The DOI matches its Crossref record; 117 of the 117 references it cites were found in a registry or an index; 3 of the 120 sources its claims cite were checked for support.
Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress
Open accessAbstract
The potential advantages of using the Internet to deliver self-care and behavior-change programs are well recognized. An aging population combined with the increasing prevalence of long-term conditions and more effective medical interventions place financial strain on all health care systems. Web-based interventions have the potential to combine the tailored approach of face-to-face interventions with the scalability of public health interventions that have low marginal costs per additional user. From a patient perspective, Web-based interventions can be highly attractive because they are convenient, easily accessible, and can maintain anonymity/privacy. Recognition of this potential has led to research in developing and evaluating Web-based interventions for self-management of long-term conditions and behavior change. Numerous systematic reviews have confirmed the effectiveness of some Web-based interventions, but a number of unanswered questions still remain. This paper reviews the progress made in developing and evaluating Web-based interventions and considers three challenging areas: equity, effectiveness, and implementation. The impact of Web-based interventions on health inequalities remains unclear. Although some have argued that such interventions can increase access to underserved communities, there is evidence to suggest that reliance on Web-based interventions may exacerbate health inequalities by excluding those on the "wrong" side of the digital divide. Although most systematic reviews have found a positive effect on outcomes of interest, effect sizes tend to be small and not all interventions are successful. Further work is needed to determine why some interventions work and others do not. This includes considering the "active ingredients" or mechanism of action of these complex interventions and the context in which they are used. Are there certain demographic, psychological, or clinical factors that promote or inhibit success? Are some behaviors or some clinical problems more amenable to change by computer-based interventions? Equally problematic is the issue of implementation and integration of such programs into routine clinical practice. Many eHealth projects end when the research is concluded and fail to become part of mainstream clinical care. One way of addressing these challenges is to apply the Medical Research Council framework for developing, evaluating, and implementing complex interventions. This includes having a strong theoretical foundation, developing a proposed mechanism or pathway of action, ensuring that the evaluation adequately reflects this proposed pathway, and considering implementation from the beginning of the development process.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review examines the potential, pitfalls, and progress of Web-based interventions for behavior change and self-management, focusing on three unresolved challenges: equity, effectiveness, and implementation. It argues that applying the Medical Research Council framework for complex interventions, together with greater use of theory, could help realize the field's potential.
Key findings
- Web-based interventions have potential advantages in reach, accessibility, tailoring, and low marginal cost per user, but effect sizes in systematic reviews "tend to be small and not all interventions are successful."
- Equity is unresolved: Internet penetration in 2011 was 11% in Africa, 24% in Asia, and 36% in Latin America/Caribbean; within the UK, access was 99% among households earning ≥£40,000 versus 43% at ≤£12,500, 95% among university graduates versus 31% among those who left school without graduating, <40% among those aged 65+, and 41% among those with work-limiting health problems or disabilities.
- Effectiveness varies by outcome: reviews support effects for smoking cessation, alcohol reduction, safer sex, and physical activity, but a UK HTA review found little or no impact of adaptive e-learning on dietary behaviors and no impact on weight loss or BMI; CCBT is effective across mild-to-moderate depression, anxiety, OCD, and phobias, whereas non-CCBT emotional interventions (social networks, personal stories) lack robust evidence of benefit or harm.
- A meta-analysis of ~85 studies covering >45,000 participants found that more extensive use of theory (particularly the Theory of Planned Behavior) and certain behavior-change techniques (eg, stress management, goal setting, action planning) were associated with larger effect sizes.
Methods
- Design: narrative review/commentary, not a systematic review; no search strategy, inclusion criteria, or formal synthesis method is reported.
- Scope: synthesizes existing systematic reviews, meta-analyses, and trials across self-management of long-term conditions, health promotion, and mental health, plus policy and implementation literature.
- Analysis: thematic discussion organized around equity, effectiveness (cognitive, behavioral, emotional outcomes, mechanism of action, cost-effectiveness), and implementation, with recommendations framed by the MRC complex interventions framework and normalization process theory.
Limitations
- The paper states that a number of unanswered questions remain, including why some interventions work and others do not, what the "active ingredients" and effective dose are, and which demographic, psychological, or clinical factors promote or inhibit success; data on user characteristics and adherence are described as "confusing and contradictory."
