% CI −2.7, −.7). Conclusions.: This computer-based telecommunications dietary behavior intervention helped improve participants' overall diet.