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Anderson ES, Winett
RA, Wojcik JR, Winett SG, Bowden T. A computerized
social cognitive intervention for nutrition behavior: direct
and mediated effects on fat, fiber, fruits, and vegetables,
self-efficacy, and outcome expectations among food shoppers.
Annals of Behavioral Medicine 2001;23:88-100.
adult supermarket shoppers; 96% female, 92% Caucasian,
median income $35,000, mean education 14.78 +/- 2.11 years
supermarket computer kiosk
for a Lifetime System (NLS): a self-administered, computer-based
intervention providing personalized information, behavior
strategies, incentives for change, goal-setting, and feedback
on specific nutrition behaviors. Contains 15 weekly segments.
group: no intervention. Intervention group: interaction
with NLS in supermarket
usage; intake of fat, fiber, fruits, and vegetables; self-efficacy;
physical outcome expectations, social outcome expectations
of 10 segments viewed per participant. Intervention group:
improved levels of fat, fiber, fruits, and vegetables;
higher nutrition-related self-efficacy; physical outcome
expectations; and social outcome expectations. More likely
to attain goals for fat, fiber, and fruits and vegetables
at posttest. Fat goal maintained at followup.
Barrera M, Glasgow
RE, McKay HG, Boles SM, Feil EG. Do Internet-based
support interventions change perceptions of social support?
An experimental trial of approaches for supporting diabetes
self-management. American Journal of Community Psychology
2002;30:637-54. [Overview, Applicability, Key Findings]
men and women with type 2 diabetes; recruited from physician
offices. Sample restricted to those who did not have Internet
access at home or work; mean age 59, 53.1% women.
home computer with Internet
Web site: All had online articles about diabetes. Coach
group also had a coach who gave dietary advice and help
with goal-setting. Social support group could exchange
information, coping, and support through a peer-directed
forum, message boards, and real-time chat. Combined group
had all of the above.
randomized into four groups: Information Only, Personal
Coach, Social Support, Combined Social Support and Coach.
Participants were provided with computers and training.
Access was restricted to just the resources in the condition
to which they were assigned.
in the Social Support Only condition had the greatest increase
in perceived social support, followed by the Combined conditions,
then the Coach Only conditions, and finally the Control
condition. Only the contrast between the two support conditions
and the control condition were significant.
Tailoring messages and design in a Web-based skin cancer
prevention intervention. International Electronic Journal
of Health Education 2001;4:290-7. [Appropriateness,
college students; mean age 21.6, 59% female; 86% Caucasian,
8% African American, 2% Asian or Pacific Islander, 1% Hispanic,
and 2% other
prevention: home computer with Internet
Web page containing messages about outcome expectations
of using sunscreen, perceived self-efficacy to use sunscreen,
skin cancer risk, high-risk behaviors, barriers, perceived
risk, and personal involvement with skin cancer. These
derived from more than 30 pieces of data from each participant.
Users chose message source, font, and font color.
group viewed a generic Web site about skin cancer prevention;
Intervention group viewed a Web site that is tailored in
both content and design.
risk behaviors, self-efficacy, expected outcomes, barriers,
in intervention group reported reading the Web page. Intervention
group had trend toward liking the source better. Intervention
group followed more links. Control group found their Web
page more relevant, while intervention group found Web
page more personalized. No difference in self-efficacy
to wear sunscreen or expected outcomes of wearing/not wearing
sunscreen. No difference at followup to sunscreen-wearing
behaviors. Treatment group showed a reduction in two of
Campbell MK, Honess-Morreale
L, Farrell D, Carbone E, Brasure M. A tailored multimedia
nutrition education pilot program for low-income women
receiving food assistance. Health Education Research
1999;14:257-67. [Appropriateness, Acceptability, Applicability,
low-income women, primarily African American women enrolled
in the Food Stamp program in Durham, NC
clinic-based computer with interactive multimedia program
at Heart: Tailored multimedia program using tailored soap
opera and interactive “info-mercials” that
provide tailored feedback about dietary fat, knowledge,
strategies for lowering fat that are based on stage of
change, modeling through the soap opera story
group: no intervention; Intervention group: one session
of Sisters at Heart
knowledge, stage of change, eating behaviors
rated program as very helpful, 66% would use it again,
and 55% said none of the information was new. Intervention
group significantly increased knowledge, stage of change,
and certain eating behaviors (baking meat and eating low-fat
snacks). Both groups lowered their fat intake at followup
but did not differ from each other.
Celio AA, Winzelberg
AJ, Wilfley DE, Eppstein-Herald D, Springer EA, Dev P,
et al. Reducing risk factors for eating disorders:
comparison of an Internet- and a classroom-delivered psycho-educational
program. Journal of Consulting and Clinical Psychology
2000;68:650-7. [Acceptability, Applicability]
female university students, 67% Caucasian, 11% African
American, 9% Asian, 7% Hispanic, Latina, 6% multiethnic
disorder prevention: home computer with Internet
Bodies: an 8-week program designed to reduce body dissatisfaction
and excessive weight concerns. It consists of readings,
exercises, online journals, and a moderated online discussion
group: wait-list control; Intervention group 1: Student
Bodies along with three in-person sessions and other readings;
Intervention group 2: Classroom education using Body Traps,
a classroom intervention with a more traditional academic
focus. This study attempted to increase adherence through
use of motivators, specifically pass/fail grading based
on completion of activities.
measures, body image, and eating attitudes and behaviors
compliance in computer group vs. 57% in classroom group.
Greater compliance in Student Bodies group using incentive
than in previous studies. Found evidence of dose-response
relationship. Computer group had significant reductions
in weight/shape concerns compared to controls; at followup,
disordered behaviors reduced. No significant effects were
found between the Body Traps and wait-list control conditions.
