Interactive Web-based Intervention Research Articles

Examining the Effectiveness of Interactive Webtoons for Premature Birth Prevention: Protocol for a Randomized Controlled Trial.

Premature birth poses significant health challenges globally, impacting infants, families, and society. Despite recognition of its contributing factors, efforts to reduce its incidence have seen limited success. A notable gap exists in the awareness among women of childbearing age (WCA) regarding both the risks of premature birth and the preventative measures they can take. Research suggests that enhancing health beliefs and self-management efficacy in WCA could foster preventive health behaviors. Interactive webtoons offer an innovative, cost-effective avenue for delivering engaging, accessible health education aimed at preventing premature birth. This protocol describes a randomized controlled trial to assess the effectiveness and feasibility of a novel, self-guided, web-based intervention-Pregnancy Story I Didn't Know in Interactive Webtoon Series (PSIDK-iWebtoons)-designed to enhance self-management efficacy and promote behaviors preventing premature birth in WCA. Using an explanatory sequential mixed methods design, this study first conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. Participants are randomly assigned to 2 groups: one accessing the PSIDK-iWebtoons and the other receiving Pregnancy Story I Didn't Know in Text-Based Information (PSIDK-Texts) over 3 weeks. We measure primary efficacy through the self-management self-efficacy scale for premature birth prevention (PBP), alongside secondary outcomes including perceptions of susceptibility, severity, benefits, and barriers based on the health belief model for PBP and PBP intention. Additional participant-reported outcomes are assessed at baseline, the postintervention time point, and the 4-week follow-up. The feasibility of the intervention is assessed after the end of the 3-week intervention period. Outcome analysis uses repeated measures ANOVA for quantitative data, while qualitative data are explored through content analysis of interviews with 30 participants. The study received funding in June 2021 and institutional review board approval in October 2023. Both the PSIDK-iWebtoons and PSIDK-Texts interventions have been developed and pilot-tested from July to November 2023, with the main phase of quantitative data collection running from November 2023 to March 2024. Qualitative data collection commenced in February 2024 and will conclude in May 2024. Ongoing analyses include process evaluation and data interpretation. This trial will lay foundational insights into the nexus of interactive web-based interventions and the improvement of knowledge and practices related to PBP among WCA. By demonstrating the efficacy and feasibility of a web-based, interactive educational tool, this study will contribute essential evidence to the discourse on accessible and scientifically robust digital platforms. Positive findings will underscore the importance of such interventions in fostering preventive health behaviors, thereby supporting community-wide efforts to mitigate the risk of premature births through informed self-management practices. Korea Disease Control and Prevention Agency (KDCA) KCT0008931; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=25857. DERR1-10.2196/58326.

Effect of Interactive Web-based Educational Intervention on Preventive Practices of Covid-19 among Internship Students

Effect of Interactive Web-based Educational Intervention on Preventive Practices of Covid-19 among Internship Students

Reducing statistics anxiety for psychology students during the global pandemic: a methodology approach

Statistics anxiety is a significant problem for students’ learning experience in the psychological sciences. This article explores a novel teaching methodological approach during the global pandemic to improve students’ performance by reducing their statistics anxiety. The subject design and teaching methodological approach were developed based on twenty years of experience taking into consideration the student feedback, while its implementation was aligned with the 5-E’s Victorian Teaching and Learning pedagogical Model (VTLM). Moreover, to reduce the statistics anxiety, two sections were embedded in the Learning Management System of the subject: (1) an interactive web-based mindfulness intervention and (2) a head-start ‘Ready, Set, Go’ information pack. The implementation of these approaches resulted in a better understanding of statistical concepts and utilization of the SPSS software by the majority of the students (80% pass-rate). Consequently, a 6% increase in pass rates and an average of 32% increase in satisfaction scores for each item in the university central survey were observed. While the uniqueness of the first year of COVID-period makes comparisons difficult, it is matched by the urgency of the need for effective interventions to support student success.

