Internet-based patient education and support interventions: a review of evaluation studies and directions for future research
Abstract
The Internet provides patients, families, and health providers with unparalleled opportunities to learn, inform, and communicate with one another. This paper is a review of studies that have evaluated the impact of professionally facilitated Internet-based programs for diverse clinical populations on health outcomes, utilization, and user satisfaction. The findings suggest that some outcomes in certain groups can be moderately improved and that user satisfaction has been generally positive. Given the increasing need to provide timely and effective patient-centered care, a stronger evidence base for eHealth applications must be established before broader deployment of such programs will take place.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
Treatment effects observed vary distinctly across eMental Health programs.
“However, treatment effects observed vary distinctly across programs [5]”
From Breaking open the black box: isolating the most potent features of a web and mobile phone-based intervention for depression, anxiety, and stress (2015) · cites this paper as [5]
Cites
Crossing the Quality Chasm: A New Health System for the 21st Century
Baker, A. (2001) · BMJ · doi:10.1136/bmj.323.7322.1192 · Cited by 10,754 · see citing works
Mail and internet surveys : the tailored design method
Dillman, D. A. (2007) · Cited by 9,587 · see citing works
Mail and Internet Surveys: The Tailored Design Method
Chisnall, P. M. (2007) · Journal of Advertising Research · doi:10.2501/s0021849907070232 · Cited by 3,240 · see citing works
Persons With Chronic Conditions
Hoffman, C. (1996) · JAMA · doi:10.1001/jama.1996.03540180029029 · Cited by 973 · see citing works
Using Internet technology to deliver a behavioral weight loss program
Tate, D. F. (2001) · JAMA · doi:10.1001/jama.285.9.1172 · Cited by 925 · cited 5× · see citing works
“[28] RCT×6 months Repeated measures (0, 3, 6 months) Hospital employees interested in weight loss Age = 40 91 Internet behavior (EXP): 24 structured weekly lessons and individualized feedback by a therapist via email, access to weight loss resources, weekly submissions of food & exercise diaries, bulletin board, struc…”
BackgroundInfluentialSocial desirability, anonymity, and internet-based questionnaires
Joinson, A. (1999) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03200723 · Cited by 818 · see citing works
Physical activity interventions targeting older adults
King, A. C., Rejeski, W. J., & Büchner, D. M. (1998) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00085-3 · Cited by 567 · see citing works
Falling through the Net: Defining the Digital Divide
Administration, N. T. A. I. (2001) · The MIT Press eBooks · doi:10.7551/mitpress/2419.003.0006 · Cited by 496 · see citing works
Impact of a patient-centered, computer-based health information/support system
Gustafson, D. (1999) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00108-1 · Cited by 461 · see citing works
Effect of computer support on younger women with breast cancer
Gustafson, D. H., Hawkins, R., Pingree, S., McTavish, F., Arora, N. K., Mendenhall, J., Cella, D. F., Serlin, R. C., Apantaku, F. M., Stewart, J., et al. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016007435.x · Cited by 387 · see citing works
Age Differences in Attitudes Toward Computers
Czaja, S. J., & Sharit, J. (1998) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/53b.5.p329 · Cited by 380 · see citing works
The Diabetes Network Internet-Based Physical Activity Intervention
McKay, H. G., King, D., Eakin, E. G., Seeley, J. R., & Glasgow, R. E. (2001) · Diabetes Care · doi:10.2337/diacare.24.8.1328 · Cited by 363 · cited 5× · see citing works
“[34] RCT × 8 weeks Subjects with Type 2 Diabetes Age = 52 78 Active lives physical activity (EXP): action planning, personalized feedback from coach, peer support via email, physical activity diary with graphical summaries (n= 38) vs.”
BackgroundInfluentialBarrera, M., Glasgow, R. E., McKay, H. G., Boles, S. M., & Feil, E. G. (2002) · American Journal of Community Psychology · doi:10.1023/a:1016369114780 · Cited by 333 · see citing works
Miller, E. T., Neal, D. J., Roberts, L. J., Baer, J. S., Cressler, S. O., Metrik, J., & Marlatt, G. A. (2002) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.16.1.56 · Cited by 332 · see citing works
Andersson, G. (2002) · Psychosomatic Medicine · doi:10.1097/01.psy.0000031577.42041.f8 · Cited by 312 · cited 6× · see citing works
“Studies that primarily relied on Internet recruitment without any initial F2F contact appeared to have higher attrition rates and interestingly, this was more so the case with subjects in the experimental groups than control subjects [31,32,35].”
