Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy.
Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy.
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DOI：
10.2196/jmir.1376
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发表时间：
2010-02-17
影响因子：
7.4
通讯作者：
Michie S
中科院分区：
文献类型：
--
作者：
Webb TL;Joseph J;Yardley L;Michie S
互联网越来越多地被用作提供旨在促进健康行为改变的干预措施的媒介。然而，迄今为止对这些干预措施的审查尚未系统地确定干预措施的特点，并将其与有效性联系起来。 本综述旨在利用最近发表的编码框架，评估使用的理论和行为改变技术，以调查哪些特点的基于互联网的干预措施最能促进健康行为的改变。此外，我们希望开发一种新的编码方案，用于评估基于互联网的干预措施的交付模式，并将不同的模式与效果大小联系起来。我们对2000年至2008年间ISI Web of Knowledge索引的数据库（包括BIOSIS Previews和Medline）进行了计算机搜索。如果（1）干预的主要组成部分是通过互联网提供的，（2）参与者被随机分配到不同的条件下，（3）干预后采取了与健康相关的行为措施，则纳入研究。 我们发现85项研究符合纳入标准，总样本量为43，236名参与者。平均而言，干预措施对健康相关行为的影响在统计学上较小，但具有显著性（d+ = 0.16，95% CI 0.09至0.23）。更广泛地使用理论与效应量的增加相关（P = 0.049），特别是，基于计划行为理论的干预往往对行为产生实质性影响（d+ = 0.36，95%CI 0.15至0.56）。与包含较少技术的干预措施相比，包含更多行为改变技术的干预措施也往往具有更大的效果（P < .001）。最后，通过使用与参与者沟通的其他方法，特别是使用短信服务或文本信息，加强了基于互联网的干预措施的有效性。该综述为基于互联网的干预科学的发展提供了一个框架，我们的研究结果为投资于更密集的基于理论的干预措施提供了一个理论基础，这些干预措施包括多种行为改变技术和交付模式。
The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery.
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DOI：
10.1016/0749-5978(91)90020-t
发表时间：
1991-12-01
影响因子：
4.6
作者：
AJZEN, I
通讯作者：
AJZEN, I
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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