- The paper states there is a paucity of data on actual cost-effectiveness of Internet interventions and a paucity of comparative data on online peer-support services.
- Evident from the text (not framed as a limitation by the author): this is a single-author narrative review without a documented systematic search or quality appraisal, so selection of cited evidence may be non-exhaustive and subject to author perspective.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
62 Not checked yet · 39 Own interpretation · 3 No basis given · 2 Partly supported · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The review included approximately 85 studies covering more than 45,000 participants.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
What the sources say
- Partly supportedcites [41] sourceExperimental — accuracy not yet measured
The Results section (Effect of Internet-based Interventions on Health-related Behavior) reports 85 studies, supporting the study count. It gives a total of 43,236 participants, not more than 45,000. (LLM, conf=0.95)
plainn = 45,000- 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.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Unfortunately, the research to date has failed to identify evidence of benefit (or harm) to users of online peer-support services.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Emotional Outcomes
What the sources say
- Partly supportedcites [58] sourceExperimental — accuracy not yet measured
The Discussion reports no robust evidence of health benefits from online peer support, and ‘No negative effects reported’ says the reviewed studies reported no harm. The claim drops the qualification ‘robust’: the Discussion acknowledges some statistically significant positive findings, while explaining why they do not establish benefit. Page numbers are unavailable in our copy. (LLM, conf=0.84)
- Not checked yetcites [59] source
- Partly supportedcites [60] sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says the evidence was too limited and low-quality to determine whether depression-focused Internet support groups improve depression outcomes. But the claim extends that uncertainty to all benefits and harms of online peer-support services. The review examines depressive symptoms, not benefits or harms generally, and its Discussion reports encouraging mood improvements in two controlled studies of other groups. (LLM, conf=0.88)
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.
- Partly supported
None of the sources cited for this claim have been checked yet.
In the paper
“Our own research on Web-based interventions supports these concerns about equity, with disproportionately high numbers of users having a university degree [29,30].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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.
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
“Unfortunately, outside of these carefully designed and executed studies, there is evidence that Web-based interventions tend to be used by more advantaged groups.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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.
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
“Moreover, the use of multimedia (eg, video, audio, and graphics) allows complex information to be presented in a simple format comprehensible even to those with low literacy skills.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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.
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 other words, those with the most need have the least access.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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.
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
“Many eHealth projects end when the research is concluded and fail to become part of mainstream clinical care.”
- Also stated in: § Cost-Effectiveness and Implementation · plain
“many interventions have not been widely disseminated.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Abstract
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.
- Also stated in: § Cost-Effectiveness and Implementation · plain
In the paper
“Access to the Internet increases with income and education.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [28] source
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.
None of the sources cited for this claim have been checked yet.
In the paper
“Web-based interventions can improve knowledge.”
- Also stated in: § Cognitive Outcomes · boosted
“there have been a number of systematic reviews and meta-analyses that have demonstrated improvements in knowledge in users of Web-based interventions [31,34].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cognitive Outcomes
boostedconditional- 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.
- Also stated in: § Cognitive Outcomes · boosted
In the paper
“Looking first at the relatively simple question of access to the Internet, it is clear that there are considerable inequities in access, both between and within countries.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [15] Internet World Stats: Usage and Population Statistics201112312012-08-11Internet usage statistics: the Internet big picturehttp://www.internetworldstats.com/stats.htm69q5RTCsT
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.
- It may state two separate claims as one. 38
- Probably not a substantial claim. 36
- The quote only partly states this claim. 1
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 most systematic reviews have found a positive effect on outcomes of interest, effect sizes tend to be small and not all interventions are successful.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Abstract
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.
In the paper
“Internet penetration in Africa was estimated at 11%, 24% in Asia, and 36% in Latin America and the Caribbean in 2011 [15].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [15] Internet World Stats: Usage and Population Statistics201112312012-08-11Internet usage statistics: the Internet big picturehttp://www.internetworldstats.com/stats.htm69q5RTCsT
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
“Web-based interventions could have two opposing impacts on health inequalities.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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.
