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.

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The present study contrasted the widely cited "buffer" model of social support with an alternative mediator model. Distinctions were drawn between the functions of social support under chronic vs. acute stress conditions, and between situation-specific stressors and major life events. Ongoing parenting stress was assessed in 96 mothers of deaf children and 118 matched controls. Tests of the competing models showed no moderating effects for social support. However, path analyses suggested that social support mediated the relationship between stressors and outcomes. Chronic parenting stress was associated with lowered perceptions of emotional support, and greater symptoms of depression and anxiety. Furthermore, parenting stress accounted for a substantial proportion of the variance in psychological distress scores in contrast to life event stress, which was only weakly related to psychological outcomes. The implications of mediational models for understanding adaptation to chronic stress are discussed.

As telecommunication technologies have become more widely available and affordable, opportunities for psychologists to engage in telebehavioral health (TBH) have expanded greatly. A national sample of 164 professional psychologists completed a 28-item survey focusing on (a) current and anticipated use of telecommunication technologies in delivering TBH services, (b) types of telecommunication modalities currently used in clinical practice, (c) ethical and legal/regulatory concerns related to delivery of TBH services, and (d) educational and training needs for TBH practice. Associations between demographic factors (i.e., age, gender, practice setting, practice region, and years since completion of highest academic degree) and responses on survey items were examined. In descending order, the technologies most commonly used by psychologists were: landline telephone, mobile telephone, e-mail, and videoconferencing. A lower proportion of psychologists working in public settings used landline telephones, mobile telephones, or e-mail to deliver TBH than that of psychologists engaged in independent practice. In regard to respondents' age, the proportion of psychologists delivering TBH collapsed across technologies was substantially higher among respondents 37 years of age or older compared with that of 36-year-olds or younger. Respondents also noted several ethical/legal barriers in providing TBH services, particularly managing emergencies, licensure requirements, and uncertainties about security, as well as confidentiality, Health Insurance Portability and Account Act (HIPAA) compliance, and malpractice insurance coverage. Overall, a substantial discrepancy was noted between psychologists' positive appraisals of ROBERT L. GLUECKAUF received his MS and PhD in clinical psychology from Florida State University. He is Professor in the Department of Behavioral Sciences & Social Medicine at the Florida State University College of Medicine and research director of the Tallahassee Memorial HealthCare Memory Disorder Clinic. His research interests lie in the development and evaluation of telehealth-based interventions for individuals with chronic health conditions and their family care partners, outcomes measurement, and spirituality and health. MARLENE M. MAHEU received her MA and PhD in clinical psychology from the California School of Professional Psychology-San Diego. She is founder and executive director of the Telebehavioral Health Institute, Inc. Her areas of professional interest include telebehavioral health professional training and consultation on legal and ethical best practices for telehealth and various technologies. KENNETH P. DRUDE received his PhD in counseling psychology from the University of Illinois. He currently serves on the Ohio Board of Psychology and has an outpatient practice in the Dayton, Ohio area. His areas of professional interest include telebehavioral training, practice, policy, and standards.

Objective: Assess the effects of videoconferencing-based counseling on the psychosocial functioning of rural teenagers with epilepsy. Setting: University and rural communities. Participants: Twenty-two teenagers with epilepsy and their parents. Interventions: Six sessions of home-based video counseling, homebased speakerphone counseling, or office-based counseling. Main Outcome Measures: Problem severity and frequency, Social Skills Rating System, modified Working Alliance Inventory, and treatment adherence. Results: Teenagers and parents reported significant reductions in both problem severity and frequency across all 3 conditions from pre-to post-6th session to the 6-month follow-up. Parents reported significant increases in prosocial behaviors from pre-to post-6th session to follow-up. In contrast, both parents and teachers reported no change in problem behaviors over time. No differences in adherence were found across the 3 modalities. Overall therapeutic alliance was high but varied as a function of family member and treatment. Conclusions: Mode of delivery did not influence initial treatment outcomes or adherence.