BackgroundMethodInfluentialLiang, M. H. (2000) · PubMed · Cited by 308 · see citing works
Effectiveness of an Internet-based program for reducing risk factors for eating disorders.
Winzelberg, A. J., Eppstein, D., Eldredge, K. L., Wilfley, D., Dasmahapatra, R., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.2.346 · Cited by 291 · see citing works
Effectiveness of an Internet-based program for reducing risk factors for eating disorders.
Winzelberg, A. J., Eppstein, D. L., Eldredge, K. L., Wilfley, D. E., Dasmahapatra, R., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.68.2.346 · Cited by 288 · see citing works
Are tailored health education materials always more effective than non-tailored materials?
Kreuter, M. W. (2000) · Health Education Research · doi:10.1093/her/15.3.305 · Cited by 273 · see citing works
A controlled trial of self-help treatment of recurrent headache conducted via the Internet.
Ström, L., Pettersson, R., & Andersson, G. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.722 · Cited by 267 · cited 5× · see citing works
“Studies that primarily relied on Internet recruitment without any initial F2F contact appeared to have higher attrition rates and interestingly, this was more so the case with subjects in the experimental groups than control subjects [31,32,35].”
BackgroundMethodInfluentialTreatment of panic disorder via the internet: A randomized trial of a self-help program
Carlbring, P., Westling, B. E., Ljungstrand, P., Ekselius, L., & Andersson, G. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80019-8 · Cited by 262 · cited 5× · see citing works
“Four studies were focused on weight reduction and/or body image [27–30], 3ve on the management of various chronic conditions [31–35], and one on preoperative education for cardiac surgery [36].”
BackgroundMethodInfluentialAging, Motor Control, and the Performance of Computer Mouse Tasks
Smith, M. W., Sharit, J., & Czaja, S. J. (1999) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1518/001872099779611102 · Cited by 260 · see citing works
Users of Internet Health Information: Differences by Health Status
Houston, T. K., & Allison, J. J. (2002) · Journal of Medical Internet Research · doi:10.2196/jmir.4.2.e7 · Cited by 252 · see citing works
Celio, A. A., Winzelberg, A. J., Wilfley, D. E., Eppstein-Herald, D., Springer, E. A., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.650 · Cited by 251 · see citing works
The Effects of a Special Computer Network on Caregivers of Persons with Alzheimer??s Disease
BRENNAN, P. F., MOORE, S. M., & SMYTH, K. A. (1995) · Nursing Research · doi:10.1097/00006199-199505000-00007 · Cited by 242 · see citing works
Patient‐centered interventions
Lauver, D., Ward, S. E., Heidrich, S. M., Keller, M. L., Bowers, B. J., Brennan, P. F., Kirchhoff, K. T., & Wells, T. J. (2002) · Research in Nursing & Health · doi:10.1002/nur.10044 · Cited by 241 · see citing works
Web-based administration of a personality questionnaire: Comparison with traditional methods
Davis, R. N. (1999) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03200737 · Cited by 220 · see citing works
Revere, D., & Dunbar, P. J. (2001) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.2001.0080062 · Cited by 208 · see citing works
Lorig, K. R., Laurent, D. D., Deyo, R. A., Marnell, M. E., Minor, M. A., & Ritter, P. L. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.7.792 · Cited by 206 · see citing works
King, A. C., Taylor, C. B., Haskell, W. L., & DeBusk, R. F. (1988) · The American Journal of Cardiology · doi:10.1016/0002-9149(88)90778-3 · Cited by 169 · see citing works
Do Internet interventions for consumers cause more harm than good? A systematic review
Bessell, T. L., McDonald, S., Silagy, C. A., Anderson, J. N., Hiller, J. E., & Sansom, L. N. (2002) · Health Expectations · doi:10.1046/j.1369-6513.2002.00156.x · Cited by 162 · see citing works
Longitudinal Construct Validity
Liang, M. H. (2000) · Medical Care · doi:10.1097/00005650-200009002-00013 · Cited by 154 · see citing works
The Feasibility of Using Internet Support for the Maintenance of Weight Loss
Harvey-Berino, J., Pintauro, S. J., & Gold, E. C. (2002) · Behavior Modification · doi:10.1177/0145445502026001006 · Cited by 135 · see citing works