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 behaviors of interest tend to be the same across both populations (ie, healthy eating, physical activity, smoking cessation, moderating alcohol consumption, and practicing safer sex), but the levels of motivation may differ.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
hedged- 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
“Interactivity is a major advantage of the Internet, both for users interacting with websites and entering personal information that allows the site to tailor the information or services offered to that specific user, and for users interacting with one another through the Web.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Potential
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
“In 2011, Internet access among those aged 65 or over was <40%, and among those with health problems or disabilities that limited the kind or amount of work able to be done, access was 41% [28].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [28] source
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.
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
“From a patient perspective, Web-based interventions can be highly attractive because they are convenient, easily accessible, and can maintain anonymity/privacy.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Abstract
plain- 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
“Many of these potential benefits have yet to be realized.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls
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: 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
“An almost unlimited amount of information can be stored on the Web, yet it can be presented in an accessible and comprehensible format, in bite-size chunks, using video, graphics, and audio, and is available at the moment of need.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Potential
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: 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. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although initial results are promising, further work is needed because many of the trials have been relatively small [44-47].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
What the sources say
plain- 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
“Numerous systematic reviews have confirmed the effectiveness of some Web-based interventions, but a number of unanswered questions still remain.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Abstract
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: 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
“External constraints that may prevent health-promoting activities include poor housing, poor working conditions, and poverty [24].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [24] source
hedgedconditional- 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.
In the paper
“Of greater concern, older people and people with disabilities or long-term illnesses are less likely to have Internet access.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [28] source
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.
It may state two separate claims as one.
In the paper
“In 2011, Internet access among people with household incomes of £40,000 or more was 99%, whereas it was only 43% among people with household incomes of £12,500 or less (half the national median income).”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [28] source
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.
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
“Moreover, access is necessary—but not sufficient—for benefiting from Web-based interventions.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
plainconditional- 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
“Similarly, among people with a university degree, access was 95%, whereas access was only 31% for those people who left school without graduating.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
- Not checked yetcites [28] source
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.
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 undertaken impressive work, demonstrating that Internet interventions can be used by and can benefit severely disadvantaged groups, including homeless drug users [25], single teenage mothers [26], and vulnerable elderly people [27].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
What the sources say
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.
None of the sources cited for this claim have been checked yet.
In the paper
“An alternative approach has been the use of computerized cognitive behavioral therapy (CCBT), which was first developed for use with people experiencing mental health problems such as depression and anxiety [42,43].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
What the sources say
plain- 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
“The Internet is now widely available in the developed world, with more than 90% penetration in Sweden, approximately 80% penetration in the United Kingdom, Australia, and the United States, and approximately 60% in Europe as a whole [15].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Potential
What the sources say
- Not checked yetcites [15] Internet World Stats: Usage and Population Statistics201112312012-08-11Internet usage statistics: the Internet big picturehttp://www.internetworldstats.com/stats.htm69q5RTCsT
plain- 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.
In the paper
“Changing dietary behaviors appears to be more challenging, with a recent systematic review for the UK Health Technology Agency finding little or no impact of adaptive e-learning technologies across a wide range of dietary behaviors and no impact on weight loss or body mass index [39].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
What the sources say
- Not checked yetcites [39] 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.
In the paper
“Although small changes in behavioral outcomes have been demonstrated, these have not converted into improved clinical outcomes [31].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
What the sources say
- Not checked yetcites [31] source
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.
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 two forms of interactivity can be used to provide formal behavior change support, decision support, and peer support.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Potential
plainconditional- 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 impact of Web-based interventions on health inequalities remains unclear.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Abstract
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: 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
“Internal, or psychological, constraints (eg, low self-efficacy or an external locus of control) may also play a part.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Pitfalls > Equity
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
“It can be postulated that the motivation of people with a long-term condition differs from those without a diagnosis of a health problem because the need for change is both more immediate and more personal.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Behavioral Outcomes
hedgeddirect- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Characteristics of the intervention that may improve adherence to the intervention include a strong theoretical foundation [41], perceived personal relevance to the user [65,66], perceived effectiveness [67,68], tailoring [69,70], persuasive technologies [71], credibility [72,73], social networking [74,75], and regular “push factors” including human support [76-78] and/or periodic prompts (eg, by”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
What the sources say
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
“One way of ensuring an intervention is used by large numbers of people is to integrate it into routine health services, but this has been rarely done to date.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
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.
