1. From Word to Web development of online interventions Andrée J. van Emst London, 2009

2. STIVORO

3. Overview Objectives ‘Stone Age’ Word (1997-2000) Word and Web (2001-2005) Web (2006-2009) Where are we now? Where do we go? Questions/Discussion

4. Objectives interventions STIVORO Raise the use of evidence-based support Help people to choose an intervention

5. System of interventions Clinical guideline: Stepped care Evidence based: Behavioural interventions Pharmacotherapy (> 10 cig/day)

6. ‘Stone Age’ (before 1997) Brochure Group training ‘Take Your Chance’

7. Word (‘1st revolution’,1997) Tailored advice version 1: paper and pencil questionnaire and letter

8. Word (1999-2000) Tailored advice and telephone counseling

9. Word and Web (2001) Tailored advice version 2: online questionnaire and paper letter

10. Word and Web (2002)  Decision aid version 1: paper and pencil/online questionnaires

11. Word and Web (2002) StopMail (After Care): online and paper questionnaire/e-mail and paper letters

12. Word and Web (2003) Tailored advice version 3: online questionnaire and e-mail (html/pdf) (paper still available)

13. Web (2005) Tailored advice version 4: online questionnaire, advice on screen and e-mail StopMail: only online questionnaire and e-mail

14. Web (2005) Tailored advice pregnant women

15. Web (2006) Decision aid version 2: ‘Triage’ tool online

16. Triage/level of intervention Triage is meant to: ensure that each smoker receives the most appropriate level of intervention (McDonald, 2006) Level 1: Information Level 2: Minimal intervention Level 3: Treatment

17. Level of pharmacotherapy intervention (>10 cig/day) Level 1: Nicotine replacement therapy Level 2: Nicotine replacement therapy or medication

18. Example triage tool

19. Results Triage Tool (2007) (N=50875)

20. Web (2008) The StopSite

21. Web (2008) The StopSIte: forum and ‘stopmeter’

22. Where are we now? Integrated online system (test and production)

23. Development and test tool Web-based application to develop tailored materials.

24. Content Management System Example CMS tailored advice pregnant women

25. Online data collection Total online interventions 1999-1/2009-05: 402.476

26. Where do we go?

27. ‘Stepped care’ online Triage Tailored Advice StopMail StopSite StopSite + Information Min. InterventionTreatment

28. StopSite+ (2009/2010)

29. Research data  Dijkstra, A. 1998 Computer-tailored interventions for smoking cessation  Willemsen, M. Wiebing,M. Van Emst,A. Zeeman,G. 2006 Helping smokers to decide on the use of efficacious smoking cessation methods  Te Poel, F. et.al. (submitted) Efficacy of a web-delivered computer tailored smoking cessation intervention: results after six months  Willemsen, M. Van Emst, A. Wiebing, M. 2008 StopMail: Effectiveness of an Automated Relapse Prevention Intervention for Smoking Cessation  Kramer,J. Willemsen, M. Conijn, B. Van Emst, A. Brunsting, S. Riper, H. 2008 Effectiveness of a web-based self-help smoking cessation intervention

30. avanemst@stivoro.nl