Saturday, February 23, 2008

How to get people to actually visit efficacious tailored health education websites, and what is needed for such education to be effective?



Last month a paper appeared in the journal Health Education that I co-authored, based on as study by Rick Crutzen, from Maastricht University. Rick and Wendy Brouwers from Erasmus University Medical Centre both work on their PhD’s based on research into why people do or do not visit, access, and stay long enough to complete e-health promotion interventions on the web. Research has indicated that so-called computer-tailored health education is more likely to result in health behaviour change than generic health education. In computer-tailoring people receive personalized feedback and advice, based on a personal assessment of the health behaviour and behavioural determinants. The web is regarded as a very promising channel to distribute such tailored advice, but studies comparing web-based and print computer-tailored intervention indicate that print-delivered versions may be more effective. One reason is that people do not visit the relevant website, or do not stay long enough to really go through the diagnosis and advice. Rick and Wendy’s studies explore why that is the case and what might make people more attentive to web-based tailored interventions.

The purpose of Rick Crutzen’s paper was to gain first insight into factors which might be associated with exposure to internet-delivered interventions. He conducted semi-structured focus group interviews with five groups of Dutch adolescents, aged 12-17 years. Several aspects of exposure, e.g. a first visit, staying long enough actually to use and process the information; and revisiting the intervention, were explored. The results indicate that word-of-mouth ‘marketing’, social comparison information, and regular reminders may help to increase exposure to web-based e-health interventions among adolescents. Further research will be conducted to test these and other issues to improve exposure.

Willemieke Kroeze recently published a paper in Health Education Research (http://her.oxfordjournals.org/) looking into what is needed for computer-tailored nutrition education to be effective. She compared three different versions of the education. A first version provided respondents with feedback about their behaviour compared to recommended intake levels, a second version provided additional feedback about the respondent’s intake compared to that of peers, and the third version also gave so-called action feedback: practical tailored information on how to make dietary changes. The results showed that the most extensive feedback was the only version that was better than non-tailored, generic nutrition information.

For abstracts of relevant papers, please see
· http://www.ncbi.nlm.nih.gov/pubmed/18209115?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
· http://www.ncbi.nlm.nih.gov/pubmed/16700634?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
· http://www.ncbi.nlm.nih.gov/pubmed/18063650?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

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