Web-based tailored intervention programs show considerable promise in effecting health-promoting behaviors and improving health outcomes across a variety of medical conditions and patient populations. This meta-analysis compares the effects of tailored versus nontailored web-based interventions on health behaviors and explores the influence of key moderators on treatment outcomes. Forty experimental and quasi-experimental studies (N =20,180) met criteria for inclusion and were analyzed using meta-analytic procedures. The findings indicated that web-based tailored interventions effected significantly greater improvement in health outcomes as compared with control conditions both at posttesting, d =.139 (95% CI = .111, .166, p <.001, k =40) and at follow-up, d =.158 (95% CI = .124, .192, p <.001, k =21). The authors found no evidence of publication bias. These results provided further support for the differential benefits of tailored web-based interventions over nontailored approaches. Analysis of participant/descriptive, intervention, and methodological moderators shed some light on factors that may be important to the success of tailored interventions. Implications of these findings and directions for future research are discussed.

No abstract

Recent government initiatives to deploy health information technology in the USA, coupled with a growing body of scholarly evidence linking online heath information and positive health-related behaviors, indicate a widespread belief that access to health information and health information technologies can help reduce healthcare inequalities. However, it is less clear whether the benefits of greater access to online health information and health information technologies is equitably distributed across population groups, particularly to those who are underserved. To examine this issue, this article employs the 2007 Health Information National Trends Survey (HINTS) to investigate relationships between a variety of socio-economic variables and the use of the web-based technologies for health information seeking, personal health information management and patient-provider communication within the context of the USA. This study reveals interesting patterns in technology adoption, some of which are in line with previous studies, while others are less clear. Whether these patterns indicate early evidence of a narrowing divide in eHealth technology use across population groups as a result of the narrowing divide in Internet access and computer ownership warrants further exploration. In particular, the findings emphasize the need to explore differences in the use of eHealth tools by medically underserved and disadvantaged groups. In so doing, it will be important to explore other psychosocial variables, such as health literacy, that may be better predictors of health consumers' eHealth technology adoption.

The Internet is increasingly being recognized for its potential for health communication and education. The perceived relative advantage of the Internet over other media is its cost-effectiveness and interactivity, which in turn contribute to its persuasive capabilities. Ironically, despite its potential, we are nowhere nearer understanding how interactivity affects processing of health information and its contribution in terms of health outcomes. An experiment was conducted to examine the effects of Web interactivity on comprehension of and attitudes towards two health Web sites, and whether individual differences might moderate such effects. Two sites on skin cancer were designed with different levels of interactivity and randomly assigned to 441 undergraduate students (aged 18-26) at a large southeastern university. The findings suggest that interactivity can significantly affect comprehension as well as attitudes towards health Web sites. The article also discusses insights into the role of interactivity on online health communications, and presents implications for the effective design of online health content.

This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month high-audience-saturation campaign took place in Lexington, KY, with Knoxville, TN, as a comparison city. Messages were especially designed and selected for the target audience (those above the median on a composite sensation-seeking/impulsive-decision-making scale). Data indicate high campaign exposure among the target audience, with 85%-96% reporting viewing one or more PSAs. Analyses indicate significant 5-month increases in condom use, condom-use self-efficacy, and behavioral intentions among the target group in the campaign city with no changes in the comparison city. The results suggest that a carefully targeted, intensive mass media campaign using televised PSAs can change safer sexual behaviors. Keywords mass media campaign; public service announcement; safer sex HIV prevention intervention research over the past 15 years has begun to show impressive results. A number of studies have shown delay of onset of sexual initiation (e.g., Coyle, Kirby, Marin, Gómez, & Gregorish, 2004), whereas other programs have led to significant increases in condom use in populations including heterosexually active individuals (see Johnson, Carey, Marsh, Levin, & Scott-Sheldon, 2003;Neumann et al., 2002, for reviews). However, most of these interventions have been implemented in small-group (e.g., Belza et al., 2001), school (e.g., Blake et al., 2003;Gallant & Maticka-Tyndale, 2004), or individuallevel clinical settings (e.g., Morrison-Beedy & Lewis, 2001). Mass media campaigns, such as televised public service announcement (PSA) campaigns, have recently been shown to be highly effective in changing a variety of behaviors (Hornik, 2002;Noar, 2006) 2001). For a number of reasons, however, the full potential of these types of media campaigns in the HIV prevention area has not yet been realized (Dejong, Wolf, & Austin, 2001;Myhre & Flora, 2000). In fact, campaigns focused on safer sexual behavior to date have tended to yield modest campaign effects (Snyder & Hamilton, 2002). Thus, we raise the following question: Can a televised PSA campaign based on formative research and sophisticated targeting principles change safer sexual beliefs and behaviors in at-risk young adults? The current study is a rigorous evaluation of a two-city, televised safer sex mass media campaign targeted toward increasing safer sex in young adults who are high sensation seekers and impulsive decision makers. HHS Public Access MASS MEDIA CAMPAIGNSAs noted by Randolph and Viswanath (2004), "Mass media campaigns to promote healthy behaviors and discourage unhealthy behaviors have become a major tool of public health practitioners in their efforts to improve the health of the public" (p. 419). Although the early h...