Although the field of health promotion has made substantial progress,1-13 our advances are limited by the evaluation methods used. We have the potential to assess the populationbased impact of our programs. However, with few exceptions, evaluations have restricted their focus to 1 or 2 of 5 "dimensions of quality" we believe to be important.There

No abstract

Internet-based support groups are a rapidly growing segment of mutual aid programs for individuals with chronic illnesses and other challenges. Previous studies have informed us about the content of online exchanges between support group members, but we know little about the ability of these interventions to change participants' perceptions of support. A randomized trial of 160 adult Type 2 diabetes patients provided novice Internet users with computers and Internet access to 1 of 4 conditions: (a) diabetes information only, (b) a personal self-management coach, (c) a social support intervention, or (d) a personal self-management coach and the support intervention. After 3 months, individuals in the 2 support conditions reported significant increases in support on a diabetes-specific support measure and a general support scale. Participants' age was significantly related to change in social support, but intervention effects were still significant after accounting for this relationship. This report is a critical first step in evaluating the long-term effects of Internet-based support for diabetes self-management. The discussion identifies directions for future research.

The Diabetes Network (D-Net), a randomized trial of an Internet-based, diabetes self-management and peer support intervention, was evaluated after 3 months. Design: The study assessed separate and combined effects of diabetes self-management and peer support. Outcomes included physiologic, behavioral, mental health, and website usage. Results are presented on the first 160 type 2 diabetes patients recruited from 16 primary care offices. Of those eligible, 61% participated in the study. Results: There was significant overall improvement, especially on dietary behavior, but no significant between-condition differences. Conclusions: Providing basic diabetes information as well as a "personal coach," self-management intervention entirely over the Internet proved feasible. Even novice computers users will participate in an Internet-based program to assist themselves in managing their diabetes. Validated Internet interventions could prove to be valuable resources that overcome many costs and limitations of conventional diabetes management.Improvements in Internet technologies paired with the dramatic drop in the cost of getting online and gains in access among the technology "have-nots" of the Digital Divide has created the potential for practitioners to assist patients with

The current article outlines a behavior-analytic approach to the study of so