Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis, Use of Behavior Change Techniques, and Mode of Delivery on Efficacy

By Thomas Llewelyn Webb, Judith Joseph, Lucy Yardley, Susan Michie. Journal of Medical Internet Research, 2010

2,597 citations recorded by the source corpus.

Background The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. Objectives The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. Methods We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. Results We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. Conclusions The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery.

Subfields: Applied Psychology, General Health Professions

View Paper: https://www.semanticscholar.org/paper/0cbca8c21ae888c14d397406fe982c084aaba8cd

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Citations in the corpus

A Meta-Analysis of Serious Digital Games for Healthy Lifestyle Promotion (2014, methodology): “Merely using behavioral prediction theories was associated with the smallest effects in our meta-analysis, whereas reviews on computer-tailored interventions have reported moderate effects for programs only based on behavioral prediction theories (Webb et al., 2010).”
Increasing Physical Activity With Mobile Devices: A Meta-Analysis (2012, background): “Multiple researchers have examined aspects of Internet-delivered interventions [15,16].”
A Meta-Analysis of Web-Delivered Tailored Health Behavior Change Interventions (2013, background): “Webb, Joseph, Yardley, and Michie (2010) examined the broad web-based intervention literature and focused their analysis primarily on the use of theory and behavior change techniques.”
Harnessing Social Media for Health Promotion and Behavior Change (2013, background): “22 HEALTH PROMOTION PRACTICE / January 2013 mixed results, but specific applications have demonstrated great promise and effect (Webb et al., 2010).”
Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions (2012, background): “Studies have shown the importance of reminders in increasing adherence and in increasing the effectiveness of web-based interventions [7, 39].”
Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support (2017, background): “ing them to build JITAIs has the potential to result in better outcomes compared to JITAIs that are not theoretically grounded [34, 123, 124].”
Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory (2013, background): “In general, the evidence indicates that intervention developers should look to the theory for guidance, as theory-based interventions have been found to be more effective than non-theory-based interventions (Peters, Kok, Ten Dam, Buijs, & Paulussen, 2009; Webb et al., 2010).”