None of the sources cited for this claim have been checked yet.
In the paper
“Although many researchers have found that women, older people, and well-educated people are all more likely to demonstrate adherence to Web-based interventions than males, younger people, and less-educated people [65,66,68,69]”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
What the sources say
hedgedcorrelational- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Although there are some interventions that have been used by very large numbers of people [82,83], many interventions have not been widely disseminated.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
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.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is also a paucity of data on actual cost-effectiveness of Internet interventions [17,34], making it difficult to determine their actual, versus potential, cost-benefits.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
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.
In the paper
“Even when an intervention is effective, the main costs tend to be incurred during development, with relatively low marginal costs per additional user, so that any cost-benefit relies on achieving large numbers of users [17].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
What the sources say
- Not checked yetcites [17] source
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.
In the paper
“A similar methodological approach, but focusing on the use of persuasive features and mechanisms embedded in Web-based interventions, found considerable use of persuasive techniques. However, the authors were unable to conclude whether specific techniques were associated with effectiveness [63].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
What the sources say
- Not checked yetcites [63] source
plain- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Qualitative data suggest that users find such “personal experiences” helpful in reaching decisions [55], but there are less data available about whether and how such narratives impact emotional or clinical outcomes [56].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Emotional Outcomes
hedged- 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.
In the paper
“Attrition from Web-based interventions is a phenomenon that has been observed frequently [64] that may undermine effectiveness.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
What the sources say
- Not checked yetcites [64] 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.
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 potential cost-effectiveness of Internet interventions is highly appealing, but an intervention has to be effective before it can be cost-effective.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
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.
None of the sources cited for this claim have been checked yet.
In the paper
“Implementation of eHealth has proved problematic in most countries, with numerous reports of delay, budget overspends, and occasional severely negative impacts on the quality and effectiveness of care [84,85].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Cost-Effectiveness and Implementation
What the sources say
- Not checked yetcites [84] Department of HealthNational Audit Office20062012-08-11LondonThe Stationery OfficeThe National Programme for IT in the NHShttp://www.nao.org.uk/publications/0506/department_of_health_the_nati.aspx?alreadysearchfor=yes69q5utIU3
- Not checked yetcites [85] source
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
“Data on user characteristics are confusing and contradictory.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
plain- 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. 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
“This may be because of differences in target populations, target behaviors, target outcomes, or differences in the content or delivery of the interventions themselves.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
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.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“others have found no association between adherence and age, gender, or education level [80,81].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Effectiveness > Mechanism of Action
plain- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“It suggests a phased approach, with early work (Phases 0 to 2) consisting of systematic literature reviews to identify what is already known, theoretical work to establish an appropriate theoretical foundation, modeling studies to establish potential rate-limiting steps and population impact, qualitative studies to determine acceptability and feasibility, studies to confirm (or deny) the proposed”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
What the sources say
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.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Phase 4 (implementation) studies are needed both to establish how best to implement the intervention into routine practice and to determine whether the benefits shown in the trial manifest outside the trial environment. Phase 4 studies can also identify unintended adverse effects [90,91].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
What the sources say
- Not checked yetcites [90] MRC Health Services and Public Health Research BoardMedical Research Council2000042012-08-11LondonMedical Research CouncilA Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Healthhttp://www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC00337269q6M4rBF
- Not checked yetcites [91] Anderson, R, 2008, BMJ source
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. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Therefore, the Medical Research Council (MRC) framework for developing, evaluating, and implementing complex interventions offers an appropriate framework for research on Web-based interventions.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
What the sources say
- Not checked yetcites [90] MRC Health Services and Public Health Research BoardMedical Research Council2000042012-08-11LondonMedical Research CouncilA Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Healthhttp://www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC00337269q6M4rBF
- Not checked yetcites [91] Anderson, R, 2008, BMJ 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.
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
“Application of theory is likely to enhance the effectiveness and success of implementation initiatives.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Implementation of Web-Based Interventions
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.