Protocol: A randomized controlled trial to assess effectiveness of a 12-month lifestyle intervention to reduce cardiovascular disease risk in families ten years after pre-eclampsia (FINNCARE)

Pre-eclampsia (PE) is a multisystem progressive disorder affecting 3–5% of pregnancies. PE independently increases the risk for premature cardiovascular disease (CVD) in mothers and their children long-term. The effectiveness of a family-centered lifestyle intervention to lower CVD risk in PE families has not previously been evaluated. In the current FINNCARE study, we prospectively compare CVD risk and CVD progression in PE families (mother, father and child) in a cross-sectional study setting 8–12 years from delivery with non-PE control families of comparable age. Furthermore, we evaluate the effectiveness and feasibility of an interactive web-based behavioral 12-month lifestyle intervention to reduce blood pressure and the CVD risk profile overall in a randomized controlled trial. In total, 300 PE families will be randomized 1:1 to a PE-intervention or a PE-control group, and the 100 non-PE control families similarly followed-up at 12 months. Primary outcome is 24-hour mean systolic BP change from baseline in mother and child. Study aims to provide information on CVD progression and CVD risk management in the family following PE.

You Don't Need an App-Conducting Mobile Smoking Research Using a Qualtrics-Based Approach.

With the increasing availability of smartphones, many tobacco researchers are exploring smartphone-delivered mobile smoking interventions as a disseminable means of treatment. Most effort has been focused on the development of smartphone applications (apps) to conduct mobile smoking research to implement and validate these interventions. However, developing project-specific smartphone apps that work across multiple mobile platforms (e.g., iOS and Android) can be costly and time-consuming. Here, using a hypothetical study, we present an alternate approach to demonstrate how mobile smoking cessation and outcome evaluation can be conducted without the need of a dedicated app. Our approach uses the Qualtrics platform, a popular online survey host that is used under license by many academic institutions. This platform allows researchers to conduct device-agnostic screening, consenting, and administration of questionnaires through Qualtrics's native survey engine. Researchers can also collect ecological momentary assessment data using text messaging prompts with the incorporation of Amazon Web Services' Pinpoint. Besides these assessment capabilities, Qualtrics has the potential for delivering personalized behavioral interventions through the use of JavaScript code. By customizing the question's web elements in Qualtrics (e.g., using texts, images, videos, and buttons), researchers can integrate interactive web-based interventions and complicated behavioral and cognitive tasks into the survey. In conclusion, this Qualtrics-based methodology represents a novel and cost-effective approach for conducting mobile smoking cessation and assessment research.

Older Adults’ Experiences in an Online Intervention for Managing Subjective Depressive Symptoms

Background: Many older adults struggle with late-life depression, stress, and anxiety, especially when facing age-related transitions including retirement, relocation, and the death of a spouse. Given the consequences of depression among older adults, which include higher rates of suicide, timely interventions that help to manage depressive symptoms are essential. Objective: The primary purpose of this study was to explore the perceived efficacy of an online program in improving subjective depressive feelings. Methods: Older adult participants were recruited for semi-structured interviews (n = 24) in a web-based intervention that included interactive games and activities undergirded by a cognitive behavioral therapy (CBT) approach. Participants were asked to provide feedback about program features, including weekly module content, games, interactive activities and community interactions, and any perceived effects on their health behaviors and/or emotional well-being. Participants’ responses were analyzed using qualitative content analysis. Results: Participants reported several gains, including developing the habit of forming ongoing, incremental goals, achieving wellness-related goals, and experiencing an overall positive shift in perspective. In addition, participants reported feeling greater gratitude, increased positivity, and improvement in mood. Featured games and activities helped to promote stress relief and entertainment, and mindfulness exercises were cited as the most helpful and/or enjoyable among participants. Participants expressed a preference for program content related to aging and aging-related transitions. Conclusions: This study demonstrated feasibility of an interactive web-based intervention for older adults with subjective depressive feelings, while also providing important findings about users’ preferences for personalized, aging-related feedback.

Young, Empowered and Strong: A Web-Based Education and Supportive Care Intervention for Young Women With Breast Cancer Across the Care Continuum.

