Internet-based interventions Robert West Professors of Health Psychology University College London 1
This talk • Why internet intrerventions? • Types of internet-based intervention • Evidence from RCTs 2
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 3
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 4
Evidence from RCTs 5
Real. U Website based on social cognitive and problem behaviour therapy; logs health/life-style habits, has interactive quiz and feedback, links to lifestyle magazine, provision of weekly, tailored emails from peer coaches; provision of financial incentive for participation 6
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 7
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 8
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 9
Internet vs non-internet control 10
Tailored vs untailored website 11
Efficacy at 6 month-follow-up 12
Internet vs ‘human’ support 13
Enhanced internet vs standard internet 14
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 15
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