Do Internet interventions for consumers cause more harm than good? A systematic review

Bessell, Tracey Lee; McDonald, Steve; Silagy, Chris; Anderson, Jeremy; Hiller, Janet E.; Sansom, Lloyd

doi:10.1046/j.1369-6513.2002.00156.x

Cited by 138 publications

(77 citation statements)

References 27 publications

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“…[10][11][12][13] A recent review suggested that there was a paucity of evidence showing that consumer use of the internet for health information has any effect on health outcomes. 14 A study investigating which of five media (paper booklet, website, audio, audio plus website, website created using Flash) patients prefer for the delivery of information about cancer suggested that this group preferred the more interactive Flash format, although there was no significant difference in knowledge changes between formats. It should be noted that the study was small (nine participants in each group) and that the focus was on patient preferences rather than knowledge and attitude changes.…”

Section: Refereed Papersmentioning

confidence: 99%

Changing public attitudes to antibiotic prescribing: can the internet help?

Madle¹,

Kostkova²,

Mani-Saada³

et al. 2004

Journal of Innovation in Health Informatics

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Introduction Antimicrobial resistance is a global problem with serious implications for modern medicine. Education of the public is essential for reducing patient pressure on GPs and subsequent inappropriate prescribing. Evaluation of educational interventions is necessary to assess their impact on public knowledge and attitudes. The aim of this study was to evaluate the effect of a health information website, part of the National electronic Library of Infection, on user knowledge and attitudes. Method Questionnaires testing user knowledge and attitudes before and after using the website. Results There were significant improvements in knowledge about the use of antibiotics and antibiotic resistance. Expectations that antibiotics should be prescribed were significantly reduced after using the website. Health professionals showed a significantly greater knowledge about antibiotics and were less likely to expect antibiotics to be prescribed for acute otitis media than non-health professionals before using the website. There was no significant difference between the knowledge of these groups after using the website, but non-health professionals continued to have higher expectations of antibiotics being prescribed than health professionals. Conclusions Health information websites can play a significant role in influencing public knowledge and attitudes. Further research is needed to investigate how people learn from these interventions and to determine their long-term impact on public attitudes and subsequent behaviour.

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Section: Refereed Papersmentioning

confidence: 99%

Changing public attitudes to antibiotic prescribing: can the internet help?

Madle¹,

Kostkova²,

Mani-Saada³

et al. 2004

Journal of Innovation in Health Informatics

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“…The delivery and content of websites is not regulated [22], and it is easy to imagine how variability across websites could make generalizations about this type of intervention problematic. However, it is possible to assess the potential for this kind of intervention to provide smoking cessation support by examining the efficacy of rigorous evaluations carried out to date.…”

Section: Introductionmentioning

confidence: 99%

Online support for smoking cessation: a systematic review of the literature

2009

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Aim To examine the efficacy and acceptability of online, interactive interventions for smoking cessation and to identify treatment effect moderators and mediators. Methods A systematic review and meta-analysis of the literature (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) was conducted, finding 11 relevant randomized controlled trials. Data were extracted and risk ratios and risk differences estimated with a random effects model. Results There was no evidence of publication bias. Included trials were of variable methodological quality. Web-based, tailored, interactive smoking cessation interventions were effective compared with untailored booklet or e-mail interventions [rate ratio (RR) 1.8; 95% confidence interval (CI) 1.4-2.3] increasing 6-month abstinence by 17% (95% CI 12-21%). No overall effect of interactive compared with static web-based interventions was detected but there was significant heterogeneity, with one study obtaining a clear effect and another failing to find one. Few moderating or mediating factors were evaluated in studies and those that were had little effect. Pooled results suggest that only interventions aimed at smokers motivated to quit were effective (RR 1.3, 95% CI 1.0-1.7). Fully automated interventions increased smoking cessation rates (RR 1.4, 95% CI 1.0-2.0), but evidence was less clear-cut for non-automated interventions. Overall, the web-based interventions evaluated were considered to be acceptable and user satisfaction was generally high. Conclusion Interactive, web-based interventions for smoking cessation can be effective in aiding cessation. More research is needed to evaluate the relative efficacy of interactive web-based interventions compared with static websites.

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“…Whilst the internet is an important source of information which provides rapid access, it can be overwhelming and difficult for the nonspecialist to know which sites provide current and correct explanations. 8 There are no published papers on the quality and readability of AMD websites. We therefore conducted this study to assess the quality of information and readability of the top internet sites for AMD.…”

Section: Introductionmentioning

confidence: 99%

Age-related macular degeneration: what do patients find on the internet?

Rennie

Hannan

Maycock

et al. 2007

Journal of the Royal Society of Medicine

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SUMMARYObjective To assess the quality of information and readability of the top internet sites for age-related macular degeneration (AMD).Design An examination of the technical information provision, quality and readability of websites found during an internet search for 'age-related macular degeneration'.Setting Six internet search engines were used to find 26 unique sites on AMD. Main outcome measures Technical information and qualitywere assessed using a simple grading system. Readability was assessed using a Simple Measure Of Gobbledygook (SMOG) rating.Results Twelve organizational, seven academic and seven commercial sites were identified. The average technical scores were 82.3%, 67.9% and 65.2% for each type of site, respectively (P=0.097, one way ANOVA). The average quality scores were 62.2%, 62.6%, and 49.5% for each type of site, respectively (P=0.356, one-way ANOVA). The average SMOG ratings were 16.3, 16.1, and 16.2 for each type of site, respectively (P=0.983, one-way ANOVA). Fifteen of the sites provided details of new and emerging treatments, with seven providing a detailed discussion.Conclusions Many websites are now meeting the challenge of providing comprehensive information about AMD and its new treatments. Quality scores were disappointing, with sites needing to provide more evidence of authorship and attribution of information. The majority of sites had SMOG scores above 10, making them difficult for the average person to understand. As physicians we need to help design and direct patients to sites that provide high quality, current information.

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Do Internet interventions for consumers cause more harm than good? A systematic review

Cited by 138 publications

References 27 publications

Changing public attitudes to antibiotic prescribing: can the internet help?

Changing public attitudes to antibiotic prescribing: can the internet help?

Online support for smoking cessation: a systematic review of the literature

Age-related macular degeneration: what do patients find on the internet?

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