Patient-centered digital interventions may help empower young women to self-manage symptoms and psychosocial concerns and support informational needs often unaddressed in clinic. Young, Empowered and Strong (YES) is an interactive web-based intervention designed to engage young women with personalized education and symptom self-management resources on the basis of responses to patient-reported outcome-based questionnaires. We piloted YES among young women (< 45 years) with newly diagnosed early breast cancer (EBC) or metastatic breast cancer (MBC) and breast cancer survivors (BCSs). Assessments were deployed weekly (EBC and MBC) or every 4 weeks (BCSs) over 12 weeks. At study completion, use, feasibility, and acceptability of YES were evaluated via a survey and semistructured interview. Thirty women were enrolled between April and June 2019: 10 EBC, 10 BCSs, and 10 MBC. The mean age at diagnosis and enrollment was 36 (range 25-44) and 39 (range 31-44) years, respectively. Most participants were actively treated (96%, 27 of 28) with endocrine therapy (54%, 15 of 28) or chemotherapy (43%, 12 of 28). Overall, 61% (180 of 296) of assessments were completed (EBC: 70%, BCSs: 63%, and MBC: 52%). Of 37 patient-reported outcome and need domains, the most frequently triggered were sexual health (EBC: 90%, BCSs: 90%, and MBC: 90%), anxiety (EBC: 80%, BCSs: 90%, and MBC: 90%), stress and mindfulness (EBC: 80%, BCSs: 90%, and MBC: 90%), and fatigue (EBC: 90%, BCSs: 80%, and MBC: 90%). On postpilot survey, participants reported that YES helped them to learn (50%, 7 of 14), monitor (43%, 6 of 14), and manage (57%, 8 of 14) their symptoms. YES is a feasible and acceptable digital intervention to support young women across the breast cancer care continuum. The nearly universal triggering of sexual and mental health needs suggests suboptimal management in the clinical setting and the potential for self-management through a digital platform.

Online psychological self-management intervention for testicular cancer survivors (e-TC 2.0): promising acceptability and preliminary efficacy, but limited feasibility

Abstract Background: Testicular cancer (TC) survivors experience greater psychological morbidity than the general population. Two-thirds of TC survivors report unmet supportive care needs regarding issues such as fear of cancer recurrence (FCR), but many are reluctant/unable to seek face-to-face help. This study prospectively assessed the feasibility, acceptability, and preliminary efficacy of an interactive web-based self-management intervention (e-TC 2.0) in reducing borderline/clinical levels of anxiety, depression, and/or FCR among TC survivors. Methods: TC survivors who had completed treatment were recruited to this single-arm phase I trial through clinicians and online advertisements. Consenting participants completed baseline questionnaires, had 12 weeks’ access to e-TC 2.0, then completed post-intervention questionnaires. Feasibility was determined by the proportion of e-TC 2.0 completed (website usage data). Acceptability was assessed with purpose-designed satisfaction measures. Preliminary efficacy was indicated by changes in anxiety/depression (HADS), distress (thermometer), and FCR (Fear of Cancer Recurrence Inventory-Short Form). Results: Thirty-nine participants started the intervention; 48% completed the first module, but only 20% completed all modules. Mean participant age was 37.1 years; mean time since diagnosis was 3.6 years. Mean acceptability scores were &gt; 8/10. Mean unmet needs, distress, FCR, anxiety, and depression levels decreased after the intervention, as did the proportion of participants above clinical cut-offs. Conclusions: e-TC 2.0 is the first web-based resource for TC survivors with borderline/clinical levels of anxiety, depression, and/or FCR. Although engagement with e-TC 2.0 was somewhat limited, website users reported high levels of satisfaction and reductions in psychological morbidity and unmet needs. e-TC 2.0 may be a useful adjunct to traditional face-to-face health professional support for TC survivors.

