Background: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. Objective: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. Methods: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. Results: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. Conclusions: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery? © Griffiths, Frances, Lindenmeyer, Antje, Powell, John, Thorogood, Margaret.

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Why Are Health Care Interventions Delivered Over the Internet? A Systematic Review of the Published Literature

The Internet increasingly serves as a platform for the delivery of public health interventions. The efficacy of Internet interventions has been demonstrated across a wide range of conditions. Much more work remains, however, to enhance the potential for broad population dissemination of Internet interventions. In this article, we examine the effectiveness of Internet interventions, with particular attention to their dissemination potential. We discuss several considerations (characterizing reach rates, minimizing attrition, promoting Web site utilization, use of tailored messaging and social networking) that may improve the implementation of Internet interventions and their associated outcomes. We review factors that may influence the adoption of Internet interventions in a range of potential dissemination settings. Finally, we present several recommendations for future research that highlight the potential importance of better understanding intervention reach, developing consensus regarding Web site usage metrics, and more broadly integrating Web 2.0 functionality.

The Delivery of Public Health Interventions via the Internet: Actualizing Their Potential

https://escholarship.org/content/qt0m10f3x5/qt0m10f3x5.pdf?t=lnpzoi

Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys.

Each day, more than 12.5 million health-related computer searches are conducted on the World Wide Web. Based on a meta-analysis of 24 published surveys, the author estimates that in the developed world, about 39% of persons with cancer are using the Internet, and approximately 2.3 million persons living with cancer worldwide are online. In addition, 15% to 20% of persons with cancer use the Internet "indirectly" through family and friends. Based on a comprehensive review of the literature, the available evidence on how persons with cancer are using the Internet and the effect of Internet use on persons with cancer is summarized. The author distinguishes four areas of Internet use: communication (electronic mail), community (virtual support groups), content (health information on the World Wide Web), and e-commerce. A conceptual framework summarizing the factors involved in a possible link between Internet use and cancer outcomes is presented, and future areas for research are highlighted.

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The Impact of the Internet on Cancer Outcomes

This book explores the patterns and dynamics of the network society through its policies. Topics range from the knowledge economy, based on technology and innovation, to organizational reform and modernization in the public sector. The contributors also examine media and communication policies. Contributors include Jorge Sampaio (president of the Portugese Republic), Manuel Castells (UCLA), Gustavo Cardoso (CIES/ISCTE, Portugal), Dale W. Jorgenson (Harvard University), Khuong M.Vu (Suffolk University), Luc Soete (UNU-INTECH and MERIT), Jane Fountain (University of Massachusetts-Amherst), James Katz (Rutgers University), Betty Collis (University of Twente, The Netherlands), Geoff Mulgan (Institute of Community Studies, London), Marcelo Branco (Brazilian Information Society), Jonathan Taplin (Annenberg School for Communication, University of Southern California), Imma Tubella (Open University of Catalonia, Barcelona), Fran?ois Bar (Annenberg School for Communication, USC), Hernan Galperin (Annenberg School for Communication, USC), Jeff Cole (Annenberg School for Communication, USC), William Mitchell (MIT), Erkki Liikanen (Bank of Finland), Pekka Himanen (Helsinki Institute for Information Society and University of California, Berkeley), Carlos Alvarez (secretary of state for the economy, Chile), and Maria Joao Rodrigues (ISCTE, University of Lisbon).

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The Network Society: From Knowledge to Policy

BACKGROUND
Women with breast carcinoma commonly experience psychologic distress following their diagnosis Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives Web-based breast cancer social support groups are widely used, but little is known of their effectiveness Preliminary evidence suggests that women benefit from their participation in web-based support groups

METHODS
Seventy-two women with primary breast carcinoma were assigned randomly to a 12-week, web-based, social support group (Bosom Buddies) The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format

RESULTS
The results indicate that a web-based support group can be useful in reducing depression and cancer-related trauma, as well as perceived stress, among women with primary breast carcinoma The effect sizes ranged from 038 to 054 Participants perceived a variety of benefits and high satisfaction from their participation in the intervention

CONCLUSIONS
This study demonstrated that the web-based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer-related trauma measures The effect size of the intervention was in the moderate range Although web-based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed Cancer 2003;97:1164–73 © 2003 American Cancer Society

DOI 101002/cncr11174

Heidi Roberts

Papers

Evaluation of an internet support group for women with primary breast cancer.