Web-based Intervention Program Research Articles

Effectiveness of a web-based acceptance and commitment therapy program for adolescent career preparation: A randomized controlled trial

Acceptance and commitment therapy (ACT) programs have rarely been used as tools for promoting adolescents' career preparation. This randomized controlled trial examined the possibility to promote the career preparation of Finnish ninth-grade adolescents (n = 249, 49% females) with a web-based five-week ACT-based online intervention program. Participants were randomly assigned to three conditions, of which two groups received an iACT including support via SMS (iACTface: iACT+two face-to-face sessions; only iACT: iACT with no face-to-face sessions) and the third (control) group received no treatment. The results showed that career-related insecurity decreased as a result of the intervention irrespective of adolescent gender or academic achievement. Intervention effects in career-choice self-efficacy, in turn, were moderated by gender as such that girls benefited more from face-to-face support during intervention than boys. All the detected immediate effects were maintained at the six-month follow-up. In turn, delayed intervention effects in career-related insecurity and career-choice self-efficacy were mainly observed among adolescents with low academic achievement. The effect sizes of the found intervention effects were moderate. The results suggest that ACT-based online intervention programs have potential to promote adolescent career preparation. However, such interventions might be especially effective for subgroups of adolescents.

Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes: A randomized controlled trial

BackgroundIndividuals with type 2 diabetes have a heightened risk of developing serious complications post hospital discharge. Web-based transitional care is a promising intervention to improve the glycemic control and quality of life of this patient group; however, whether web-based transitional care can improve the glycemic control and quality of life of this group remains unknown. Further, the mechanisms underlying the relationships between the intervention and both glycemic control and quality of life have not been fully explored. ObjectivesThe aims of this study were to develop a web-based transitional care program and evaluate its effects on the glycemic control and quality of life of Chinese patients with type 2 diabetes and to explore the mediating roles of self-efficacy and treatment adherence. DesignRandomized controlled trial. Settings and participantsThis study was conducted in a large regional hospital in Guangzhou City, China. Patients diagnosed with type 2 diabetes were included. MethodsA total of 116 eligible participants were randomly assigned to receive either the 3-month web-based transitional care program or usual care. Assessments of hemoglobin A1c (HbA1c), self-efficacy, treatment adherence, and quality of life were conducted at baseline and at 3 months. Analysis followed the intention-to-treat principle. A generalized estimating equation was used to determine intervention effects on HbA1c and quality of life. Path analysis was used to assess the mediation of these effects by changes in self-efficacy and treatment adherence during the intervention. ResultsParticipants in the intervention group had significantly greater improvements in HbA1c (β = 2.87; p < 0.01) and quality of life (β = 7.69; p < 0.01) compared with the control group. The relationships between the intervention and both glycemic control and quality of life were significantly mediated by improved self-efficacy (indirect effect: β = 0.18, p < 0.05) and improved treatment adherence (indirect effect: β = 0.17, p < 0.05); overall, the model explained 52.5% of the variance in HbA1c and 34.2% of the variance in quality of life. ConclusionsOur study identified beneficial effects of a web-based transitional care program on glycemic control and quality of life post hospital discharge in people with type 2 diabetes, and the underlying mediating mechanisms. The effectiveness and feasibility of this web-based intervention program suggests that its application should be promoted in community settings to reduce poor outcomes in people with type 2 diabetes.Tweetable abstract: The web-based transitional care program can improve patients’ glycemic control and quality of life.Registration number: ChiCTR2000035603

Web-Based Dietary and Physical Activity Intervention Programs for Patients With Hypertension: Scoping Review.

