The DOI matches its Crossref record; 67 of the 71 references it cites were found in a registry or an index; none of the 60 sources its claims cite is checked for support yet.
A Behavior Change Model for Internet Interventions
Open accessAbstract
BACKGROUND: The Internet has become a major component to health care and has important implications for the future of the health care system. One of the most notable aspects of the Web is its ability to provide efficient, interactive, and tailored content to the user. Given the wide reach and extensive capabilities of the Internet, researchers in behavioral medicine have been using it to develop and deliver interactive and comprehensive treatment programs with the ultimate goal of impacting patient behavior and reducing unwanted symptoms. To date, however, many of these interventions have not been grounded in theory or developed from behavior change models, and no overarching model to explain behavior change in Internet interventions has yet been published. PURPOSE: The purpose of this article is to propose a model to help guide future Internet intervention development and predict and explain behavior changes and symptom improvement produced by Internet interventions. RESULTS: The model purports that effective Internet interventions produce (and maintain) behavior change and symptom improvement via nine nonlinear steps: the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change and symptom improvement through various mechanisms of change. The improvements are sustained via treatment maintenance. CONCLUSION: By grounding Internet intervention research within a scientific framework, developers can plan feasible, informed, and testable Internet interventions, and this form of treatment will become more firmly established.
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Claims the paper makes
84 Own interpretation · 31 Not checked yet · 1 Sources not found · 1 No basis given
In the paper
“The environment can provide support or serve as a barrier to individuals implementing a self-help treatment program [22].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
What the sources say
- Not checked yetcites [22] Glasgow RE, Eakin EG. Issues in diabetes self-management. In: Shumaker SA, Schron EB, Ockene JK, McBee WL, eds. The Handbook of Health Behavior Change. 2nd ed. New York: Springer; 1998: 435.
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“In the Internet intervention model, environmental factors, similar to Glasgow’s “Pyramid of Influences,” [22] can impact each component of the model in potentially significant ways.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
What the sources say
- Not checked yetcites [22] Glasgow RE, Eakin EG. Issues in diabetes self-management. In: Shumaker SA, Schron EB, Ockene JK, McBee WL, eds. The Handbook of Health Behavior Change. 2nd ed. New York: Springer; 1998: 435.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Although preliminary research has demonstrated the importance of some of these elements [24–26], additional work is necessary to determine the best use of each.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
What the sources say
- Not checked yetcites [24] Ritterband LM, Cox DJ, Gordon T, et al. The inclusion of audio, graphics, and interactivity in an internet intervention for pediatric encopresis. Child Health Care. 2006; 35: 47-59. source
- Not checked yetcites [25] Danaher BG, Boles SM, Akers L, Gordon JS, Severson HH. Defining participant exposure measures in web-based health behavior change programs. J Med Internet Res. 2006; 8: e15. source
- Not checked yetcites [26] Hurling R, Fairley BW, Dias MB. Internet-based exercise intervention systems: Are more interactive designs better? Psychol Health. 2006; 21: 757-772. source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Behavior change is also affected by environmental factors; family and the community can shape behaviors through positive or negative reinforcement.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, determining an optimal set of elements is complicated by the wide range of intervention types, patient populations, computing systems, and technologies as different elements of varying degrees will likely be necessary depending on the program focus area.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgeddirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Symptom improvement can be influenced by changes in the user’s surroundings that help to reduce significant symptoms.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plainconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some of the characteristics are fixed and cannot be manipulated, such as age or gender, but many can be modified (e.g., cognitive factors, beliefs and attitudes, and skills).”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > User Characteristics
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, interventions can be tailored based on an individual user’s characteristics.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > User Characteristics
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Environmental factors can influence user characteristics by shaping a user’s knowledge or motivation to use this treatment approach.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Problematic sleep symptoms can be reduced if environmental triggers are identified and corrected.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plaindirect- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 64
- The quote only partly states this claim. 2
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None of the sources cited for this claim have been checked yet.
