Is It Time to Start Focusing on the Content of Computer‐delivered Interventions?

Crutzen, Rik

doi:10.1111/j.1360-0443.2011.03539.x

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…The content of the website is important [12], but the specific characteristics of the website itself are also important. A previous study stressed the need for future research to systematically manipulate website characteristics and, subsequently, to link these manipulations to website use [13].…”

Section: Introductionmentioning

confidence: 99%

The Role of User Control in Adherence to and Knowledge Gained from a Website: Randomized Comparison Between a Tunneled Version and a Freedom-of-Choice Version

Crutzen¹,

Cyr²,

Vries³

2012

J Med Internet Res

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BackgroundInternet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to these interventions once they are accessed is very low. Therefore, it is relevant and necessary to systematically manipulate website characteristics to test their effect on website use. This study focuses on user control as a website characteristic.ObjectiveTo test whether and how user control (the freedom of choice to skip pages) can increase website use and knowledge gained from the website.MethodsParticipants older than 18 years were drawn from the Dutch Internet population (in June 2011) and completed a hepatitis knowledge questionnaire. Subsequently, they were randomly assigned to three groups: (1) a tunneled version of the website with less user control; (2) a high user control version of the website where visitors had the freedom of choice to skip pages; and (3) a control group that was not exposed to the website. Participants completed (1) a questionnaire of validated measures regarding user perceptions immediately after exposure to the website (except for the control group), and (2) a hepatitis knowledge questionnaire after one week to test whether participants in the experimental groups only clicked through the website or actually processed and learned its content. Server registrations were used to assess website use. Analyses of covariance (ANCOVA) using all available data were conducted to determine whether user control increases website use. Structural equation models (SEM) using all available data were constructed to test how user control increases website use—a latent variable derived from number of pages visited and time on website.ResultsOf the 1044 persons invited to participate, 668 took part (668/1044, 64.0%). One half of participants (332/668 49.7%) were female and the mean age was 49 years (SD 16). A total of 571 participants completed the one-week follow-up measure regarding hepatitis knowledge (571/668, 85.5%). The findings demonstrate that having less user control (ie, a tunneled version of the website) had a negative effect on users’ perception of efficiency (F1,452 = 97.69, P < .001), but a positive effect on number of pages visited (F1,452 = 171.49, P < .001), time on the website (F1,452 = 6.32, P = .01), and knowledge gained from the website (F1,452 = 134.32, P < .001). The direct effect of having less user control appeared to surpass the effect mediated by efficiency, because website use was higher among participants exposed to the tunneled version of the website in comparison with those having the freedom of choice to skip pages.ConclusionsThe key finding that visitors demonstrated increased website use in the tunneled version of the website indicates that visitors should be carefully guided through the intervention for future intervention websites.

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Section: Introductionmentioning

confidence: 99%

The Role of User Control in Adherence to and Knowledge Gained from a Website: Randomized Comparison Between a Tunneled Version and a Freedom-of-Choice Version

Crutzen¹,

Cyr²,

Vries³

2012

J Med Internet Res

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“…Descriptions of content in previous research have been insufficiently detailed to allow the field to progress quickly and understand the large heterogeneity of effect between different interventions (Crutzen, 2011;Michie, 2008;Strecher, 2008). By contrast, the current study is one of the first evaluations of an internet-based smoking cessation intervention that is committed to the public sharing of intervention content, which is underlined by the use of an open-source development platform and transparent reporting of the development process .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, there was little evidence relating to long-term abstinence (6 months or more) with biochemical verification of smoking status. It is not clear which included components account for the differences in effectiveness, as internet interventions have often been presented as 'black boxes' with limited description of their content (Crutzen, 2011;Michie, 2008;Strecher, 2008). In order to establish the components critical to an effective intervention, it is necessary for researchers to report transparently on the content of new smoking cessation websites.…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of a theory-based interactive internet-based smoking cessation intervention (‘StopAdvisor’): Study protocol