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
“An alternative approach used in the mental health field is “facilitated access” in which use of the intervention is monitored and supported by a health care worker or therapist.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
plain- 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
“Kraft [97] has advised researchers to consider the use of an intervention as the first behavior change to target.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
What the sources say
- Not checked yetcites [97] source
plain- 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
“Achieving large numbers of users often requires implementing and integrating interventions into routine health care, but this has proved difficult to date.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Implementation of Web-Based Interventions
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.
None of the sources cited for this claim have been checked yet.
In the paper
“The precursor to NPT, normalization process model (NPM), originated from a large body of work on eHealth and was developed to explain the observation that many eHealth initiatives failed to embed into routine practice [112,113].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Implementation of Web-Based Interventions
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.
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
“These early phase studies aim to optimize both the intervention and the evaluation, with a view to ensuring that a final Phase 3 trial will provide a definitive answer.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
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
“This provides empirical support for the proposed “pathway of action” of the intervention.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
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
“Thus if an intervention has been designed to cause changes in self-efficacy and outcome expectancies, it is important that the evaluation determines whether changes in these proximal outcomes occur as well as whether the target behavior changes.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
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.
None of the sources cited for this claim have been checked yet.
In the paper
“The MRC framework advises the use of a theoretical framework for development of the intervention, and this advice is supported by the empirical literature which demonstrates that theoretically informed Web-based interventions are more likely to be effective than those without a theoretical foundation.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Development of Web-Based Interventions
boostedcorrelational- 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
“Eysenbach [64] has argued that researchers need to document and publish the content of interventions just as they should document both the planned and actual level of engagement by participants with interventions under evaluation.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
What the sources say
- Not checked yetcites [64] source
plain- 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.
In the paper
“Theories offer us generalizable frameworks that can apply across different settings and individuals, the opportunity for incremental accumulation of knowledge, and an explicit framework for analysis [95].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Development of Web-Based Interventions
What the sources say
- Not checked yetcites [95] Clinical Effectiveness Research Agenda GroupImplementation Science20092012-08-11LondonDepartment of HealthAn Implementation Research Agenda. A report prepared for the High Level Group on Clinical Effectivenesshttp://www.implementationscience.com/content/4/1/18/additional/69q6Wnw1Z
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.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“He advocates “tunnelling,” or highly tailored pre-determined routes through the intervention, coupled with numerous proactive contacts by the intervention to the user delivered through short message service (SMS), email, or automated phone calls [98,99].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Evaluation of the Web-Based Intervention
plain- 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.
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
“Researchers interested in developing a Web-based behavior-change intervention have a wide range of psychological theories from which to choose.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Development of Web-Based Interventions
plain- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“A similar toolkit, the eHealth Implementation Toolkit (e-HIT), is aimed specifically at eHealth interventions and has been developed for use by managers and other staff charged with implementing eHealth initiatives (ie, implementers) [120-122].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply Theory to the Implementation of Web-Based Interventions
What the sources say
plain- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“It has been highly influential, with many additional publications on applying, extending, and revising the framework [92-94].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
What the sources say
plain- 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
“Only when both the intervention and the trial parameters have been optimized and the mechanism of action has been well defined, should researchers proceed to a Phase 3 randomized controlled trial to establish the effectiveness of the intervention.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
plainconditional- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“This framework was first published in 2000 [90] and revised in 2008 [91].”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Progress > Apply the Medical Research Council Framework
What the sources say
- Not checked yetcites [90] MRC Health Services and Public Health Research BoardMedical Research Council2000042012-08-11LondonMedical Research CouncilA Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Healthhttp://www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC00337269q6M4rBF
- Not checked yetcites [91] Anderson, R, 2008, BMJ source
plain- 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
“Use of an appropriate theoretical framework (eg, NPT and its associated tool kit) may help researchers work through implementation issues in a structured fashion.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Conclusions
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
“This will facilitate improved research designs to evaluate interventions because important mediators or proximal outcomes will be clearly specified.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Conclusions
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
“It has argued that the application of the MRC framework for development, evaluation, and implementation of complex interventions, together with a greater use of theory could help address these challenges.”
§ Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress > Conclusions
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.
- Rests on an assumption: Normalization is important for sustainability.
The paper relies on this without support.
Normalization is important for sustainability.
“Normalization is important for sustainability.”