Chewning B, Mosena
P, Wilson D, Erdman H, Potthoff S, Murphy A, et al.
Evaluation of a computerized contraceptive decision aid
for adolescent patients. Patient Education and Counseling
1999;38:227-39. [Acceptability, Applicability]
adolescent patients in Chicago (96% African American) and
Madison (94% white) family planning clinics
decision-making: clinic-based computer program
for “Contraceptive Decision-making Program”:
user can choose a contraceptive method from a menu of choices,
learn how method is used, graphical presentation of effectiveness,
assess personal situation for appropriateness of method,
method benefits and costs, feedback about barriers, and
patient printout to facilitate discussion with clinician.
group: has standard clinic visit. Intervention group: interacts
with computer program before clinic visit.
to computer use, contraceptive knowledge, outcome expectations
re: birth control effectiveness, adoption of oral contraceptive
(OC), discon-tinuation of OC, pregnancies
Madison participants and 98% of Chicago participants liked
the computer program. Significant increase in knowledge,
greater immediate impact on outcome expectations, no effect
of computer on length of usage of OC, trend toward reduced
pregnancy in Madison but not in Chicago.
Clarke G, Reid E, Eubanks
D, O’Connor E, DeBar LL, Kelleher C, et al. Overcoming
Depression on the Internet (ODIN): a randomized controlled
trial of an Internet depression skills intervention program.
Journal of Medical Internet Research 2002;4:e14.
adults with and without depression recruited from a large
HMO, matched by age and gender
home computer with Internet
Depression on the Internet (ODIN): a self-paced, skills
training program focusing on the acquisition and use of
cognitive restructuring techniques
group: received a link to the Kaiser Permanente Online
home page where they could receive information and were
free to receive other treatment as needed. Intervention
group received a link to the intervention.
patient use of the site; found that their population was
more seriously depressed than that for which the intervention
was designed. No effect of Internet program across entire
sample; post hoc analysis showed modest effect among those
with lower level depression. Analyses showed no dose-response
relationship but limited dose overall.
D, Kreiter C, Kinzer S, Peterson M. A randomized controlled
trial of an information prescription for pediatric patient
education on the Internet. Archives of Pediatric and
Adolescent Medicine 2004;158:857-62. [Appropriateness]
parents recruited from a pediatric practice with the majority
white, female, and college-educated; 68% had used computer
for health information
information: home computer with Internet
Web sites on the World Wide Web
group: had standard clinic visit. Intervention group: offered
computer training and information prescriptions (IPs) of
recommended Web sites. Surveyed 2-3 weeks after clinic
group used the Internet more for general and child health
information. 32% of those in intervention group used the
IP. 66.2% of the Internet information resources used by
the intervention group were prescribed by the physicians.
Compared with nonusers, IP users were more likely to state
they would use the IP again in the future and had already
recommended the IP to family or friends.
HK, Friedman RH, Glanz K, Tennstedt S, Smigelski C, Pinto
BM, et al. Randomized trial of a “talking computer”
to improve adults’ eating habits. American Journal
of Health Promotion 2001;15:215-24. [Overview, Acceptability,
adults from a large medical practice. Mean age 45.9; 72.1%
women; 44.9% Caucasian, 44.6% African Americans, 24.2%
educated beyond college
home telephone-linked communi-cation (TLC) system
an interactive, computer-based system. Uses computer-mediated
digitized human speech over the telephone to ask questions
to monitor the patients’ behaviors; patient uses
keypad to enter answers. This program focuses on improving
group: received TLC-PA (see Pinto
et al., 2002). Intervention group: conversation with
the TLC-Eat, enter answers to questions, TLC provides information,
suggestions, help with goal setting, etc.
intake, stage of change, self-rated diet, intent to change,
and confidence in making changes
group increased by 1.1 serving of fruit, other food groups
showed positive trends. Dose-response relationship seen
with higher users eating less fat, more fruit and fiber.
More subjects in intervention group moved forward in stage
of readiness to change for eating fruits and whole grains,
but no difference for vegetables, red meat, and whole fat
Feil EG, Noell J, Lichtenstein
E, Boles SM, McKay HG. Evaluation of an Internet-based
smoking cessation program: lessons learned from a pilot
study. Nicotine and Tobacco Research 2003;5:189-94.
adult smokers, 72% female, 81% white, 80% at least some
cessation: home computer with Internet
Network: Internet-based smoking cessation program using
structured quit plan, interpersonal support with peers
and professionals, anti-tobacco entertainment, library
used several different Internet and non-Internet recruitment
strategies, randomized into one of four incentive and reminder
conditions ($10/e-mail, $10/U.S. mail, $20/e-mail, $20/U.S.
with program; how they found the Web site; smoking behavior,
cessation, support, cessation self-efficacy, past use of
other cessation aids
successful recruitment strategy made use of Internet search
engines and user groups, with search engines yielding the
most participants. Cessation rate at 3 months was 18%.
Participants recruited via Internet had higher cessation
rates. No difference in response to questionnaires with
$10 or $20 incentives. No difference in response to mail
or e-mail followup reminders.
O’Connor G, Friedman RH. Development and implementation
of the home asthma telemonitoring (HAT) system to facilitate
asthma self-care. Medical Informatics 2001;810-14.
[Overview, Applicability, Cost Savings]
patients (did not describe further or provide N)
home asthma telemonitoring (HAT) system
system lets user enter data (peak flow, etc.), provides
analysis, and points user to care plan, educational components;
sends reports to providers.
HAT system, reports on preliminary findings from a randomized
findings show higher patient compliance to asthma action
plans in comparison to control. Lung function test results
collected at home were comparable to those collected under
the supervision of trained professionals.