Computer-delivered Interventions for Health Promotion and Behavioral Risk Reduction: a Meta-analysis of 75 Randomized Controlled Trials, 1988-2007

Overview

Journal Prev Med

Specialty Public Health

Date 2008 Apr 12

PMID 18403003

Citations 171

Authors

David B Portnoy

Lori A J Scott-Sheldon

Blair T Johnson

Michael P Carey

Affiliations

Soon will be listed here.

Abstract

Objective: The use of computers to promote healthy behavior is increasing. To evaluate the efficacy of these computer-delivered interventions, we conducted a meta-analysis of the published literature.

Method: Studies examining health domains related to the leading health indicators outlined in Healthy People 2010 were selected. Data from 75 randomized controlled trials, published between 1988 and 2007, with 35,685 participants and 82 separate interventions were included. All studies were coded independently by two raters for study and participant characteristics, design and methodology, and intervention content. We calculated weighted mean effect sizes for theoretically-meaningful psychosocial and behavioral outcomes; moderator analyses determined the relation between study characteristics and the magnitude of effect sizes for heterogeneous outcomes.

Results: Compared with controls, participants who received a computer-delivered intervention improved several hypothesized antecedents of health behavior (knowledge, attitudes, intentions); intervention recipients also improved health behaviors (nutrition, tobacco use, substance use, safer sexual behavior, binge/purge behaviors) and general health maintenance. Several sample, study and intervention characteristics moderated the psychosocial and behavioral outcomes.

Conclusion: Computer-delivered interventions can lead to improved behavioral health outcomes at first post-intervention assessment. Interventions evaluating outcomes at extended assessment periods are needed to evaluate the longer-term efficacy of computer-delivered interventions.

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References

Reyna V, Farley F . Risk and Rationality in Adolescent Decision Making: Implications for Theory, Practice, and Public Policy. Psychol Sci Public Interest. 2015; 7(1):1-44. DOI: 10.1111/j.1529-1006.2006.00026.x. View

Schinke S, Schwinn T, Ozanian A . Alcohol abuse prevention among high-risk youth: computer-based intervention. J Prev Interv Community. 2006; 29(1-2):117-30. PMC: 1483065. DOI: 10.1300/J005v29n01_08. View

Williams C, Griffin K, Macaulay A, West T, Gronewold E . Efficacy of a drug prevention CD-ROM intervention for adolescents. Subst Use Misuse. 2005; 40(6):869-78. DOI: 10.1081/ja-200042219. View

Maio R, Shope J, Blow F, Gregor M, Zakrajsek J, Weber J . A randomized controlled trial of an emergency department-based interactive computer program to prevent alcohol misuse among injured adolescents. Ann Emerg Med. 2005; 45(4):420-9. DOI: 10.1016/j.annemergmed.2004.10.013. View

Marsch L, Bickel W . Efficacy of computer-based HIV/AIDS education for injection drug users. Am J Health Behav. 2004; 28(4):316-27. DOI: 10.5993/ajhb.28.4.3. View

Schinke S, Schwinn T, Cole K . Preventing Alcohol Abuse among Early Adolescents through Family and Computer-Based Interventions: Four-Year Outcomes and Mediating Variables. J Dev Phys Disabil. 2007; 18(2):149-161. PMC: 1766321. DOI: 10.1007/s10882-006-9009-5. View

Etter J . Comparing the efficacy of two Internet-based, computer-tailored smoking cessation programs: a randomized trial. J Med Internet Res. 2005; 7(1):e2. PMC: 1550632. DOI: 10.2196/jmir.7.1.e2. View

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

Walters S, Wright J, Shegog R . A review of computer and Internet-based interventions for smoking behavior. Addict Behav. 2005; 31(2):264-77. DOI: 10.1016/j.addbeh.2005.05.002. View

10.

Block G, Wakimoto P, Metz D, Fujii M, Feldman N, Mandel R . A randomized trial of the Little by Little CD-ROM: demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population. Prev Chronic Dis. 2005; 1(3):A08. PMC: 1253473. View

11.

Ryan P, Lauver D . The efficacy of tailored interventions. J Nurs Scholarsh. 2002; 34(4):331-7. DOI: 10.1111/j.1547-5069.2002.00331.x. View

12.

Kosma M, Cardinal B, McCubbin J . A pilot study of a web-based physical activity motivational program for adults with physical disabilities. Disabil Rehabil. 2006; 27(23):1435-42. DOI: 10.1080/09638280500242713. View

13.

Rovniak L, Hovell M, Wojcik J, Winett R, Martinez-Donate A . Enhancing theoretical fidelity: an e-mail-based walking program demonstration. Am J Health Promot. 2005; 20(2):85-95. DOI: 10.4278/0890-1171-20.2.85. View

14.

Campbell M, Farrell D, Carbone E, Brasure M . A tailored multimedia nutrition education pilot program for low-income women receiving food assistance. Health Educ Res. 1999; 14(2):257-67. DOI: 10.1093/her/14.2.257. View

15.

Lawrence T, Aveyard P, Evans O, Cheng K . A cluster randomised controlled trial of smoking cessation in pregnant women comparing interventions based on the transtheoretical (stages of change) model to standard care. Tob Control. 2003; 12(2):168-77. PMC: 1747729. DOI: 10.1136/tc.12.2.168. View

16.

Chiauzzi E, Green T, Lord S, Thum C, Goldstein M . My student body: a high-risk drinking prevention web site for college students. J Am Coll Health. 2005; 53(6):263-74. PMC: 1885481. DOI: 10.3200/JACH.53.6.263-274. View

17.

Downs J, Murray P, Bruine de Bruin W, Penrose J, Palmgren C, Fischhoff B . Interactive video behavioral intervention to reduce adolescent females' STD risk: a randomized controlled trial. Soc Sci Med. 2004; 59(8):1561-72. DOI: 10.1016/j.socscimed.2004.01.032. View

18.

Dijkstra A, de Vries H, Roijackers J . Computerized tailored feedback to change cognitive determinants of smoking: a Dutch field experiment. Health Educ Res. 1998; 13(2):197-206. DOI: 10.1093/her/13.2.197. View

19.

Oenema A, Brug J . Feedback strategies to raise awareness of personal dietary intake: results of a randomized controlled trial. Prev Med. 2003; 36(4):429-39. DOI: 10.1016/s0091-7435(02)00043-9. View

20.

Fisher J, Fisher W . Changing AIDS-risk behavior. Psychol Bull. 1992; 111(3):455-74. DOI: 10.1037/0033-2909.111.3.455. View