et al. 2013

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Background: Internet-based interventions can help smokers to quit compared with brief written materials or no intervention. However, they are not widely used, particularly by more disadvantaged smokers, and there is significant variation in their effectiveness. A new smoking cessation website ('StopAdvisor') has been systematically developed on the basis of PRIME theory, empirical evidence, web-design expertise and user-testing with socioeconomically disadvantaged smokers. This paper reports the protocol of a randomised controlled trial to evaluate the efficacy of StopAdvisor and determine whether it translates across the social spectrum. Methods:The trial has two arms with participants randomised to the offer of the interactive 'StopAdvisor' website (intervention condition) or a non-interactive, static website (control condition). Participants are adults from the UK, who smoke every day and are willing to make a serious quit attempt within a month of enrolment. At least 4260 participants will be recruited with a minimum of 2130 in each of two socio-economic sub-groups. The intervention comprises a structured quit plan and a variety of theory-and evidence-based behaviour change techniques for smoking cessation. Tailored support is offered in the form of a series of tunnelled sessions and a variety of interactive menus for use up to a month before, and then for one month after quitting (http://www.lifeguideonline.org/player/play/stopadvisordemonstration). The control is a static website that presents brief and standard advice on smoking cessation. Assessments are at baseline and 2-, 4-and 7-months post-enrolment. The primary outcome measure will be Russell Standard 6-months sustained abstinence, defined as self-reported continuous abstinence verified by saliva cotinine or anabasine at 7-month follow-up. Secondary outcome measures will include 7-day point-prevalence abstinence at 7-month follow-up, selfreported abstinence at 2-and 4-month follow-ups, satisfaction ratings of the website and quantitative indices of website interaction. All analyses will be by intention to treat and the Study protocol for RCT of StopAdvisor 2 main analysis will compare the two conditions on the primary outcome measure using a logistic regression model, adjusted for baseline characteristics. The efficacy of the intervention across the social spectrum will be assessed by a logistic regression focussing on the interaction between condition and socio-economic disadvantage.Trial registration: ISRCTN99820519.

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“…These factors relate to the visitor (e.g., people's motivation to be healthy [6], [7]) as well as the intervention website (e.g., offering tailored information [8], [9]). Not only is the content of the website important [10], but also the specific characteristics of the website itself. The current study aims to systematically manipulate a website characteristic – i.e., social presence – and link this to (1) website use and (2) user perceptions as the working mechanisms behind this possible effect of social presence.…”

Section: Introductionmentioning

confidence: 99%

Social Presence and Use of Internet-Delivered Interventions: A Multi-Method Approach

et al. 2013

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ObjectiveInternet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to intervention websites once they are accessed is very low. This study tests whether and how social presence elements can increase website use.MethodsA website about Hepatitis A, B, and C virus infections was used in a preparatory lab-based eye-tracking study assessing whether social presence elements attract participants' attention, because this is a prerequisite for affecting website use. In the following field study, 482 participants representative of the Dutch population were randomized to either a website with or a website without social presence elements. Participants completed a questionnaire of validated measures regarding user perceptions immediately after exposure to the website. Server registrations were used to assess website use.ResultsParticipants in the experimental condition focused on the social presence elements, both in terms of frequency (F(1, 98) = 40.34, p<.001) and duration (F(1, 88) = 39.99, p<.001), but did not differ in website use in comparison with the control condition; neither in terms of the number of pages visited (t(456) = 1.44, p = .15), nor in terms of time on the website (t(456) = 0.01, p = .99).ConclusionsAdding social presence elements did not affect actual use of an intervention website within a public health context. Possible reasons are limited attention for these elements in comparison with the main text and the utilitarian value of intervention websites.

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Is It Time to Start Focusing on the Content of Computer‐delivered Interventions?

Cited by 7 publications

References 5 publications

The Role of User Control in Adherence to and Knowledge Gained from a Website: Randomized Comparison Between a Tunneled Version and a Freedom-of-Choice Version

The Role of User Control in Adherence to and Knowledge Gained from a Website: Randomized Comparison Between a Tunneled Version and a Freedom-of-Choice Version

A randomised controlled trial of a theory-based interactive internet-based smoking cessation intervention (‘StopAdvisor’): Study protocol

Social Presence and Use of Internet-Delivered Interventions: A Multi-Method Approach

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