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
“The application was equipped with neither “push” factors nor an advanced decision support system providing feedback based on accumulated data and other personal profiles, which are advocated for long-term usage, according to relevant studies [62-65].”
From Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes (2013) · cites this paper as [65]
Experimental — accuracy not yet measuredIn the citing paper
“The application was equipped with neither “push” factors nor an advanced decision support system providing feedback based on accumulated data and other personal profiles, which are advocated for long-term usage, according to relevant studies [62-65].”
From Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes (2013) · cites this paper as [65]
In the citing paper
“Research demonstrates that web-based interventions offer both utility and positive effects on outcomes of interest (Murray, 2012).”
From A Pilot Study of a Cohort-Based Solution-Focused Wellness Group for Graduate Students Using Solution-Focused Coaching 🇵🇱 🇷🇴 (2022) · cites this paper as Murray, 2012
Citations
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Why do people use information technology? A critical review of the technology acceptance model
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Sick individuals and sick populations
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Patient Self-management of Chronic Disease in Primary Care
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“Effective self-management programs have been shown to reduce health care costs and improve quality of life across a range of conditions [8-10].”
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The evolving concept of health literacy
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Sick individuals and sick populations
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ResultAn implementation research agenda
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BackgroundAssessing the level of healthcare information technology adoption in the United States: a snapshot
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“Characteristics of the intervention that may improve adherence to the intervention include a strong theoretical foundation [41], perceived personal relevance to the user [65,66], perceived effectiveness [67,68], tailoring [69,70], persuasive technologies [71], credibility [72,73], social networking [74,75], and regula…”
BackgroundOnline support for smoking cessation: a systematic review of the literature
Shahab, L., & McEwen, A. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02710.x · Cited by 275
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BackgroundWhy is it difficult to implement e-health initiatives? A qualitative study
Murray, E., Burns, J., May, C., Finch, T., O'Donnell, C., Wallace, P., & Mair, F. (2011) · Implementation Science · doi:10.1186/1748-5908-6-6 · Cited by 270
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“Interventions based on CCBT have been shown to be acceptable, effective, and cost-effective across a range of mental health problems including mild to moderate depression, anxiety, obsessive-compulsive disorder, and phobias [48-54].”
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Adherence in Internet-based interventions.
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Social Network Structure of a Large Online Community for Smoking Cessation
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Can stand‐alone computer‐based interventions reduce alcohol consumption? A systematic review
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Next Generation Users: The Internet in Britain
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BackgroundComputer‐Mediated Social Support: Single Young Mothers as a Model System
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Self-citationNew MRC guidance on evaluating complex interventions
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Computer-Assisted Learning and Evaluation in Medicine
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“…to the intervention include a strong theoretical foundation [41], perceived personal relevance to the user [65,66], perceived effectiveness [67,68], tailoring [69,70], persuasive technologies [71], credibility [72,73], social networking [74,75], and regular “push factors” including human…”
BackgroundNewman, M. G., Szkodny, L. E., Llera, S. J., & Przeworski, A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.10.002 · Cited by 139
The Information Architecture of Behavior Change Websites
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Self-citationInternet Interventions for Long-Term Conditions: Patient and Caregiver Quality Criteria
Kerr, C., Murray, E., Stevenson, F. A., Gore, C., & Nazareth, I. (2006) · Journal of Medical Internet Research · doi:10.2196/jmir.8.3.e13 · Cited by 126
Self-citationUnderstanding factors that inhibit or promote the utilization of telecare in chronic lung disease
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Wallace, P., Murray, E., McCambridge, J., Khadjesari, Z., White, I. R., Thompson, S. G., Kalaitzaki, E., Godfrey, C., & Linke, S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0014740 · Cited by 114 · cited 1×
“Our own research on Web-based interventions supports these concerns about equity, with disproportionately high numbers of users having a university degree [29,30].”