In the paper
“We hypothesize that effective Internet intervention programs will produce change in behaviors and reduce unwanted symptoms (as well as maintain improvement) via the following steps: the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change via different mechanisms of change (e.g”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model
What the sources say
- Not checked yetcites [12] Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974; 2: 328-335. source
- Not checked yetcites [13] Prochaska JO, DiClemente CC. The transtheoretical approach. In: Norcross JC, Goldfried MR, eds. Handbook of Psychotherapy Integration. New York: Basic Books; 1992: 300-334.
- Not checked yetcites [14] Lefebvre RC, Rochlin L. Social marketing. In: Glanz K, Lewis FM, Rimer B, eds. Health Behavior and Health Education: Theory, Research, and Practice. 2nd ed. San Francisco: Jossey-Bass; 1997: 384-402.
- Not checked yetcites [15] Miller NE, Dollard J. Social Learning and Imitation. New Haven: Yale University Press; 1941.
- Not checked yetcites [16] Matarazzo JD, Weiss SM, Herd JA, Miller NE, Weiss SM, eds. Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York: Wiley; 1984.
- Not checked yetcites [17] Casmir FL, ed. Building communication theories: A socio/cultural approach. Hillsdale: Erlbaum; 1994.
- Not checked yetcites [18] Fisher JD, Fisher WA. The information-motivation-behavioral skills model. In: DiClemente R, Crosby R, Kegler M, eds. Emerging Theories in Health Promotion Practice and Research. 2nd ed. San Francisco: Jossey Bass; 2002: 40-70.
hedgeddirect- Asserted: fails — The authors may not put it forward as true.
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Probably not a substantial claim. The authors may not put it forward as true. The quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Website use leads to behavior change via different mechanisms of change (e.g., knowledge and motivation).”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This will, in part, dictate the program’s appeal to the user.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. The quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“which is influenced by support and website characteristics”
- Also stated in: § Results · plain
“which is influenced by support and website characteristics.”
§ A Behavior Change Model for Internet Interventions > Abstract > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“treatment maintenance helps users maintain these gains.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Change mechanisms can be influenced by the support of the user’s school; for example, within a weight loss intervention, a school lunch program that makes nutritious lunches available can affect the motivation of obese children.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plainconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“For example, laws restricting smoking can enhance smoking cessation outcomes [23].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
What the sources say
- Not checked yetcites [23] Biener L, Abrams DB, Follick MJ, Dean L. A comparative evaluation of a restrictive smoking policy in a general hospital. Am J Public Health. 1989; 79: 192-195. source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In fact, these user characteristics may serve as predictor variables [20, 21] or be targeted for change along with the identified problem.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > User Characteristics
What the sources say
- Not checked yetcites [20] Magee JC, Ritterband LM, Thorndike FP, Cox DJ, Borowitz SM. Exploring the relationship between parental worry about their child’s health and usage of an Internet intervention for pediatric encopresis. J Pediatr Psychol. 2009; 34: 530-538. source
- Not checked yetcites [21] Tercyak KP, Abraham AA, Graham AL, Wilson LD, Walker LR. Association of multiple behavioral risk factors with adolescents’ willingness to engage in eHealth promotion. J Pediatr Psychol. 2009; 34: 457-469. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Behavior change impacts physiology and target behaviors to bring about symptom improvement”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the user, influenced by environmental factors, affects website use and adherence”
- Also stated in: § Results · plain
“the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics.”