The safe use of dating applications among men who have sex with men: a study protocol for a randomised controlled trial to evaluate an interactive web-based intervention to reduce risky sexual behaviours

BackgroundNotably, both international and local studies have found a high prevalence of sexually transmitted infections (STIs) and risky sexual behaviours, such as condomless anal sex, substance misuse in conjunction with sex (‘chemsex’) and group sex, among men who have sex with men (MSM) dating application (app) users. Although the use of dating apps is an emerging sexual risk factor, little effort has been expended on the promotion of safe sex and good sexual health among the users of those apps. Therefore, the aim of the proposed study is to develop and evaluate the effectiveness of an interactive web-based intervention in improving the sexual health of MSM dating app users in Hong Kong.MethodsA two-armed randomised controlled trial will be conducted. Chinese MSM dating app users will be recruited and randomly allocated into either the intervention (n = 200) or control group (n = 200). Subjects in the intervention group will receive the web-based intervention containing interactive content that (1) encourages a positive attitude towards consistent condom use and HIV/STI testing and negative attitude towards chemsex and group sex; (2) positions condom use and regular HIV/STI testing as normative; and (3) targets improved perceived self-efficacy concerning condom use and negotiation and HIV/STI testing. The control group will receive only web-based information without sexual health components. Subjects in both groups will be evaluated at baseline and three and 6 months after baseline. The primary outcome will be the frequency of condomless anal sex in the past 3 months.DiscussionThe proposed study will aid development of culturally relevant health promotion programmes aimed at minimising the potential harm of dating app use and promoting the sexual health of MSM dating app users. The web-based intervention, if found successful, will have important clinical and policy implications, as it can be adopted by the government and non-governmental organisations targeting MSM. Moreover, the proposed intervention can reach many MSM at relatively low cost, and thus has the potential to check the burgeoning HIV/STI epidemic among MSM in Hong Kong in a cost-effective manner.Trial registrationInternational standard randomized controlled trial number (ISRCTN) registry: ISRCTN16681863 registered on 28 April 2020.

Mindfulness and Skills Based Distress Reduction in Oncology: The Web-Based Psycho-Oncological Make It Training

In rural areas, breast cancer-affected patients still do not receive sufficient psycho-oncological care that addresses their specific needs. As a partial solution, telemedicine and web-based applications (eHealth) can add value to their psycho-oncological care as part of self-management regardless of personnel resources, geographical distance from providers, and time constraints. Thus far, however, those supportive aspects of psycho-oncological care are lacking in German-speaking rural areas. For this reason a web-based intervention was developed. Based on the results of a representative cross-sectional and the current literature, we developed a manual and program called Make It Training (Mindfulness and skills based distress reduction in oncology) which was programmed for the websetting. The interactive web-based intervention with 8 sessions integrates different media, including tutorial videos, audio, personal skills box and individual exercises to enhance knowledge about specific disease-related themes. The intervention derives from mindfulness and conveys psychoeducational elements and cognitive behavioural skills with the themes of emotion management, resources, stress management, and self-compassion. The acceptance testing (N=35) showed considerable acceptance and satisfaction. 87% of the patients would recommend the Make it Training to other patient. Prospectively, this training could convey effective strategies for coping with disease-related burden. The Make It Training is an innovative self-management program that can be used for the stepped-care approach and be implemented in rural areas and thereby enhance current outpatient care.

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children.

This prospective, randomized, controlled trial for parents of overweight and obese 3- to 7-year-olds was performed to assess the feasibility of a program promoting healthy eating and lifestyle by targeting parents as agents of change. The intervention was composed of 6-in-person group sessions and a customized website over 12 months. The control group received customary care. The primary outcome was feasibility of the intervention to promote healthy behavior change measured by attendance. The secondary outcome was effectiveness assessed by attaining reduced body mass index (BMI) z scores, healthy behavior changes and increased parent self-efficacy. Seventy-three child-parent dyads were enrolled; 14 parents never attended any sessions. Participation in follow-up assessments did not meet the hypothesized level. Ultimate BMI z scores did not differ between control and intervention groups. Parenting skills did not improve in the intervention group. This intervention to achieve healthy lifestyle changes in children via their parents as "change agents" was unsuccessful.