BackgroundHypertension is the root cause of many chronic diseases. Lifestyle changes (ie, dietary alterations and physical activity) are seen to be an important step in the prevention and treatment of hypertension. Educating people through web-based interventional programs could offer an effective solution and help these patients with hypertension in the existing health care scenario.ObjectiveIn this study, the researchers conducted a scoping literature review of the web-based dietary changes and physical activity–related intervention programs designed for the patients with hypertension and identified the methodologies, effectiveness, protocols, and theories, which could affect and improve existing clinical activities.MethodsThis review followed the scoping review methodology to identify and process the peer-reviewed studies published between 2010 and 2020. The literature searches were conducted on the following electronic databases: PubMed, Web of Science, MEDLINE (Medical Literature Analysis and Retrieval System Online), ScienceDirect, Scopus, and Google Scholar. By using relevant search terms, studies were included if they offered information related to the web-based intervention tools, specifically dietary and physical activity intervention for patients with hypertension. Studies written or translated in English language and published within the date range (January 2010 to March 2020) were included.ResultsOverall, 1441 articles were initially identified. The reviewers included 35 articles after removing duplicates and screening titles. Only 21 articles were assessed for full review, and 15 were kept for analysis. The researchers selected 15 web-based intervention articles published on the topic of hypertension from 7 countries. A few of these 15 web-based tools (4, 27%) included more than 3 functions and provided a lot of important information (such as appointments, health records, or viewable care). Several tools were standalone tools (11, 73%), while most of the tools supported communication intervention–related lifestyle or behavioral changes (13, 87%) and medication adherence (6, 40%). It was found that physicians (9, 60%), allied health professionals (5, 33%), and nurses (5, 33%) were the health care providers who generally used these tools for communicating with their patients. More than half of the above tools (10, 67%) were assessed by different researchers in randomized controlled trials, while 5 tools (33%) were investigated in nonrandomized studies.ConclusionsWe identified many web-based intervention programs for patients with hypertension from the literature databases. The findings indicate that numerous benefits can be derived after using a web-based dietary and physical activity intervention program for hypertension focusing on lifestyle changes. However, developers need to consider the preferences of the patients with regard to the information or the design features while developing or modifying web-based educational websites. These tools could be used for designing a patient-tailored website intervention program that is based on diet and physical activities for patients with hypertension.

E-Health Exercise Intervention for Pediatric Patients with Congenital Heart Disease: A Randomized Controlled Trial

To improve health-related physical fitness (HRPF) (primary outcome) and health-related quality of life (HRQoL) with a web-based motor intervention program in pediatric patients with congenital heart disease (CHD). Overall, 70 patients (13.0±2.6years; 34% girls) aged 10-18years with moderate or complex CHD severity were randomly allocated 1:1 to an intervention or control group. The intervention group trained 3 times per week for 20minutes in a web-based exercise program over a period of 24weeks. The control group followed lifestyle per usual. At baseline and follow-up HRPF was assessed via 5 tasks of the FITNESSGRAM and converted to a HRPF z score. HRQoL was assessed with KINDLself-report questionnaire. In total, 61 patients completed the follow-up. There was no change in total HRPF z score (intervention group: 0.14±0.38 vs control group: 0.09±0.38, P=.560) and total HRQoL (intervention group: -1.73±8.33 vs control group: 1.31±7.85, P=.160) after the 24-week web-based exercise intervention. This was true for all subcategories of HRPF and HRQoL. There were no adverse events associated with the web-based exercise intervention. We found that 24weeks of web-based exercise intervention with an aimed volume of 60minutes ofexercise per week was safe but did not improve HRPF and HRQoL in children with moderate or complex CHD. Clinicaltrials.gov: NCT03488797.

Preferences Regarding a Web-Based, Neighborhood-Level Intervention Program to Promote Household Energy Conservation

ABSTRACT The aim of this study is to investigate people’s willingness to participate in and their preferences regarding a web-based, neighborhood-level energy conservation program. We created a hypothetical program that incorporates several intervention strategies and presented it to 715 respondents in the form of a stated choice experiment. A strong majority of participants indicated that they would be willing to join such a program. Their preferences as to how the program should be constructed reflected interest in personalized feedback, privacy protection, monetary incentives for reducing energy use, and a relatively short-term initial commitment. However, there was variation in people’s taste for such attributes. We conclude with reflections on how to design and implement a web-based intervention program and on future research possibilities.