§ A Behavior Change Model for Internet Interventions > Abstract > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
- Also stated in: § Results · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These elements dictate the development and use of an Internet intervention.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Connections between environment and other components of the model can be identified, measured, and evaluated to provide critical information regarding the overall impact of the environment.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Environment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Some researchers have already begun conducting these important deconstruction studies with computer and Internet-based programs [31–33]”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
What the sources say
- Not checked yetcites [31] Greist JH, Marks IM, Baer L, et al. Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry. 2002; 63: 138-145. source
- Not checked yetcites [32] Wright J, Wright A, Albano AM, et al. Computer-assisted cognitive therapy for depression: Maintaining efficacy while reducing therapist time. Am J Psychiatry. 2005; 162: 1158-1164. source
- Not checked yetcites [33] Tate DF, Jackvony EH, Wing RR. A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program. Arch Intern Med. 2006; 166: 1620-1625. source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“There is research indicating that external support of the application may improve adherence and outcomes for many disorders [33, 47, 50]; however, this is not always found to be the case [48, 49]”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Support
What the sources say
- Not checked yetcites [33] Tate DF, Jackvony EH, Wing RR. A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program. Arch Intern Med. 2006; 166: 1620-1625. source
- Not checked yetcites [47] Spek V, Cuijpers P, Nyklicek I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis. Psychol Med. 2007; 37: 319-328. source
- Not checked yetcites [50] Christensen H, Griffiths KM, Korten AE, Brittliffe K, Groves C. A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website. J Med Internet Res. 2004; 6: e46. source
- Not checked yetcites [48] Andersson G, Lundström P, Ström L. Internet-based treatment of headache: Does telephone contact add anything? Headache. 2003; 43: 353-361. source
- Not checked yetcites [49] Klein B, Austin D, Pier C, et al. Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference? Cogn Behav Ther. 2009; 38: 100-113. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although this issue may seem unimportant, appearance may be critical as it likely encourages initial (and continued) use of the website and may increase overall engagement.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Usage is affected by the user characteristics, environmental factors, the actual website, and support.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“For example, there is a huge need for psychological services for the treatment of insomnia, a significant health problem with one third of the adult population reporting symptoms of insomnia and approximately 10% meeting diagnostic criteria for an insomnia disorder [53–56].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
What the sources say
- Not checked yetcites [53] Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders, an opportunity for prevention? JAMA. 1989; 262: 1479-1484. source
- Not checked yetcites [54] Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry. 1985; 42: 225-232. source
- Not checked yetcites [55] Ohayon MM. Epidemiology of insomnia: What we know and what we still need to learn. Sleep Med Rev. 2002; 6: 97-111. source
- Not checked yetcites [56] Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry. 1997; 154: 1417-1423. source
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Symptom improvement (and then maintenance of these gains) is the goal of most Internet interventions.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While some interventions are purely self-guided applications, other researchers have developed semi-self-guided applications that require clinician assistance.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“People may approach and use Internet interventions differently than any other form of treatment, and it is critical to take into consideration user expectations [45].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
What the sources say
- Not checked yetcites [45] Christensen H, Mackinnon A. The law of attrition revisited. J Med Internet Res. 2006; 8: e20. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Internet intervention model lends itself to testing the impact of adherence on behavior change, as well as testing how other factors influence adherence.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The elements of personalization and tailoring are critical to Internet interventions and could be considered some of the primary elements distinguishing Internet interventions from other self-help programs.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Identifying which core components of treatment are necessary for everyone, as well as determining which additional modules are needed by only some users, can help provide treatments that are more efficient, effective, and relevant.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plainconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Support also directly impacts the development of the system (website), as this component needs to be implemented into the design of the application.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Support
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These are hypothesized to impact user engagement and other mechanisms of change, including acquisition of knowledge and motivation.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: fails — The authors may not put it forward as true.
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Probably not a substantial claim. The authors may not put it forward as true. It may state two separate claims as one.