Cancer-Related Fatigue in Post-Treatment Cancer Survivors: Theory-Based Development of a Web-Based Intervention.

BackgroundCancer-related fatigue (CrF) is the most common and disruptive symptom experienced by cancer survivors. We aimed to develop a theory-based, interactive Web-based intervention designed to facilitate self-management and enhance coping with CrF following cancer treatment.ObjectiveThe aim of our study was to outline the rationale, decision-making processes, methods, and findings which led to the development of a Web-based intervention to be tested in a feasibility trial. This paper outlines the process and method of development of the intervention.MethodsAn extensive review of the literature and qualitative research was conducted to establish a therapeutic approach for this intervention, based on theory. The psychological principles used in the development process are outlined, and we also clarify hypothesized causal mechanisms. We describe decision-making processes involved in the development of the content of the intervention, input from the target patient group and stakeholders, the design of the website features, and the initial user testing of the website.ResultsThe cocreation of the intervention with the experts and service users allowed the design team to ensure that an acceptable intervention was developed. This evidence-based Web-based program is the first intervention of its kind based on self-regulation model theory, with the primary aim of targeting the representations of fatigue and enhancing self-management of CrF, specifically.ConclusionsThis research sought to integrate psychological theory, existing evidence of effective interventions, empirically derived principles of Web design, and the views of potential users into the systematic planning and design of the intervention of an easy-to-use website for cancer survivors.

A study protocol for a randomised controlled trial of an interactive web-based intervention: CancerCope

IntroductionApproximately 35% of patients with cancer experience clinically significant distress, and unmet psychological supportive care needs are prevalent. This study describes the protocol for a randomised controlled trial (RCT) to...

An interactive web-based intervention on nutritional status, physical activity and health-related quality of life in patient with metabolic syndrome: a randomized-controlled trial (The Red Ruby Study)

Background/Objectives:Physical inactivity and unhealthy nutritional behaviors are recognized as the key factors in the cause and management of metabolic syndrome (MetS). The effectiveness of interactive web-based interventions on dietary intakes, physical activity and health-related quality of life (HRQOL) among people with MetS is currently unknown.Methods:The two-arm randomized-controlled trial was conducted for patients with MetS from June through December 2012 in Tehran, Iran. Participants (n=160) were recruited through online registration on the study website. After free clinical assessments of eligible participants for MetS, they were randomly assigned to intervention and control groups (n=80). All participants received general information about cardiovascular diseases and MetS risk factors via the website. The intervention group logged in to interactive part including My Healthy Heart Profile, received tailored calorie-restricted diet and used all parts of the interactive prevention program. Anthropometric measures, glycemic status, lipid profile, physical activity and food intake were evaluated at the beginning and after 6-month follow-up. HRQOL was assessed at beginning, 3- and 6-month follow-up.Results:There were no significant differences between the intervention and control groups on age, gender, education and MetS factors. In comparison with control group, the intervention group showed significant changes in moderate physical activity 260.3±473.6 vs 101.6±213.1 MET-min/week, walking 505.2±505.3 vs 321±884 MET-min per week, cholesterol intake −88.4±158.7 vs −8.3±6 mg per day, total calories −430.2±957.5 vs −392.9±34.7 kcal per day and sodium 1336.9±2467 vs 1342±3200.4 mmol per day. With regard to HRQOL, the intervention group showed greater improvement in general health and vitality (P<0.05 for all).Conclusion:These results indicate the positive impact of a lifestyle intervention by a web-based program on physical activity, dietary intake and several dimension of QoL. The use of web-based approaches is a great interest to manage patients at high cardiovascular risk, especially where the prevalence of obesity, MetS and diabetes is increasing.

Efficacy of a Sleep Quality Intervention in People With Low Back Pain: Protocol for a Feasibility Randomized Co-Twin Controlled Trial.