Guided web-based treatment program for reducing cannabis use: a randomized controlled trial

BackgroundThe aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population.MethodsA double blinded randomized controlled trial with a parallel group design was conducted (intervention group n = 151, wait-list control group n = 152). Follow-up 12 weeks from treatment commencement of a 13-module intervention. The primary outcome was frequency of cannabis use. Time by group interaction effects were modeled using generalized estimated equations and the instrumental variable approach was used to estimate the effect of intervention adherence.ResultsAt follow-up, the intention to treat (ITT) analyses did not show any significant time by group effects. A significant association between intervention adherence and scores on the cannabis abuse screening test (CAST) was found. Secondary analysis excluding participants who had received other professional help revealed time by group effects for secondary outcomes gram cannabis consumed past week, number of dependency criteria and CAST score. Due to methodological limitations, these latter results should be interpreted with caution.ConclusionsIn this study we did not find a web-based treatment program with therapist guidance to be more effective than a waiting-list in reducing frequency of cannabis use.Trial registration The trial was pre-registered at ClinicalTrials.gov (NCT02408640) April 3, 2015

A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial

BackgroundThis study aimed to describe the design and present the baseline characteristics of a web-based lifestyle intervention program, which comprises of sequentially and simultaneously delivered intervention modules targeting physical activity (PA) and fruit and vegetable consumption (FVC) in Chinese college students.MethodsThe study adopted a randomized placebo-controlled trial, using the Health Action Process Approach (HAPA) and the Compensatory Carry-Over Action Model (CCAM) as the theoretical backdrops. 556 Chinese college students participated in the 8-week web-based lifestyle intervention program. All eligible participants were randomly assigned to one of four groups: 1) the PA-first arm which received a 4-week intervention addressing PA followed by a 4-week intervention addressing FVC; 2) the FVC-first arm which received a 4-week intervention addressing FVC followed by a 4-week intervention addressing PA; 3) the PA + FVC simultaneous arm that received an 8-week intervention addressing both PA and FVC at the same time; and 4) the placebo-control arm that received 8 weeks of general health information, which is not relevant for changing actual PA and FVC behaviors. Data collection includes four time-points: at the beginning and end of the intervention, and a 3-month and 12-month follow-up after the intervention.ResultsAt baseline, 41.7% of participants were male and 58.3% were female. 41.0% of the participants did not meet the standard PA-recommendations, while 69.6% did not adhere to the standard FVC-recommendations. In total, only 19.6% of participants met both PA and FVC recommendations. Baseline characteristics across the four groups had no significant differences (all P = .17–.99), indicating successful randomization.ConclusionsThe preliminary results indicate a high prevalence of unhealthy lifestyles in college students in China, which further supports the need for web-based health intervention programs. This is also the first study that examines the comparative effectiveness of simultaneously and sequentially delivered lifestyle interventions in the Chinese population. These findings may contribute to the creation of future web-based health behavior change interventions.Trial registrationClinicalTrails.gov: NCT03627949, 14 August, 2018.

Effects of a Web-based Binge Eating Disorder Intervention Program on Depression and Quality of Life in Overweight or Obese Females (P16-065-19)

ObjectivesWeb-based treatment programs have shown encouraging results in reducing symptoms in Binge Eating Disorder (BED) patients in European studies but no significant studies have been conducted with American subjects. This pilot randomized controlled trial aimed to assess the efficacy of a web-based outpatient treatment program in overweight and obese females diagnosed with BED in the United States. MethodsA total of 12 overweight or obese women with BED, aged 20–73, were analyzed in this study. In face-to-face (FF) group (n = 8), participants received a total 12 one-on-one weekly counseling from either a mental health counselor or a Registered Dietitian (RD) sessions. In web-based (WB) group (n = 4), participants received the same counseling through an online telemedicine software program. Outcomes were measured at 3 months including questionnaires SCL-90R (Symptom Checklist 90 Revised), BDI-II (Beck Depression Inventory II), and IWQOL-Lite (Impact of Weight on Quality of Life – short form) assessing psychological health, and quality of life. Between group and within group differences were examined. ResultsIn the end of study, significant improvements were observed in WB group for SCL-90R depression scale (P = 0.000), and IWQOL total score (P = 0.02). There were no significant changes in FF participants. There were no differences between two groups in the end of program neither. ConclusionsWeb-based treatment programs could potentially be an effective approach for binge eating disorder patients. Large scale randomized clinical trials are warranted to further assess the efficacy of web-based approaches in treating eating disorders. Funding SourcesUs Women and Girls’ Health Endowed Research Professorship; Complimentary telemedicine software from Fruit Street company.

Effects of a Web-Based Intervention for PE Teachers on Students' Perceptions of Teacher Behaviors, Psychological Needs, and Intrinsic Motivation.

