Interactive computer-based interventions for sexual health promotion

Bailey, Julia V; Murray, Elizabeth; Rait, Greta; Mercer, Catherine H; Morris, Richard W; Peacock, Richard; Cassell, Jackie; Nazareth, Irwin

doi:10.1002/14651858.cd006483.pub2

Cited by 183Adolescent Sexual and Reproductive HealthSexuality, Behavior, and TechnologyMobile Health and mHealth Applications

Interactive computer-based interventions for sexual health promotion

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Bailey, Julia V, Murray, Elizabeth, Rait, Greta, Mercer, Catherine H, Morris, Richard W, Peacock, Richard, Cassell, Jackie, Nazareth, Irwin·2010·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd006483.pub2PMC PMC13139710

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Abstract

BACKGROUND: Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. OBJECTIVES: To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and economic outcomes. SEARCH STRATEGY: We searched more than thirty databases for randomised controlled trials (RCTs) on ICBI and sexual health, including CENTRAL, DARE, MEDLINE, EMBASE, CINAHL, British Nursing Index, and PsycINFO. We also searched reference lists of published studies and contacted authors. All databases were searched from start date to November 2007, with no language restriction. SELECTION CRITERIA: RCTs of interactive computer-based interventions for sexual health promotion, involving participants of any age, gender, sexual orientation, ethnicity or nationality. 'Interactive' was defined as packages that require contributions from users to produce tailored material and feedback that is personally relevant. DATA COLLECTION AND ANALYSIS: Two review authors screened abstracts, applied eligibility and quality criteria and extracted data. Results of RCTs were pooled using a random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes. We assessed heterogeneity using the I(2) statistic. Separate meta-analyses were conducted by type of comparator: 1) minimal intervention such as usual practice or leaflet, 2) face-to-face intervention or 3) a different design of ICBI; and by type of outcome (cognitive, behavioural, biological outcomes). MAIN RESULTS: We identified 15 RCTs of ICBI conducted in various settings and populations (3917 participants). Comparing ICBI to 'minimal interventions' such as usual practice, meta-analyses showed statistically significant effects as follows: moderate effect on sexual health knowledge (SMD 0.72, 95% CI 0.27 to 1.18); small effect on safer sex self-efficacy (SMD 0.17, 95% CI 0.05 to 0.29); small effect on safer-sex intentions (SMD 0.16, 95% CI 0.02 to 0.30); and also an effect on sexual behaviour (OR 1.75, 95% CI 1.18 to 2.59). Data were insufficient for meta-analysis of biological outcomes and analysis of cost-effectiveness.In comparison with face-to-face sexual health interventions, meta-analysis was only possible for sexual health knowledge, showing that ICBI were more effective (SMD 0.36, 95% CI 0.13 to 0.58). Two further trials reported no difference in knowledge between ICBI and face-to-face intervention, but data were not available for pooling. There were insufficient data to analyse other types of outcome.No studies measured potential harms (apart from reporting any deterioration in measured outcomes). AUTHORS' CONCLUSIONS: ICBI are effective tools for learning about sexual health, and they also show positive effects on self-efficacy, intention and sexual behaviour. More research is needed to establish whether ICBI can impact on biological outcomes, to understand how interventions might work, and whether they are cost-effective.

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Systematic reviews and meta-analyses of Web-based interventions for specific behaviors including smoking cessation, reducing alcohol consumption, safer sexual behaviors, and increasing physical activity have positive findings, even if effect sizes tend to be small.
“Hence, the positive findings of that numerous systematic reviews and meta-analyses of the effects of Web-based interventions for specific behaviors including smoking cessation [36], reducing alcohol consumption [37], safer sexual behaviors [34], and increasing physical activity [38] are reassuring even if the effect sizes tend to be small.”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [34]
Web-based interventions can improve knowledge.
“Web-based interventions can improve knowledge.”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [34]
Some, but not all, Web-based interventions have a positive impact on mediators of behavior change such as intention and self-efficacy.
“There are also data suggesting that some, but not all, Web-based interventions have a positive impact on mediators of behavior change such as intention and self-efficacy [34].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [34]
There is a paucity of data on actual cost-effectiveness of Internet interventions, making it difficult to determine their actual, versus potential, cost-benefits.
“There is also a paucity of data on actual cost-effectiveness of Internet interventions [17,34], making it difficult to determine their actual, versus potential, cost-benefits.”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [34]

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Avina 2006 {published data only} Avina C. An evaluation of a web-based sexual assault prevention program for college women. Dissertation Abstracts International: Section B 2006; Vol. 67, issue 3-B:1691.
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BULLETIN ADJ BOARD$ OR BULLETINBOARD$ OR MESSAGEBOARD$ OR MESSAGE ADJ BOARD$
RUBBER ADJ DAMS Interactive computer-based interventions for sexual health promotion (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 134. RANDOMIZED-CONTROLLED-TRIAL#.
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computer$.TI., unrestricted Interactive computer-based interventions for sexual health promotion (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews 27. internet.TI., unrestricted 28. Internet#.
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DE. OR Sexually-Transmitted-Diseases-Viral#.DE Interactive computer-based interventions for sexual health promotion (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews 62. Sexual-Health#.DE 63. Sex-Education#.DE

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Interactive computer-based interventions for sexual health promotion (Review)
(2010)
Summary of ‘Interactive computer‐based interventions for sexual health promotion’
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Commentary on ‘Interactive computer‐based interventions for sexual health promotion’ with a response from the review authors
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Authors: Bailey, J. V., Murray, E., Rait, G., Mercer, C. H., Morris, R. W., Peacock, R., Cassell, J., & Nazareth, I.
Affiliations: The Royal Free Hospital (GB)
Mortimer Market Centre (GB)
Archway Healthcare Library; Holborn Union Building Archway Campus, Highgate Hill London UK N19 5LW
Brighton and Sussex Medical School (GB)
ORCID: Bailey, Julia V
Murray, Elizabeth
Rait, Greta
Mercer, Catherine H
Morris, Richard W
Cassell, Jackie
Nazareth, Irwin
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2010-09-08
Volume: 2010
Issue: 9
Pages: CD006483-CD006483
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd006483.pub2
PMC: PMC13139710
OpenAlex: W1826230558
Cited by: 183
References: 147
Citations by year: 2026: 3 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 8 · 2021: 9 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 24 · 2016: 12 · 2015: 18 · 2014: 16 · 2013: 14 · 2012: 16
FWCI: 2.45
Type: journal article
Language: en
Open access: green
pmc.ncbi.nlm.nih.gov
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: National Institute for Health and Care Research (CL-2006-18-009)
Topics: Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: sexual health promotion, sexual health knowledge, sexual behavior, face-to-face intervention, personalized feedback, internet-based health interventions, cost-effectiveness, HIV prevention, sexually transmitted infections, young adults, older adults, people with disabilities, sexual orientation, gender identity, sexual minority health
MeSH terms: Computer-Assisted Instruction, Health Promotion, Humans, Sex Education, Randomized Controlled Trials as Topic

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