This paper addresses the important issue of how computer technology has been and should be used to foster health promotion. I The conclusions of our review of the field can be stated very briefly. The designers of computer assisted health education systems have typically tried to produce surrogates for other methods of education (such as lectures, health campaigns, or reading lists) rather than designing systems that utilize the unique advantages of computers in assisting learning and facilitating behavioral change.We see three fundamental advantages of computers: (a) they allow users to explore "what if' questions, simulate real world experiences, confidentiaIly and anonymously address sensitive subjects, and practice new skills; (b) they are ideally suited to request, organize, process, and quickly update infonna- 'We use the term health promotion rather than health education because our focus excludes the important area of patient education, which deals with how to cope with preexisting health conditions and illness (such as diabetes or cancer). Health promotion (171, 43,78) as it is addressed in this paper is a prohlem-based field employing a "combination of methods to facilitate voluntary adaptations of behavior conducive to health" (74). 3870163-7525/87/0510-0387$02.00 Annu. Rev. Public Health 1987.8:387-415. Downloaded from www.annualreviews.org Access provided by 54.244.106.145 on 05/11/18. For personal use only. Quick links to online contentFurther ANNUAL REVIEWS GUSTAFSON ET ALtion from data bases, literature, and experts as well as the user; (c) they can be programmed to make this information selectively available to the individual user at a time, speed, and format of presentation controlled by the user.Employing insights provided by literature on tbe dynamics of individual and group decisions , systems analysis, problem solving, social cognition, health psychology, and behavior change, health promotion system designers should now begin to utilize these advantages to produce more effective health promotion systems.The paper has five sections: (a) a summary of the history and current status of computer-assisted health promotion efforts; (b) an analysis of the goals of health-promotion efforts; (c) a description of a problem-solving model for health promotion; (d) a review of recent advances in technology and software systems; and (e) a model, using the example of stress, of how an ideal computer-based health promotion problem-solving system might work. This last section builds on recent technological software advances and the problem solving model described in the previous sections.The ideas presented in this paper are based on: (a) literature review of computer-assisted health education; technology and hardware; individual and group decision making, problem solving, health psychology, social cogni tion, and behavior change; (b) interviews with 20 leading educators, human factors engineers, decision scientists , and computer scientists; and (c) five years of experience developing, testing, and implemen...