Internet-based interventions Robert West Professors of Health Psychology University College London
This talk Why internet intrerventions? Types of internet-based intervention Evidence from RCTs
Why internet interventions? Potentially low unit cost Potentially wide reach 24-hour accessibility from multiple locations Opportunities for tailoring Guaranteed fidelity to protocol Continuous data gathering to inform development Capacity to retain identity on the system
Types of internet-based intervention Internet-only vs internet plus Generic vs medication-specific Fully automated vs partially automated Tailored vs untailored Involving users vs not involving users
Evidence from RCTs
RealU Website based on social cognitive and problem behaviour therapy; logs health/life-style habits, has interactive quiz and feedback, links to life-style magazine, provision of weekly, tailored e-mails from peer coaches; provision of financial incentive for participation
Happy Endings Daily e-mail to direct to webpage; pre-recorded daily audio message (log-on call) and up to three text messages, proactive log-off call in evening to assess smoking and provide relapse prevention information when necessary, plus directs to craving helpline; fully automated tunnel design; participants received reminders
CHESS SCRP Online system with log in leading to tailored feedback, information provision, support centre providing web-based cognitive–behavioural techniques (chatroom/ask the expert) and folder to carry out emotional writing paradigm/keep diary; participants received reminders
QSN Tailored (tunnel design), interactive webpage providing educational information, cessation preparation, personal quit plan and date, behavioural tasks, thought and mood management, peer support (chatroom), expert advice and prompts
Internet vs non-internet control
Tailored vs untailored website
Efficacy at 6 month-follow-up
Internet vs ‘human’ support
Enhanced internet vs standard internet
Conclusions Some evidence of efficacy but wide variability Unclear what are most useful features Problems with uptake, adherence and equity Open-access ‘technological’ approach to development will speed progress Apply modification Monitor result