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How to motivate employees to get up and get active: Send them an e-mail message.

That’s why a group of employees who were not regularly active before increased their participation in moderate intensity physical activities by almost an hour a week and decreased the amount of time they spent in sedentary activities.

The 351 Kaiser Permanente Northern California employees were randomly selected to be in an "intervention group" that received a series of weekly e-mail messages. The e-mails suggested small, practical, individually tailored goals, such as eating fruit for a snack three times a week, walking for 10 minutes a day at lunch time, or walking to the store instead of driving.

The program continued for 16 weeks, according to the results of the Kaiser Permanente Division of Research study. It was a controlled study with a total of 787 Kaiser Permanente employees.

The second group of 436 employees only received an immediate e-mail feedback at the start of the intervention program indicating whether or not their reported physical activity and diet met national guidelines, the researchers said.

The employees in the "intervention" received the e-mails in their work or home accounts for four months that were tailored to their individual needs and life situation – for example, whether they had small children at home or busy schedules that posed barriers to exercise and diet improvement. The messages linked to a personal home page with tips for achieving the small-step goals the respondent had selected, educational materials and tracking and simulation tools. Reminder messages were sent between each intervention message.

By the end of the intervention study period, the employees who received the weekly e-mail messages were found to be more physically active, eating more fruits and vegetables, and reducing their intake of saturated fats and trans fats, compared to the control group.

The researchers found that the biggest changes occurred among those in the intervention group, who did not meet minimum national standards for exercise and diet at the start of the trial. These employees increased their physical activities by almost an hour a week and cut back the amount of time they spent in such sedentary activities as watching TV and videos, by about two hours a week, the study researchers reported.

The study also found that the changes had a lasting effect four months after the intervention ended.

"The takeaway message here for people who want to improve their diet and physical activity, and for employers who want a healthier workforce, is that e-mail intervention programs are a very cost-effective way to get healthy," said study lead investigator Barbara Sternfeld, Ph.D., senior research scientist with the Kaiser Permanente Division of Research and the study’s lead investigator.

"A tailored e-mail program includes all the things that behavioral scientists have said for years about changing behavior: small goals tailored for the individual, reinforcement, and tracking but delivered in a mass, cost-effective way," she added.

The intervention initiatives is called A Lifestyle Intervention Via E-mail (ALIVE) program and was developed by NutritionQuest.

The study is believed to be one of the first to send messages directly into individuals’ e-mail inboxes, rather than requiring them to actively go online to access and read their messages.

The results offer additional support for the potential of the Internet and e-mail to reach large segments of the population to inspire healthier lifestyle choices, the researchers said.

"Given that the majority of Americans eat poorly and fail to exercise enough, effective e-mail programs could be a useful way to improve health," the researchers observed.

Some 55 percent don’t perform the recommended 30 minutes of moderate physical activity most days of the week, according to the US Centers for Disease Control (CDC) which funded the initiative.

"Using e-mail to get people active is a great use of existing technology that is cheap and readily available," said Dr. Bob Sallis, a Kaiser Permanente family physician, regional exercise champion for Kaiser Permanente’s Southern California region and former president of the American College of Sports Medicine.

"Anything we can do to increase activity level is going to improve health because we know that exercise is medicine. It’s medicine you can take to live a longer and healthier life," he said.

Results of the study were published in the American Journal of Preventive Medicine.

Additional researchers on the Kaiser Permanente study include: Charles P. Quesenberry Jr., Ph.D., Gail Husson, MPH, and Melissa Nelson, MA, MPH, of the Kaiser Permanente Division of Research; Gladys Block, Ph.D., Torin J. Block, BA, Clifford Block, Ph.D., and Jean C. Norris, DrPH.

The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large.

Addresses: Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612; (510) 891-3400, www.dor.kaiser.org. NutritionQuest, 15 Shattuck Square, Suite 288, Berkeley, CA 94704; (510) 704-8514, www.nutritionquest.com.