Skip to main content
Article thumbnail
Location of Repository

Why are health care interventions delivered over the internet? : a systematic review of the published literature

By Frances Griffiths, Antje Lindenmeyer, John Powell, Pam Lowe and Margaret Thorogood


Background: As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are\ud using the networking potential of the Internet, and several of them have evaluated these interventions.\ud Objective: The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect\ud on the work of the pioneers in this field in order to inform future research.\ud Methods: We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a\ud known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the\ud Internet, and these reasons were categorized.\ud Results: We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions\ud were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the\ud nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming\ud isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention.\ud A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this\ud mode of delivery.\ud Conclusions: One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential\ud for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility,\ud and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of\ud cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of\ud Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably\ud backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention\ud delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question:\ud What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery

Topics: RA
Publisher: Journal of Internet Medical Research
OAI identifier:

Suggested articles


  1. (2004). A 67-year-old man who e-mails his physician. doi
  2. (1998). A computer network for Alzheimer's caregivers and use of support group services.
  3. (1998). A computer-mediated intervention for Alzheimer's caregivers.
  4. (2000). A controlled trial of self-help treatment of recurrent headache conducted via the Internet. doi
  5. (2006). A critical analysis of the literature on the Internet and consumer health information. doi
  6. A new smoking cessation programme using the Internet. Tob Control 1999;8(1):109-110 [FREE Full text] [Medline: doi
  7. (2002). A web-based self-monitoring system for people living with HIV/AIDS. doi
  8. Alzheimer's Caregiver Support Online: lessons learned, initial findings and future directions.
  9. (1992). Alzheimer's disease caregivers' uses of a computer network. doi
  10. (2003). An interactive Internet site for the management of patients with congestive heart failure.
  11. (2001). An interactive internet-based intervention for women at risk of eating disorders: a pilot study. doi
  12. (2000). Baby CareLink: using the internet and telemedicine to improve care for high-risk infants. Pediatrics doi
  13. (2002). Can a Back Pain E-mail Discussion Group improve health status and lower health care costs?: A randomized study. doi
  14. Clinical trial of an Internet-based case management system for secondary prevention of heart disease. doi
  15. (1998). Computer network home care demonstration: a randomized trial in persons living with AIDS. doi
  16. Computer-based support groups. Nursing in cyberspace. doi
  17. (1991). ComputerLink: electronic support for the home caregiver. doi
  18. ComputerLink: the impact of a computer network on Alzheimer's caregivers' decision-making confidence and skill. Medinfo 1995;8:1546.
  19. (1998). Constantinou PS. Evaluation of a computer-mediated eating disorder intervention program. doi
  20. Delivering interventions for depression by using the internet: randomised controlled trial. doi
  21. (1993). Development and pivotal evaluation of a computer-based support system for women with breast cancer. doi
  22. (2002). Do Internet-based support interventions change perceptions of social support?: An experimental trial of approaches for supporting diabetes self-management.
  23. (2002). Does using the Internet facilitate the maintenance of weight loss? doi
  24. (2001). Effect of computer support on younger women with breast cancer. doi
  25. Effectiveness of a computer-based interactive eating disorders prevention program at long-term follow-up. Eat Disord 2003;14(1):17-30. [Medline: doi
  26. (2000). Effectiveness of an Internet-based program for reducing risk factors for eating disorders. doi
  27. Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. doi
  28. (2005). eHealth and the future: promise or peril? BMJ doi
  29. (2003). Electronic support groups for breast carcinoma: a clinical trial of effectiveness. Cancer doi
  30. (2003). Evaluation of an internet support group for women with primary breast cancer. Cancer doi