In the paper
“Costs must also be considered [9] as the incorporation of any support increases the time, effort, and finances to implement an Internet intervention and can significantly reduce the ability to disseminate this type of intervention on any grand scale.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Support
What the sources say
- Not checked yetcites [9] Tate DF, Finkelstein EA, Khavjou O, Gustafson A. Cost effectiveness of Internet interventions: Review and recommendations. Ann Behav Med. 2009. doi: 10.1007/s12160-009-9131-6 . source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to note that many of the user characteristics can be modified through intervention use and serve as mechanisms of change.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Mechanisms of Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These prescriptions are part of the treatment and are also designed to increase commitment and boost adherence.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Some researchers have been incorporating personalized e-mails and telephone support as methods of increasing adherence [47–49].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
What the sources say
- Not checked yetcites [47] Spek V, Cuijpers P, Nyklicek I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis. Psychol Med. 2007; 37: 319-328. source
- Not checked yetcites [48] Andersson G, Lundström P, Ström L. Internet-based treatment of headache: Does telephone contact add anything? Headache. 2003; 43: 353-361. source
- Not checked yetcites [49] Klein B, Austin D, Pier C, et al. Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference? Cogn Behav Ther. 2009; 38: 100-113. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Users may expect to complete a limited subset of a program to satisfy their needs, whereas other users may plan and need to complete the full treatment offered.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
What the sources say
- Not checked yetcites [45] Christensen H, Mackinnon A. The law of attrition revisited. J Med Internet Res. 2006; 8: e20. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It likely also further engages the user and may increase the individual’s desire to use the system.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“The application should, however, meet some minimum requirements of effectiveness [9].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
What the sources say
- Not checked yetcites [9] Tate DF, Finkelstein EA, Khavjou O, Gustafson A. Cost effectiveness of Internet interventions: Review and recommendations. Ann Behav Med. 2009. doi: 10.1007/s12160-009-9131-6 . source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Given that there is a significant amount of misinformation on the Internet [34], providing accurate, clear, and simple information is critical to creating and delivering efficacious applications that will be well-received.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
What the sources say
- Not checked yetcites [34] Eysenbach G, Powell J, Kuss O, Sa ER. Empirical studies assessing the quality of health information for consumers on the World Wide Web: A systematic review. JAMA. 2002; 287: 2691-2700. source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Behavior change is typically necessary for the symptoms to improve.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Behavior Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Without human involvement, Internet interventions can serve as many people as the computer servers are scaled to support.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Support
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Regardless of the delivery mechanism, users approach the intervention with a set of user characteristics, and use of that intervention is shaped by various influences including the environment and support.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Obviously, the symptoms are specific to the problem and treatment application.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ultimately, behavior change and symptom improvement occur via various mechanisms of change.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Testing also provides a method to teach (or highlight) specific content that can be presented through the use of multiple choice or true/false questions with corrective feedback.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Each of these elements provide a different way of delivering content that may impact use of the system due to the individual’s engagement, usability, and enjoyment of the program, as well as potentially impacting specific mechanisms of change.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As the needs of external support are reduced, the reach of Internet interventions exponentially increases.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Support
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Providing feedback can serve as a significant form of reinforcement.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While the ultimate measure of success of most Internet interventions is symptom improvement, this is usually dictated by the occurrence of behavior change.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Behavior Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Reinforcement is utilized to help motivate the user to learn and progress through the program.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The benefits of such a system, including widespread use and accessibility, may far outweigh reduced effectiveness compared to the gold standard.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Symptom Improvement
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Given these different uses of an Internet intervention, it is much more difficult to make sense of usage data, as someone who appears to be a “dropout” or nonadherent user may actually be someone who obtained “success” with a low treatment dose [45].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website Use
What the sources say
- Not checked yetcites [45] Christensen H, Mackinnon A. The law of attrition revisited. J Med Internet Res. 2006; 8: e20. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Behavioral contracts, concerning what the patient is willing to do (and when), and written instructions are known to enhance behavior change [27].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Website
What the sources say
