Background-The increasing prevalence of overweight and obesity underscore the need for evidence-based, easily disseminable interventions for weight management that can be delivered on a population basis. The Transtheoretical Model (TTM) offers a promising theoretical framework for multiple behavior weight management interventions.
Full reviews were conducted on 37 public websites on health behavior change for disease prevention and management. All had at least four of five of the `5A's for effective health behavior change treatment on the Internet' (advise, assess, assist, anticipatory guidance and arrange follow-up) that are assumed to be minimum criteria for a program to have the potential for producing behavior change. The strength of these 37 programs included: rationales provided for assessments; privacy and confidentiality protections; some form of feedback provided; and some form of interactivity. The weaknesses included: few were theory driven; few had individualized tailoring; few had empirically based tailoring; and few were evidence based or reported subsequent plans for evaluation.
Advancing the science and practice of health promotion and disease management on the Internet requires a systematic program of research examining the population impact of such programs. With impact described as the combination of effectiveness and participation, such research needs to include the examination of the quality and effectiveness of programs that are available to the general public, as well as descriptive and predictive knowledge about population readiness to participate in such programs.There have been few studies examining the quality of interactive health behavior change (HBC) programs on the Internet, and even fewer investigations of the effectiveness of such programs. Based on the review of over 300 HBC programs on the Internet using the “5 A's” of Health Behavior Change on the Internet (HBC-I Screener), which represent standard minimum guidelines for evaluation, it appears HBC on the Internet is in the early stages of development. As health behavior change on the Internet matures from the provision of health information to meeting the requirements necessary to produce health behavior change, and as program developers take advantage of the interactive nature of the Internet, the basic screening and expanded evaluation criteria developed in this project will provide templates for both consumers and developers of programs. The second component necessary for evaluating the impact of HBC on the Internet is the extent to which the population is ready to participate in such programs. We need to move beyond a narrow focus on early adopters and produce a population perspective that includes those not ready, those getting ready, and those ready to use such programs, as well as those already participating. By understanding participation levels of such programs, and what drives this participation, the development and dissemination of practical tailored and targeted interventions can help maximize population participation in Internet programs for health behavior change.
A growing number of major health care organizations, such as the American Heart Association and the Mayo Clinic, are investing considerable resources in developing and marketing Internet-based programs for health promotion and disease management. These programs have the potential to provide some of the best-tailored interventions in behavior change science at relatively low costs. This report discusses review criteria developed in order to conduct a systematic evaluation of Internet programs for preventive behaviors (alcohol, diet, exercise and smoking) and disease management (pediatric asthma, depression and diabetes.) These criteria can be used to develop and evaluate the quality of health promotion programs on the Internet.
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