(2001) · Journal of Health Communication · doi:10.1080/108107301752384442 · Cited by 131 · see citing works
Zabinski, M. F., Pung, M. A., Wilfley, D. E., Eppstein, D. L., Winzelberg, A. J., Celio, A. A., & Taylor, C. B. (2001) · International Journal of Eating Disorders · doi:10.1002/eat.1036 · Cited by 126 · see citing works
Brennan, P. F., Moore, S. M., Björnsdóttir, G., Jones, J., Visovsky, C. M., & Rogers, M. L. (2001) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2001.01902.x · Cited by 125 · see citing works
(1995) · PubMed · Cited by 117 · see citing works
Networking health: prescriptions for the Internet
(2000) · Choice Reviews Online · doi:10.5860/choice.38-2191 · Cited by 110 · see citing works
From Eliza to Internet: a brief history of computerized assessment
Epstein, J., & Klinkenberg, W. D. (2001) · Computers in Human Behavior · doi:10.1016/s0747-5632(01)00004-8 · Cited by 103 · see citing works
Consumers and evaluation of interactive health communication applications
Gustafson, D. H. (1999) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00104-4 · Cited by 99 · see citing works
Developers and evaluation of interactive health communication applications
Henderson, J. V., Noell, J. W., Reeves, T. C., Robinson, T. N., & Strecher, V. J. (1999) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(98)00106-8 · Cited by 85 · see citing works
Computer network home care demonstration: a randomized trial in persons living with AIDS
Flatley-Brennan, P. (1998) · Computers in Biology and Medicine · doi:10.1016/s0010-4825(98)00029-8 · Cited by 76 · see citing works
Zusy, M. J. (2019) · Pflegezeitschrift · doi:10.1007/s41906-019-0028-0 · Cited by 75 · see citing works
Telecommunication Support for Rural Women With Diabetes
Smith, L., & Weinert, C. (2000) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572170002600412 · Cited by 72 · see citing works
The Use of Home-Based Computers to Support Persons Living With AIDS-ARC
Brennan, P. F., Ripich, S., & Moore, S. M. (1991) · Journal of Community Health Nursing · doi:10.1207/s15327655jchn0801_1 · Cited by 71 · see citing works
Use of a Home-Care Computer Network by Persons With AIDS
Brennan, P. F., & Ripich, S. (1994) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300006218 · Cited by 70 · see citing works
Web-based education and support for patients on the cardiac surgery waiting list
Scherrer-Bannerman, A., Fofonoff, D., Minshall, D. K., Downie, S., Brown, M. C., Leslie, F., & McGowan, P. (2000) · Journal of Telemedicine and Telecare · doi:10.1258/1357633001935662 · Cited by 50 · see citing works
Health e-People: The Online Consumer Experience
Cain, M. M., Sarasohn-Kahn, J., & Mittman, R. (2000) · Cited by 49 · see citing works
Winett, R. A., Roodman, A. A., Winett, S. G., Bajzek, W., Rovniak, L. S., & Whiteley, J. A. (1999) · Journal of Gender Culture and Health · doi:10.1023/a:1023233416859 · Cited by 47 · see citing works
The internet as a research tool: Worth the price of admission?
Lenert, L. A., & Skoczen, S. (2002) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2404_01 · Cited by 39 · see citing works
White, T. M., & Hauan, M. J. (2002) · PubMed · Cited by 4 · see citing works
Stopsmoking.ucsf.edu: Web-based Randomized Trials of Smoking Cessation Interventions.
Lenert, L., Muñoz, R. F., Stoddard, J., et al. (2002) · Europe PMC (PubMed Central) · Cited by 2 · see citing works
Age Did Not Influence Use of the HeartCare System
Ground, A., Jones, J., & Flatley-Brennan, P. (2002) · PubMed Central · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Interactive Health Communication Applications for people with chronic disease
Murray, E., Burns, J., See Tai, S., Lai, R., & Nazareth, I. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004274.pub4 · Cited by 722 · see citing works
Morrison, L. G., Yardley, L., Powell, J., & Michie, S. (2012) · Telemedicine and e-Health · doi:10.1089/tmj.2011.0062 · Cited by 290 · see citing works
Internet-based treatment for social phobia: A randomized controlled trial
Berger, T., Hohl, E., & Caspar, F. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20603 · Cited by 198 · see citing works
Internet and psychological treatment. How well can they be combined?