Interventions based on self-determination theory to help teachers support their students' autonomy have measured teachers' autonomy-supportive and controlling behaviors as unidimensional constructs. This study investigated whether a Web-Based Autonomy-Supportive Intervention Program (WB-ASIP) for physical education (PE) teachers would alter their students' perceptions of (a) the teachers' multidimensional autonomy-supportive and controlling behaviors, (b) their own psychological need satisfaction and frustration, and (c) perceived intrinsic motivation. We found that WB-ASIP significantly increased students' perceptions of all autonomy-supportive teacher behaviors and students' need satisfaction. At follow-up, we found that WB-ASIP led to a significant decrease in students' perception of teacher intimidation behaviors and students' autonomy frustration. These results suggest that a web-based intervention program to enhance PE teachers' autonomy-supportive behavior and minimize their controlling behavior was partially effective in positively changing their students' perceptions.

Basic computer skills and computer preferences of inner-city hospitalized medical patients: implications for web-based alcohol screening and brief intervention

ABSTRACTHealth care delivery is being transformed by the use of computer technology, and integrated physical health with mental and behavioral health care are national priorities. This study examined the basic computer skills and computer preferences of inner-city hospitalized medical patients in a design study of a web-based alcohol screening and brief intervention program prototype. Participants were 26 patients observed going through the program prototype using both a laptop computer and mouse, and an iPad. The majority of patients were able to do all the basic laptop and basic iPad skills to complete the program prototype, including older patients (aged 50 years or older) and patients with a high school degree or less. Patient computer preference was 3:1 for the use of an iPad versus a laptop computer, and the majority of patients preferred to complete a web-based versus an in-person brief intervention health program. Inner-city hospitalized medical patients appear able to complete and may be receptive to web-based alcohol screening and brief intervention programs.

Caregiver-Focused, Web-Based Interventions: Systematic Review and Meta-Analysis (Part 2)

BackgroundApproaches to support the health and well-being of family caregivers of adults with chronic conditions are increasingly important given the key roles caregivers play in helping family members to live in the community. Web-based interventions to support caregivers have the potential to lessen the negative health impacts associated with caregiving and result in improved health outcomes.ObjectiveThe primary objective of this systematic review and meta-analysis was to examine the effect of caregiver-focused, Web-based interventions, compared with no or minimal Web-based interventions, on caregiver outcomes. The secondary objective was to assess the effect of different types of Web-based interventions (eg, education, peer and professional psychosocial support, and electronic monitoring of the care recipient), compared with no or minimal Web-based interventions, on caregiver outcomes.MethodsMEDLINE, EMBASE, CIHAHL, PsychInfo, Cochrane, and AgeLine were searched from January 1995 to April 2017 for relevant randomized controlled trials (RCTs) or controlled clinical trials (CCTs) that compared caregiver-focused, Web-based intervention programs with no or minimal Web-based interventions for caregivers of adults with at least one chronic condition. Studies were included if they involved: adult family or friend caregivers (aged ≥18 years) of adults living in the community with a chronic condition; a caregiver-focused, Web-based intervention of education or psychosocial support or electronic monitoring of the care recipient; and general caregiver outcomes (ie, burden, life satisfaction, self-efficacy or mastery, reaction to problem behavior, self-esteem, strain, and social support). Title and abstract as well as full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for these caregiver outcomes were meta-analyzed.ResultsThe search yielded 7927 unique citations, of which 294 studies were screened at full text. Of those, 14 studies met the inclusion criteria; 12 were RCTs and 1 study was a CCT. One study used an RCT design in 1 country and a CCT design in 2 other countries. The beneficial effects of any Web-based intervention program, compared with no or minimal Web-based intervention, resulted in a mean increase of 0.85 points (95% CI 0.12 to 1.57) for caregiver self-esteem, a mean increase of 0.36 points (95% CI 0.11 to 0.62) for caregiver self-efficacy or mastery, and a mean decrease of 0.32 points (95% CI −0.54 to −0.09) for caregiver strain. However, the results are based on poor-quality studies.ConclusionsThe review found evidence for the positive effects of Web-based intervention programs on self-efficacy, self-esteem, and strain of caregivers of adults living with a chronic condition. Further high-quality research is needed to inform the effectiveness of specific types of Web-based interventions on caregiver outcomes.Trial RegistrationPROSPERO CRD42018091715; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=91715 (Archived by WebCite at http://www.webcitation.org/738zAa5F5)

A Systematic Review and Meta-Analysis of Applicability of Web-Based Interventions for Individuals with Depression and Quality of Life Impairment.