- Not checked yetcites [27] Cox DJ, Tisdelle DA, Culbert JP. Increasing adherence to behavioral homework assignments. J Behav Med. 1988; 11: 519-522. source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, it is possible that environmental influences impact users after they have begun using the system, thus potentially impacting users’ adherence midway through the program.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The model for Internet interventions proposes that individuals approach an Internet intervention with a set of user characteristics that are influenced by environmental factors.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The user characteristics in turn impact their use of the website.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Website use is also influenced by website characteristics, adherence to the site, and support offered by the program to assist users in their use of the intervention.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, user characteristics may predict use of the website, as well as ultimate symptom improvement, and evaluating these user variables (e.g., disease severity, readiness for change) could help future developers tailor the intervention accordingly.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The environment affects all components of the model, and measuring these influences is important to understanding the impact of the environment on the user, usage of the system, change mechanisms, changing of behaviors, symptom improvement, and treatment maintenance.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Examining website use is another distinctive aspect to the model, potentially providing the most meaningful information to researchers, clinicians, and users.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Measurement indicates that each component, area, and element of the model can be examined and measured.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“However, relapse prevention can be used to avert deterioration and maintain successes and can be used to enhance the maintenance of behavior change and symptom improvements [59].”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Treatment Maintenance
What the sources say
- Not checked yetcites [59] Marlatt GA, George WH. Relapse prevention and the maintenance of optimal health. In: Shumaker SA, Schron EB, Ockene JK, McBee WL, eds. The Handbook of Health Behavior Change. 2nd ed. New York: Springer; 2004: 33-58.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While not unique to Internet interventions, it is critical to also measure the mechanisms of change, behavior change, symptom improvement, and treatment maintenance components to determine the ability of Internet interventions to deliver effective treatments.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To clarify, the model depicts a recurrent cyclical process.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Relapse prevention information is incorporated in order to help the user reduce the possibility of problems returning and develop plans to address future problems should they occur.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Treatment Maintenance
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By drawing on multiple disciplines and previously established theories and models, this model enables us to conceptualize, identify, and measure the factors likely to contribute to behavior change (and symptom improvement) in Internet interventions.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Implications of the Model
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The usefulness of any model is determined by how well it can be evaluated, and the current model and its components can be operationalized and measured in numerous ways.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Treatment success is maintained through relapse prevention.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“First, the model is an oversimplification of how Internet interventions produce behavior change.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Building in ways of addressing problems with adherence, such as stepped care approaches, and measuring the resulting changes in adherence can provide information and understanding that reaches beyond that of treatment programs delivered via the Internet.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite this linear depiction, however, the model is not conceptualized as a unidirectional process. Instead, steps can be repeated or even occur out of order.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The model then predicts that website use leads to behavior change via various mechanisms of change and that the behavior changes result in symptom improvement.”
§ A Behavior Change Model for Internet Interventions > The Internet Intervention Model > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the mechanisms of change, behavior change, and symptom improvement may all have an impact on user characteristics which in turn continue to affect these processes.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Dismantling the program and determining which treatment elements help result in positive change should lead to more efficient yet still highly effective programs utilizing only the necessary ingredients.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This model extends our knowledge about the development, testing, and usage of Internet interventions and has both important clinical and research implications.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Implications of the Model
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This model of Internet interventions helps identify the various components of an Internet intervention and presents the relationships among the various components in an effort to explain and predict behavior change and symptom improvement across interventions.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Implications of the Model
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Internet intervention model enables the field to do just that.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Implications of the Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Determining which aspects of a treatment application are utilized may uncover the most helpful aspects of treatment.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The usefulness of any model is determined by how well it can be evaluated, and the current model and its components can be operationalized and measured in numerous ways.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Measuring the associated support component will contribute to a greater understanding of usage and adjunctive assistance.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Users will continue to use the Internet intervention even as they change behaviors and experience symptom improvement, which will cause changes in their user characteristics, which will impact their continued use of the system, and so on.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“It is critical for clinicians and researchers to understand how health behavior changes and to transform that knowledge about behavior into useful strategies for health enhancement [11].”