Carlbring, P., & Andersson, G. (2006) · Computers in Human Behavior · doi:10.1016/j.chb.2004.10.009 · Cited by 151 · see citing works
SCHUBART, J. R., STUCKEY, H. L., GANESHAMOORTHY, A., & SCIAMANNA, C. N. (2011) · CIN: Computers, Informatics, Nursing · doi:10.1097/ncn.0b013e3182065eed · Cited by 135 · see citing works
Stinson, J. N., Lalloo, C., Harris, L., Isaac, L., Campbell, F., Brown, S., Ruskin, D., Gordon, A., Galonski, M., Pink, L. R., et al. (2014) · Pain Research and Management · doi:10.1155/2014/935278 · Cited by 149 · see citing works
Stinson, J., McGrath, P., Hodnett, E., Feldman, B., Duffy, C., Huber, A., Tucker, L., Hetherington, R., Tse, S., Spiegel, L., et al. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1349 · Cited by 130 · see citing works
Linke, S., Murray, E., Butler, C., & Wallace, P. (2007) · Journal of Medical Internet Research · doi:10.2196/jmir.9.2.e10 · Cited by 127 · see citing works
Carlbring, P., Furmark, T., Steczkó, J., Ekselius, L., & Andersson, G. (2006) · Clinical Psychologist · doi:10.1080/13284200500378662 · Cited by 90 · see citing works
Schnall, R., Mosley, J. P., Iribarren, S. J., Bakken, S., Carballo-Diéguez, A., & Brown III, W. (2015) · JMIR mHealth and uHealth · doi:10.2196/mhealth.4882 · Cited by 89 · see citing works
Socio-technical and organizational challenges to wider e-Health implementation
Vitacca, M., Mazzù, M., & Scalvini, S. (2009) · Chronic Respiratory Disease · doi:10.1177/1479972309102805 · Cited by 76 · see citing works
Whitton, A. E., Proudfoot, J., Clarke, J., Birch, M.-R., Parker, G., Manicavasagar, V., & Hadzi-Pavlovic, D. (2015) · JMIR Mental Health · doi:10.2196/mental.3573 · Cited by 69 · see citing works
Patient-focused Internet interventions in reproductive medicine: a scoping review
Aarts, J. W. M., van den Haak, P., Nelen, W. L. D. M., Tuil, W. S., Faber, M. J., & Kremer, J. A. M. (2012) · Human Reproduction Update · doi:10.1093/humupd/dmr045 · Cited by 52 · see citing works
Goessens, B. M. B., Visseren, F. L. J., de Nooijer, J., van den Borne, H. W., Algra, A., Wierdsma, J., & van der Graaf, Y. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2008.06.004 · Cited by 40 · see citing works
Prince, A. C., Moosa, A., Lomer, M. C. E., Reidlinger, D. P., & Whelan, K. (2015) · Health Expectations · doi:10.1111/hex.12219 · Cited by 29 · see citing works
myPainPal: co-creation of a mHealth app for the management of chronic pain in young people
Cooke, M., Richards, J., Tjondronegoro, D., Raj Chakraborty, P., Jauncey-Cooke, J., Andresen, E., Theodoros, J., Paterson, R., Schults, J., Raithatha, B., et al. (2021) · Informatics for Health and Social Care · doi:10.1080/17538157.2021.1892697 · Cited by 18 · see citing works
- Authors
- Nguyen, H. Q., Carrieri-Kohlman, V., Rankin, S. H., Slaughter, R., & Stulbarg, M. S.
- Corresponding author
- Nguyen, Huong Q.
- ORCID
- Nguyen, Huong Q.
- Venue
- Computers in Biology and Medicine
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 34
- Issue
- 2
- Pages
- 95-112
- ISSN
- 0010-4825 (ISSN-L)
- OpenAlex
- W2078579089
- Cited by
- 147
- References
- 53
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 11 · 2018: 5 · 2017: 10 · 2016: 6 · 2015: 5 · 2014: 12 · 2013: 9 · 2012: 12
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Computers in Biology and Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f31nr007820-02)
- National Institute of Nursing Research (1F31NR007820)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- e-health, online health interventions, patient support services, health outcomes, health care utilization, user satisfaction, patient-centered care
- MeSH terms
- Chronic Disease, Evaluation Studies as Topic, Health Education, Health Promotion, Humans, Outcome Assessment, Health Care, 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.
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 ›
Are you an author, or do you see a problem with this page? Request a review