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The Ins and Outs of an Online Bipolar Education Program: A Study of Program Attrition
Nicholas, J., Proudfoot, J., Parker, G., Gillis, I., Burckhardt, R., Manicavasagar, V., & Smith, M. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1450 · Cited by 97
Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT)
Murray, E., May, C., & Mair, F. (2010) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-10-61 · Cited by 96
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Outcome predictors in guided and unguided self-help for social anxiety disorder
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Teledermatology in the U.K.: lessons in service innovation
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An Internet administered treatment program for obsessive–compulsive disorder: A feasibility study
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An overview of structuration theory and its usefulness for nursing research
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Effect of Adding a Virtual Community (Bulletin Board) to Smokefree.gov: Randomized Controlled Trial
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Review of Interactive Safer Sex Web Sites: Practice and Potential
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Self-citationBig is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001
Ellingsen, G., & Monteiro, E. (2003) · Methods of Information in Medicine · doi:10.1055/s-0038-1634231 · Cited by 45
Bennett-Levy, J., & Perry, H. (2009) · Australasian Psychiatry · doi:10.1080/10398560902948126 · Cited by 43
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Kraft, P., & Yardley, L. (2009) · Psychology & Health · doi:10.1080/08870440903068581 · Cited by 37
Economic evaluation of an Internet-based weight management program.
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The e-health implementation toolkit: qualitative evaluation across four European countries
MacFarlane, A., Clerkin, P., Murray, E., Heaney, D. J., Wakeling, M., Pesola, U.-M., Waterworth, E. L., Larsen, F., Makiniemi, M., & Winblad, I. (2011) · Implementation Science · doi:10.1186/1748-5908-6-122 · Cited by 34
Self-citationImplementing a Web-based Information Resource at an Inner-city Community Church: Lessons Learned
CASHEN, M. S., SKLAR, B. M., NGUYEN, H. H. T., JUST, M., GALZAGORRY, G., & BAKKEN, S. (2002) · CIN: Computers, Informatics, Nursing · doi:10.1097/00024665-200211000-00011 · Cited by 11
May, C. R., Finch, T., Ballini, L., MacFarlane, A., Mair, F., Murray, E., Treweek, S., & Rapley, T. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-245 · Cited by 3
Self-citation
Research works printed but not linked: 5
Cited by
Sorted by citations
Granja, C., Janssen, W., & Johansen, M. A. (2018) · Journal of Medical Internet Research · doi:10.2196/10235 · Cited by 578
“Multimedia Appendix 1 [19-239] presents the outcomes.”
Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial
Chaplin, E., Hewitt, S., Apps, L. D., Bankart, J., Pulikottil-Jacob, R., Boyce, S., Morgan, M. D., Williams, J. E., & Singh, S. J. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013682 · Cited by 145
Antypas, K., & Wangberg, S. C. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3132 · Cited by 147
EHealth Technologies in Inflammatory Bowel Disease: A Systematic Review.
Jackson, B. D., Gray, K., Knowles, S. R., & De Cruz, P. (2016) · Journal of Crohn's and Colitis · doi:10.1093/ecco-jcc/jjw059 · Cited by 126
O'Brien, N., Heaven, B., Teal, G., Evans, E. H., Cleland, C., Moffatt, S., Sniehotta, F. F., White, M., Mathers, J. C., & Moynihan, P. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5790 · Cited by 135
“Although a Web-based intervention was a planned consideration of the research team, we were cognizant of the potential limitations related to the so-called digital divide and subsequent health inequalities in intervention access and use [65].”
Metadata
- Authors
- Murray, E.
- Affiliations
- University College London (GB)
- Corresponding author
- Murray, Elizabeth
- ORCID
- Murray, Elizabeth
- Venue
- Medicine 2.0
- Publisher
- JMIR Publications Inc.
- Published
- 2012-08-14
- Volume
- 1
- Issue
- 2
- Pages
- e3
- ISSN
- 1923-2195 (ISSN-L)
- PMC
- PMC4084772
- OpenAlex
- W1990682749
- Semantic Scholar
- 9df2e6a2abb5681b956d48cd0444286309af5d22
- Cited by
- 219
- References
- 117
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 7 · 2023: 15 · 2022: 16 · 2021: 20 · 2020: 13 · 2019: 15 · 2018: 13 · 2017: 33 · 2016: 25 · 2015: 25 · 2014: 12 · 2013: 6 · 2012: 1
- FWCI
- 19.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Medicine 2 0 (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- 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, e-health, behavior change, self-management, chronic disease, self-care, digital divide, health disparities, implementation, complex interventions, MRC framework, mechanism of action, scalability, health care costs
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 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
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.
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