BACKGROUND: Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. OBJECTIVE: To evaluate the effect of tailored web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index -- BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. METHODS: Overall, 3,876 employees in the Swedish transport services were emailed a web-based questionnaire. They were randomized into: control group (group A, 498 of 1,238 answered, 40.23%), or intervention web (group B, 482 of 1,305 answered, 36.93%), or intervention web+telephone (group C, 493 of 1,333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored web-based health feedback, and group C received tailored web-based health feedback plus optional telephone coaching if the participants' reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention web+telephone. Descriptive statistics, the Chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. RESULTS: Overall, 981 of 1473 (66.60%) employees participated at baseline (men 66.7%, mean age 44 years, mean BMI 26.4 kg/m2) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47.8%, and 165 of 324 participants, 50.9%, for groups B and C, respectively) and physical activity habits (181 of 301 participants, 60.1%, and 207 of 324 participants, 63.9%, for B and C, respectively) compared with the control group A (122 of 356 participants, 34.3%, for diet and 177 of 356 participants, 49.7%, for physical activity). At follow-up, the intervention groups had significantly decreased motivation (group B p < 0.001 for change in diet; p < 0.001 for change in physical activity; group C p = 0.007 for change in diet; p < 0.001 for change in physical activity), whereas the control group reported significantly increased motivation to change diet and physical activity (p < 0.001 for change in diet; p < 0.001 for change in physical activity). CONCLUSION: Tailored web-based health feedback and the offering of optional telephone coaching did not have a positive health effect on employees in the transport services. However, our findings suggest an increased short-term motivation to change health behaviors related to diet and physical activity among those receiving tailored web-based health feedback.

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