Poor sleep quality is highly prevalent in patients with low back pain (LBP) and is associated with high levels of pain, psychological distress, and physical disability. Studies have reported a bidirectional relationship between sleep problems and intensity of LBP. Accordingly, effective management of LBP should address sleep quality. In addition, genetics has been found to significantly affect the prevalence of both LBP and insomnia. Our study aims to establish the feasibility of a trial exploring the efficacy of a web-based sleep quality intervention in people with LBP, with the genetic influences being controlled for. 30 twins (15 complete pairs) with subacute or chronic LBP (>6 weeks) will be recruited from the Australian Twin Registry. Participants will be randomly assigned to one of the two groups with each twin within a pair receiving either an interactive web-based sleep intervention based on cognitive behavioral therapy principles (intervention) or a web-based education program (control) for 6 weeks. The feasibility of the trial will be investigated with regard to recruitment rate, feasibility of data collection and outcome measure completion, contamination of intervention, acceptability and experience of intervention, and sample size requirement for the full trial. Patient outcomes will be collected electronically at baseline, immediately post-treatment, and at 3-months' follow-up post-randomization. This trial employs a robust design that will effectively control for the influence of genetics on treatment effect. Additionally, this study addresses sleep quality, a significant but under-explored issue in LBP. Results will inform the design and implementation of the definitive trial.

Healthy mind, healthy body: A randomized trial testing the efficacy of a computer-tailored vs. interactive web-based intervention for increasing physical activity and reducing depressive symptoms

Physical activity is an effective primary or adjunctive treatment to reduce depressive symptoms. Computer-tailored and interactive web-based physical activity interventions are potentially effective and accessible means for promoting physical activity, but little evidence exists regarding their efficacy in reducing depressive symptoms. We conducted a 2-arm randomised trial to compare the efficacy of these web-based interventions for increasing physical activity and reducing depressive symptoms. Participants (18 years or older and had no health condition limiting physical activity) were randomised to have access to a web-based physical activity intervention program with either computer-tailored advice (MyPAA) or interactive features (Walk 2.0). Only half of participants accessed the website at least once (MyPAA: allocated n = 252, accessed program n = 154, 61.1%; Walk 2.0: allocated n = 262, accessed program n = 120, 45.8%). Participants and the research team were blinded to group assignment. There were no significant between-group differences in change of self-reported physical activity or depressive symptoms. Physical activity significantly increased from baseline to one month (g = 0.21) and three months (g = 0.20), and depressive symptoms significantly decreased from baseline to one month (g = 0.36) and three months (g = 0.42). People who visited the website more and for longer had larger changes in physical activity and depressive symptoms than those who visited less. Web-based interventions with computer-tailoring and interactive features show promise as a method for increasing physical activity and reducing depressive symptoms, particularly for those who engage with the program. Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12613001215718.

Health, Stigma, and the Burden of Smoking in College: A Thematic Analysis.

Authorities estimate that 16.7% of adults 18-24 smoke, and many initiate or increase cigarette smoking while in college. Thus, college represents a critical time for intervention. Simmons et al developed and tested an interactive Web-based intervention that includes a component for inducing dissonance through creating video testimonials about the negatives of smoking. We applied thematic analysis to video content to identify smoking's negative consequences as reflected in testimonials from 78 college smokers. We identified common themes and calculated the amount of time spent discussing each theme and the strength of language used. Social stigma and health consequences of smoking emerged as multidimensional themes; other common topics included financial burden, chemicals in cigarettes, and cravings/addiction. These results provide insight into the attitudes of college student smokers. Addressing these topics may be important for message development in intervention and prevention studies.

Interactive web-based lifestyle intervention and metabolic syndrome: findings from the Red Ruby (a randomized controlled trial).