§ A Behavior Change Model for Internet Interventions > Conclusion > Implications of the Model
What the sources say
- Not matchedcites [11] Glanz K, Lewis F, Rimer B. Linking theory, research, and practice. In: Glanz K, Lewis F, Rimer B, eds. Health Behavior and Health Education: Theory, Research, and Practice. 2nd ed. San Francisco: Jossey-Bass; 1997: 19-35.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although evaluating different aspects of the website (e.g., color, layout, organization) is a time-intensive undertaking, it is essential in helping to predict and explain behavior change via Internet interventions.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although simplification encourages understanding and facilitates use, such brevity fails to capture all aspects of intervention processes.”
§ A Behavior Change Model for Internet Interventions > Conclusion > Limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Clearly, some elements will need to be incorporated into all Internet interventions (e.g., understandable content); however, different elements (and varying amounts of these elements) will be necessary for diverse treatments and populations.”
§ A Behavior Change Model for Internet Interventions > Evaluation of the Internet Intervention Model
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
The paper relies on this without support.
Many Internet interventions have not been grounded in theory or developed from behavior change models.
“To date, however, many of these interventions have not been grounded in theory or developed from behavior change models”
The paper relies on this without support.
No overarching model to explain behavior change in Internet interventions has yet been published.
“and no overarching model to explain behavior change in Internet interventions has yet been published.”
The paper relies on this without support.
There has been no published theoretical model underlying these programs.
“Although there has been a recent proliferation of Internet health interventions [1, 4, 10], there has been no published theoretical model underlying these programs.”
The paper relies on this without support.
We are unaware of literature documenting how technology, specifically the Internet, can be used to promote behavior change and subsequent symptom improvement with an underlying theoretical model.
“Although various books provide recommendations for effective website design [19], we are unaware of literature documenting how technology, specifically the Internet, can be used to promote behavior change and subsequent symptom improvement with an underlying theoretical model.”
The paper relies on this without support.
Feasibility and efficacy data have been established in Internet intervention research, but true effectiveness studies are needed.
“While feasibility and efficacy data have been established in Internet intervention research, true effectiveness studies are needed.”
The paper relies on this without support.
Any type of prevention or treatment program can fit within the website and website use components of the model.
“In a sense, the website and website use components of this model could be considered a “black box” in that any type of prevention or treatment program could fit here.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Practitioners recommended incorporating vignettes featuring parents and children with EBSA, as they enhance knowledge retention, and motivation (Ritterband et al., 2009).”
From Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance. (2024) · cites this paper as Ritterband et al., 2009
Experimental — accuracy not yet measuredIn the citing paper
“It is believed that the quality and design of websites can influence adherence and outcomes (24), although this belief has generally not been rigorously tested.”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [24]
In the citing paper
“However, little is known about the fundamental experience of participating in an Internet-based intervention, and even less is known about the dimensions through which this experience engages a participant’s mental health.”
From Adolescent and parent experiences with a primary care/Internet-based depression prevention intervention (CATCH-IT) (2011) · cites this paper as [19]
In the citing paper
“with the added benefits of convenience, privacy, and providing clinicians with the ability to provide a full-spectrum of care to patients even in remote areas [29; 48].”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [48]
In the citing paper
“Patients also benefit as they can access self-management information in private and at their own convince over the long term–which is an important consideration when managing a condition that by definition is chronic [48].”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [48]
In the citing paper
“Our BIT model extends the Ritterband model [5] by including the intentions of the developer and by increasing the level of granularity.”
From The Behavioral Intervention Technology Model: An Integrated Conceptual and Technological Framework for eHealth and mHealth Interventions (2014) · cites this paper as [5]
Citations
Cites
(1985) · Medical Entomology and Zoology · Cited by 19,180
Health Behavior and Health Education: Theory, Research, and Practice
(1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-4-350_1 · Cited by 13,232
Historical Origins of the Health Belief Model
Rosenstock, I. M. (1974) · Health Education Monographs · doi:10.1177/109019817400200403 · Cited by 6,116
The World Health Report 2002 - Reducing Risks, Promoting Healthy Life
Available, N. A. N. (2003) · Education for Health · doi:10.1080/1357628031000116808 · Cited by 6,078
Epidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743 · cited 1×
“criteria for an insomnia disorder [53–56].”