ObjectiveThe purpose of this meta-analysis was to determine the applicability of web-based treatment programs for individuals with depression and quality of life impairments.MethodsWe conducted database and manual searches using imprecise search-term strategy and inclusion criteria. Research published from 2005 to December 2015 was included in this study. Upon review, a total of 12 published papers on web-based intervention for individuals with depression were assessed eligible for this meta-analysis. Effect sizes were estimated for depression and quality of life.ResultsThe mean effect size of web-based treatment on depressive symptoms was 0.72. However, unlike the result showing medium to large effect size, the analysis on the quality of life did not yield adequate effects of web-based interventions.ConclusionOur results suggest robust benefits of employing web-based treatments for depressive symptoms. However, the adequacy of these relatively new intervention tools for individuals who suffer severe impairments of quality of life was found insufficient. The current study demonstrates the need to further develop web-based intervention techniques to improve overall functioning, as well as the clinical symptoms of patients with mental disorders.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial.

BackgroundNo existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan.ObjectiveThe aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults.MethodsIn this randomized controlled trial, participants were assessed at three time points—baseline, postintervention (5 weeks later), and a follow-up after 3 months—from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g).ResultsOut of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, P<.001), and a significant interaction (η2=0.01, P=.009). Middle-income participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046).ConclusionsThis Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to maintain and increase vegetable intake for other groups.Trial RegistrationCurrent Controlled Trials (UMIN-ICDR): UMIN000019376; https://upload.umin.ac.jp/cgi-open-bin/ icdr_e/ctr_view.cgi?recptno=R000022404 (Archived by WebCite at http://www.webcitation.org/6u9wihBZU)

Web-Based Intervention to Improve Implantable Cardioverter Defibrillator Patients' Shock-Related Anxiety and Quality of Life: A Randomized Controlled Trial.

In spite of its effectiveness, implantable cardioverter defibrillator (ICD) patients face psychological problems such as shock-related anxiety due to device shocks. The aim of this study was to evaluate whether a web-based intervention program for ICD patients would reduce shock-related anxiety and improve quality of life compared with usual care. This was a randomized controlled trial study including a total of 76 patients. Data were collected using Turkish versions of the Florida Shock Anxiety Scale and Short Form Health Survey (SF-36) at 0 (baseline), 3, and 6 months. Following intervention, there was a significant decrease in shock anxiety levels of patients and a statistically significant increase in social functioning, role-physical, mental health, vitality, and bodily pain subdimensions of SF-36. While no statistically significant difference was found between groups in terms of summary scores of SF-36, our results suggest that web-based interventions can be useful for ICD patients.

Computerized Behavioral Interventions: Current Products and Recommendations for Substance Use Disorder Treatment

Unlike traditional methods of delivering substance use disorder (SUD) and mental health treatment, computerized behavioral interventions deliver services via computers, smartphones, and other electronic devices. In recent years, there has been a proliferation of Web-based treatment programs designed for certain target populations. Studies have shown that many of these programs are evidence-based, and some are just as effective as traditional in-person interventions. This article reviews current computerized behavioral interventions and makes recommendations for how these tools can be incorporated into SUD treatment services.

Corrigendum to: "Effectiveness of a multidimensional web-based intervention program to change Brazilian health practitioners' attitudes toward the lesbian, gay, bisexual and transgender population".

Corrigendum to: J Health Psychol DOI 10.1177/1359105316628748 Unfortunately, the online published article has an error in one of the analyses. On page 365, fifth paragraph, the corrected statistical report is (Δ 1.66, 95% CI [3.32, .01], t (305) = -1.98, p<.05), not (Δ 1.66, 95% CI [3.32, .01], t (305) = -1.66, p <.05). In spite of this correction, there is no change in the direction of the test and therefore in the interpretation of this result.

A Web-Based Psychoeducational Intervention Program for Depression and Anxiety in an Adult Community in Selangor, Malaysia: Protocol of a Randomized Controlled Trial.

