Cited by 259Digital Mental Health InterventionsMobile Health and mHealth ApplicationsHealth Literacy and Information Accessibility

Internet-delivered health interventions that work: systematic review of meta-analyses and evaluation of website availability

Open access
Rogers, Mary AM, Lemmen, Kelsey, Kramer, Rachel, Mann, Jason, Chopra, Vineet·2017·Journal of Medical Internet Research

Abstract

BACKGROUND: Due to easy access and low cost, Internet-delivered therapies offer an attractive alternative to improving health. Although numerous websites contain health-related information, finding evidence-based programs (as demonstrated through randomized controlled trials, RCTs) can be challenging. We sought to bridge the divide between the knowledge gained from RCTs and communication of the results by conducting a global systematic review and analyzing the availability of evidence-based Internet health programs. OBJECTIVES: The study aimed to (1) discover the range of health-related topics that are addressed through Internet-delivered interventions, (2) generate a list of current websites used in the trials which demonstrate a health benefit, and (3) identify gaps in the research that may have hindered dissemination. Our focus was on Internet-delivered self-guided health interventions that did not require real-time clinical support. METHODS: A systematic review of meta-analyses was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO Registration Number CRD42016041258). MEDLINE via Ovid, PsycINFO, Embase, Cochrane Database of Systematic Reviews, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. Inclusion criteria included (1) meta-analyses of RCTs, (2) at least one Internet-delivered intervention that measured a health-related outcome, and (3) use of at least one self-guided intervention. We excluded group-based therapies. There were no language restrictions. RESULTS: Of the 363 records identified through the search, 71 meta-analyses met inclusion criteria. Within the 71 meta-analyses, there were 1733 studies that contained 268 unique RCTs which tested self-help interventions. On review of the 268 studies, 21.3% (57/268) had functional websites. These included evidence-based Web programs on substance abuse (alcohol, tobacco, cannabis), mental health (depression, anxiety, post-traumatic stress disorder [PTSD], phobias, panic disorders, obsessive compulsive disorder [OCD]), and on diet and physical activity. There were also evidence-based programs on insomnia, chronic pain, cardiovascular risk, and childhood health problems. These programs tended to be intensive, requiring weeks to months of engagement by the user, often including interaction, personalized and normative feedback, and self-monitoring. English was the most common language, although some were available in Spanish, French, Portuguese, Dutch, German, Norwegian, Finnish, Swedish, and Mandarin. There were several interventions with numbers needed to treat of <5; these included painACTION, Mental Health Online for panic disorders, Deprexis, Triple P Online (TPOL), and U Can POOP Too. Hyperlinks of the sites have been listed. CONCLUSIONS: A wide range of evidence-based Internet programs are currently available for health-related behaviors, as well as disease prevention and treatment. However, the majority of Internet-delivered health interventions found to be efficacious in RCTs do not have websites for general use. Increased efforts to provide mechanisms to host "interventions that work" on the Web and to assist the public in locating these sites are necessary.

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  • Digital interventions can be scaled at low cost.

    “Digital interventions can be scaled at low cost [16]”

    From Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial (2023) · cites this paper as [16]

    The Discussion’s Principal Findings describe the large potential audience for Internet programs, and the Conclusions say that wider dissemination could provide a cost-effective way to improve health globally. But the paper presents this as a possibility contingent on expanding access, not as an established finding that digital interventions can be scaled at low cost. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Internet-delivered treatment programs have become more prevalent.

    “Internet-delivered treatment programs have become more prevalent [22]”

    From Internet-delivered treatment for patients suffering from severe functional somatic disorders: Protocol for a randomized controlled trial (2023) · cites this paper as [22]

    The Discussion’s Conclusions identify Internet-delivered treatments currently available across several health areas, but do not say whether such programs have become more prevalent over time. Searches for increasing numbers, growth, and proliferation of these programs found no passage establishing that trend. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 1

  1. [145]Christensen H Griffiths KM Mackinnon AJ Brittliffe K Online randomized controlled trial of brief and full cognitive behaviour therapy for depression Psychol Med 2006 12 36 12 1737 46 10.1017/S0033291706008695 16938144 S0033291706008695 16938144 · DOI · Paper page

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Authors
Rogers, M. A., Lemmen, K., Kramer, R., Mann, J., & Chopra, V.
Affiliations
University of Michigan (US)
Corresponding author
Rogers, Mary AM
Venue
Journal of Medical Internet Research
Published
2017-03-24
Volume
19
Issue
3
Pages
e90
ISSN
1438-8871 (ISSN-L)
OpenAlex
W2598169213
Cited by
259
References
148
Citations by year
2026: 10 · 2025: 22 · 2024: 14 · 2023: 27 · 2022: 38 · 2021: 46 · 2020: 38 · 2019: 33 · 2018: 26 · 2017: 5
FWCI
3.23
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
Keywords
online intervention, website availability, evidence dissemination, addiction treatment, mental health interventions, diet and physical activity, insomnia, chronic pain, self-monitoring, research gaps
MeSH terms
Health Promotion, Humans, Mental Health, Risk Factors, Meta-Analysis as Topic, Health Behavior, Internet

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