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524
Mediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · cited 1×
“Mechanisms of change bring about the desired behavior change and ultimate symptom improvement, functioning as the catalysts for transformation [51].”
BackgroundEpidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.262.11.1479 · Cited by 2,440
Epidemiologic Study of Sleep Disturbances and Psychiatric Disorders: An Opportunity for Prevention?
Ford, D. E. (1989) · JAMA · doi:10.1001/jama.1989.03430110069030 · Cited by 2,252
Eysenbach, G., Powell, J., Kuss, O., & Sa, E.-R. (2002) · JAMA · doi:10.1001/jama.287.20.2691 · Cited by 1,871
Research works printed but not linked: 2
- Petty RE, Cacioppo JT. Motivational factors in consumer response to advertisements. In: Geen RG, Beatty WW, Arkin RM, eds. Human Motivation. New York: Allyn and Bacon; 1984: 418-454.
- US Department of Commerce. A Nation Online: How Americans are Expanding their Use of the Internet. US Department of Commerce. Washington: Government Printing Office; 2002.
Cited by
Sorted by citations
Webb, T. L., Joseph, J., Yardley, L., & Michie, S. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1376 · Cited by 2,517
“For example, navigational format (eg, the extent to which users are “tunnelled” to particular information vs given free choice [54]), entertainment value (eg, use of quizzes, stories, graphics), appearance (eg, color, layout, screen size [18]), and credibility (eg, the extent to which the website cites sources, creden…”
BackgroundPerski, O., Blandford, A., West, R., & Michie, S. (2017) · Translational Behavioral Medicine · doi:10.1007/s13142-016-0453-1 · Cited by 1,193
“As the framework proposed by Ritterband and colleagues [29] and the ontology proposed by West and Michie [4] explicitly linked engagement to behaviour change, we drew on these to structure our conceptual framework, mapping the other existing frameworks onto it.”
BackgroundMethodInfluentialUnderstanding and Promoting Effective Engagement With Digital Behavior Change Interventions
Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., Merchant, G. C., Naughton, F., & Blandford, A. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.015 · Cited by 1,118
Mohr, D. C., Cuijpers, P., & Lehman, K. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1602 · Cited by 1,097
“While a wide variety of factors such as the design of the eHealth intervention and patient factors have been suggested as potential factors in adherence and attrition [1, 4], support provided by clinicians or coaches, via telephone, email, and chat rooms, has been shown across many treatment targets to enhance adheren…”
BackgroundMohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.03.008 · Cited by 693
“) [24,69]; adding human support and adherence promotion via phone, e-mail or other media [4]; using incentives [70,71] and making resources more engaging through gaming elements [72].”
Metadata
- Authors
- Ritterband, L. M., Thorndike, F. P., Cox, D. J., Kovatchev, B. P., & Gonder-Frederick, L. A.
- Affiliations
- University of Virginia Health System (US)
- Corresponding author
- Ritterband, Lee M.
- ORCID
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-08
- Volume
- 38
- Issue
- 1
- Pages
- 18-27
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC2878721
- OpenAlex
- W2161380409
- Cited by
- 591
- References
- 71
- Citations by year
- 2026: 13 · 2025: 22 · 2024: 22 · 2023: 45 · 2022: 29 · 2021: 45 · 2020: 50 · 2019: 43 · 2018: 48 · 2017: 33 · 2016: 48 · 2015: 31 · 2014: 53 · 2013: 34 · 2012: 37
- FWCI
- 29.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R34 MH70805, R34MH070805)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD028160)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- online intervention, behavior change models, online health interventions, mechanisms of change, medication adherence, maintenance therapy, symptom improvement, website characteristics, user support, environmental factors, behavioral medicine
- MeSH terms
- Behavior Therapy, Computer Simulation, Evaluation Studies as Topic, Humans, Models, Psychological, Therapy, Computer-Assisted, User-Computer Interface, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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