  31. Evaluation of an internet-based physical activity intervention: a preliminary investigation. Ann Behav Med 2003;25(2):92-99. [Medline: doi
  32. (2003). Evaluation of an Internet-based smoking cessation program: lessons learned from a pilot study. Nicotine Tob Res doi
  33. (2000). Framework for design and evaluation of complex interventions to improve health. BMJ
  34. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. doi
  35. (1999). Impact of a patient-centered, computer-based health information/support system.
  36. (2006). In-home online support for caregivers of survivors of stroke: a feasibility study. Comput Inform Nurs 2002;20(4):157-164. [Medline: 22097714] [doi: 10.1097/00024665-200207000-00012] J Med Internet Res
  37. (2003). Innovations in access to care: a patient-centered approach.
  38. (2003). Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. doi
  39. Internet tool for communication and education in diabetes. doi
  40. (2002). Internet-based diabetes self-management and support: initial outcomes from the Diabetes Network project. Rehabil Psychol doi
  41. (2004). Internet-based treatment for insomnia: a controlled evaluation. doi
  42. (2003). Internet-based treatment of headache: does telephone contact add anything? Headache doi
  43. (2006). Med Internet Res doi
  44. (1994). Networks for home care support: the ComputerLink project. Caring
  45. (2005). Pilot study of an Internet patient-physician communication tool for heart failure disease management. doi
  46. (2003). Print versus website physical activity programs: a randomized trial. doi
  47. Process and outcome evaluation of an online support group for Asian American male college students. doi
  48. (2004). Providing a web-based online medical record with electronic communication capabilities to patients with congestive heart failure: randomized trial. doi
  49. (2000). Reducing risk factors for eating disorders: comparison of an Internet- and a classroom-delivered psychoeducational program. doi
  50. (2001). Reducing risk factors for eating disorders: targeting at-risk women with a computerized psychoeducational program. doi
  51. Student bodies: psycho-education communities on the Web.
  52. Technology-based advances in the management of depression: focus on the COPE<sup>TM</sup> program. doi
  53. Teen central: assessment of an Internet-based support system for children with cystic fibrosis. doi
  54. Telecommunication support for rural women with diabetes. Diabetes Educ 2000;26(4):645-655. [Medline: doi
  55. (1998). The buffering effect of a computer support network on caregiver strain. doi
  56. (2000). The chatline as a communication and educational tool in adolescents with insulin-dependent diabetes: preliminary observations. Diabetes Care doi
  57. (2003). The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results. Prev Med doi
  58. (2004). The effectiveness of Web-based vs. non-Web-based interventions: a meta-analysis of behavioral change outcomes. doi
  59. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nurs Res 1995;44(3):166-172. [Medline: doi
  60. (2002). The feasibility of using Internet support for the maintenance of weight loss. Behav Modif doi
  61. The impact of a computer network on pediatric pain and anxiety: a randomized controlled clinical trial. Soc Work Health Care 2002;36(2):21-33. [Medline: 22443081] [doi: 10.1300/J010v36n02_02] doi
  62. (2003). The impact of health information on the Internet on health care and the physician-patient relationship: national U.S. survey among 1.050 U.S. doi
  63. The impact of the Internet on cancer outcomes. doi
  64. (2000). The online care revolution: how the Web helps Americans take better care of themselves.
  65. The use of e-mail in the identification of bulimia nervosa and its treatment. European Eating Disorders Review 2001;9(3):182-193. [doi: 10.1002/erv.411] doi
  66. (1991). The use of home-based computers to support persons living with AIDS/ARC. doi
  67. (2003). Treatment of panic disorder via the Internet: a randomized trial of CBT vs. applied relaxation. J Behav Ther Exp Psychiatry doi
  68. (2005). Treatment of panic disorder: live therapy vs. self-help via the Internet. Behav Res Ther doi
  69. (1994). Use of a home-care computer network by persons with AIDS. doi
  70. (2001). Using Internet technology to deliver a behavioral weight loss program. doi
  71. (2002). Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores. doi
  72. (2004). Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial. doi
  73. (2004). What e-Health can offer. Bull World Health Organ
  74. (2005). What is eHealth (4): a scoping exercise to map the field. doi
  75. Young Parents Project: a 21st-century nursing intervention. Issues Compr Pediatr Nurs 1999;22(4):153-165. [Medline: doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.