BackgroundMetabolic syndrome is a growing public health problem worldwide. Several interventions have been proposed to specifically target the problem. This study evaluated the effectiveness of an interactive web-based lifestyle for management of metabolic syndrome.MethodsThis randomized controlled trial was conducted from June through August 2012 in Tehran, Iran. Participants were individuals with metabolic syndrome who had registered on the study website. Interested eligible participants were invited for a free clinic visit and clinical assessment. They were randomly assigned to the intervention (n = 80) or control (n = 80) group. The intervention group received an interactive web-based program called the Healthy Heart Profile and were followed for 6 months. The control group received general information on metabolic syndrome. Anthropometric measures, glycemic status, and lipid profile were evaluated at baseline, and at 3- and 6-month follow-up assessments. Metabolic syndrome was defined according to The National Cholesterol Education Program Adult Treatment Panel (ATP) III report except for waist circumference, which was modified to ≥90 cm for both genders for the Iranian population.ResultsIn total, 1,437 individuals registered on the study website. The mean age of participants was 44.2 years (SD = 10.0). There were no significant differences between the intervention and control groups on any baseline variable except that participants in the intervention group recorded higher levels of LDL. The results showed a decrease in metabolic syndrome in both groups. These reductions were significantly greater in the intervention group at the 3- and 6-month follow-ups. The intervention group showed significantly greater decreases (P < 0.05) over the control group for, respectively, systolic blood pressure (3-month: −10 versus −6 mmHg; 6-month: −11 versus −8 mmHg), diastolic blood pressure (3-month: −10 versus −4 mmHg; 6-month: −11 versus −6 mmHg), weight (3-month: −2 versus −1 kg; 6-month: −4 versus −1 kg), body mass index (3-month: −0.5 versus −0.2 kg/m2; 6-month: −1.1 versus −0.4 kg/m2) and improvement in HDL (3-month: 2 versus 0.64 mg/dl; 6-month: 6 versus 4 mg/dl).ConclusionThe findings suggest that the web-based interactive program was beneficial for individuals with metabolic syndrome. Comprehensive interactive web-based prevention programs are promising to help involve patients in improving management of metabolic syndrome and adopting a healthy lifestyle.Trial registrationIRCT201111198132N1. Registered 27 May 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0950-4) contains supplementary material, which is available to authorized users.

Web-based programme works for lower socioeconomic groups

Smoking cessation interventions that are internet based are attractive because they are low cost, but there are questions about their effectiveness and whether they reach all strata of society equally. StopAdvisor is a new interactive (email and telephone) web-based intervention for smoking cessation targeted at people of low socioeconomic status.

Behavioural weight management programmes for adults assessed by trials conducted in everyday contexts: systematic review and meta-analysis.

This systematic review and meta-analysis of effectiveness trials comparing multicomponent behavioural weight management programmes with controls in overweight and obese adults set out to determine the effectiveness of these interventions implemented in routine practice. To be included, interventions must have been multicomponent, delivered by the therapists who would deliver the intervention in routine practice and in that same context, and must be widely available or feasible to implement with little additional infrastructure or staffing. Searches of electronic databases were conducted, and augmented by screening reference lists and contacting experts (November 2012). Data were extracted by two reviewers, with mean difference between intervention and control for 12-month change in weight, blood pressure, lipids and glucose calculated using baseline observation carried forward. Data were also extracted on adverse events, quality of life and mood measures. Although there were many published efficacy trials, only eight effectiveness trials met the inclusion criteria. Pooled results from five study arms providing access to commercial weight management programmes detected significant weight loss at 12 months (mean difference −2.22 kg, 95% confidence interval [CI] −2.90 to −1.54). Results from two arms of a study testing a commercial programme providing meal replacements also detected significant weight loss (mean difference −6.83 kg, 95% CI −8.39 to −5.26). In contrast, pooled results from five interventions delivered by primary care teams showed no evidence of an effect on weight (mean difference −0.45 kg, 95% CI −1.34 to 0.43). One study testing an interactive web-based intervention detected a significant effect in favour of the intervention at 12 months, but the study was judged to be at high risk of bias and the effect did not persist at 18 months. Few studies reported other outcomes, limiting comparisons between interventions. Few trials have examined the effectiveness of behavioural weight loss programmes delivered in everyday contexts. These trials suggest that commercial interventions delivered in the community are effective for achieving weight loss. There is no evidence that interventions delivered within primary care settings by generalist primary care teams trained in weight management achieve meaningful weight loss.