BackgroundMental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens.ObjectiveThe objective of this study is to investigate the effectiveness of 4 weeks of a Web-based psychoeducational intervention program for depressive and anxiety symptoms in the community of Selangor, Malaysia.MethodsA two-arm randomized controlled trial of a single-blind study will be conducted to meet the objective of this study. We aim to recruit 84 participants each for the intervention and control groups. The recruitment will be from participants who participated in the first phase of this research. The primary outcomes of this study are depressive and anxiety scores, which will be assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7, respectively. The secondary outcome includes mental health literacy of the participants, which will be assessed using the self-developed and adapted Mental Health Literacy Questionnaire. The psychoeducational intervention program consists of four sessions, which will be accessed each week. The depressive and anxiety symptoms will be compared between participants who participated in the psychoeducational program compared with the control group. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at follow-ups at week 5 and week 12, respectively.ResultsThe psychoeducational intervention program consists of four sessions, which will be accessed at each week. The depressive and anxiety symptoms will be compared between the intervention and control groups using a series of mixed ANOVAs. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at two follow-ups at week 5 and week 12, respectively.ConclusionsTo our knowledge, this study will be the first randomized controlled trial of a Web-based psychoeducational intervention program for depression and anxiety in an adult community in Malaysia. The results from this study will determine the effectiveness of a psychoeducational intervention program in the management of depression and anxiety among adults in the community. If proven to be effective, the intervention can serve as a new modality to manage and reduce the burden of these disorders in the community.ClinicalTrialInternational Standard Randomized Controlled Trial Number (ISRCTN): 39656144; http://www.isrctn.com/ISRCTN39656144 (Archived by WebCite at http://www.webcitation.org/6hSVhV71K)

Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review.

BackgroundOne relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web.ObjectiveOur aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy.MethodsWeb keyword searches were carried out on three major search engines (Google, Bing, and Yahoo—UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool.ResultsThe search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access fee. Half of the programs offered some form of paid therapist or professional support. Programs varied in treatment length and number of modules and employed a variety of presentation modes. Relatively few programs had published research evidence of the intervention’s efficacy.ConclusionsThis review represents a snapshot of available Web-based intervention programs for anxiety that could be found by consumers in March 2015. The consumer is confronted with a diversity of programs, which makes it difficult to identify an appropriate program. Limited reports and existence of empirical evidence for efficacy make it even more challenging to identify credible and reliable programs. This highlights the need for consistent guidelines and standards on developing, providing, and evaluating Web-based interventions and platforms with reliable up-to-date information for professionals and consumers about the characteristics, quality, and accessibility of Web-based interventions.

Effectiveness of a multidimensional web-based intervention program to change Brazilian health practitioners' attitudes toward the lesbian, gay, bisexual and transgender population.

The objective of this study was to assess the effectiveness of a multidimensional (educational, affective and behavioural) web-based intervention to change healthcare practitioners' attitudes toward lesbian, gay, bisexual and transgender population. It aimed to measure gender and sexual (GenSex) prejudice pre- and post-intervention in relation to sociodemographic characteristics. A total of 307 health practitioners from southern Brazil enrolled and completed the follow-up assessment. The intervention had significant effects, varying across traditionally high prejudiced groups. State- and street-level continuous prejudice reduction policies are suggested.

The efficacy of a web-based gambling intervention program for high school students: A preliminary randomized study

Early onset in adolescent gambling involvement can be a precipitator of later gambling problems. The aim of the present study was to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. Students attending a high school in Italy (N = 168) participated in the present study (58% male – age, M = 15.01; SD = 0.60). Twelve classes were randomly assigned to one of two conditions: intervention (N = 6; 95 students) and control group (N = 6; 73 students). Both groups received personalized feedback and then the intervention group received online training (interactive activities) for three weeks. At a two-month follow-up, students in the intervention group reported a reduction in gambling problems relative to those in the control group. However, there were no differences in gambling frequency, gambling expenditure, and attitudes toward the profitability of gambling between the two groups. In addition, frequent gamblers (i.e., those that gambled at least once a week at baseline) showed reductions in gambling problems and gambling frequency post-intervention. Frequent gamblers that only received personalized feedback showed significantly less realistic attitudes toward the profitability of gambling post-intervention. The present study is the first controlled study to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. The results indicate that a brief web-based intervention delivered in the school setting may be a potentially promising strategy for a low-threshold, low-cost, preventive tool for at-risk gambling high school students.