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Vol 14, No 2 (2012) - Mar-Apr


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Web-based and Mobile Health Interventions

The Influence of User Characteristics and a Periodic Email Prompt on Exposure to an Internet-Delivered Computer-Tailored Lifestyle Program

Francine Schneider, Liesbeth van Osch, Daniela N Schulz, Stef PJ Kremers, Hein de Vries

J Med Internet Res 2012 (Mar 01); 14(2):e40

HTML PDF XML Abstract

Background: The Internet is a promising medium in the field of health promotion for offering tailored and targeted lifestyle interventions applying computer-tailored (CT) techniques to the general public. Actual exposure to CT interventions is not living up to its high expectations, as only a (limited) proportion of the target group is actually using these programs. Objective: To investigate exposure to an Internet-delivered, CT lifestyle intervention, targeting physical activity, fruit and...

Initial and Sustained Participation in an Internet-delivered Long-term Worksite Health Promotion Program on Physical Activity and Nutrition

Suzan JW Robroek, Dennis EM Lindeboom, Alex Burdorf

J Med Internet Res 2012 (Mar 05); 14(2):e43

HTML PDF XML Abstract

Background: Determinants of participation in health promotion programs are largely unknown. To evaluate and implement interventions, information is needed regarding their reach as well as regarding the characteristics of program users and non-users. Objective: In this study, individual, lifestyle, and health indicators were investigated in relation to initial, and sustained participation in an Internet-delivered physical activity and healthy nutrition program in the workplace setting. In...

Program Completion of a Web-Based Tailored Lifestyle Intervention for Adults: Differences between a Sequential and a Simultaneous Approach

Daniela N Schulz, Francine Schneider, Hein de Vries, Liesbeth ADM van Osch, Peter WM van Nierop, Stef PJ Kremers

J Med Internet Res 2012 (Mar 08); 14(2):e26

HTML PDF XML Abstract

Background: Unhealthy lifestyle behaviors often co-occur and are related to chronic diseases. One effective method to change multiple lifestyle behaviors is web-based computer tailoring. Dropout from Internet interventions, however, is rather high, and it is challenging to retain participants in web-based tailored programs, especially programs targeting multiple behaviors. To date, it is unknown how much information people can handle in one session while taking part in a multiple behavior...

The Role of User Control in Adherence to and Knowledge Gained from a Website: Randomized Comparison Between a Tunneled Version and a Freedom-of-Choice Version

Rik Crutzen, Dianne Cyr, Nanne K. de Vries

J Med Internet Res 2012 (Mar 09); 14(2):e45

HTML PDF XML Abstract

Background: Internet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to these interventions once they are accessed is very low. Therefore, it is relevant and necessary to systematically manipulate website characteristics to test their effect on website use. This study focuses on user control as a website characteristic. Objective: To test whether and how user control (the freedom of choice to skip pages) can increase website use and...

Design of a Website on Nutrition and Physical Activity for Adolescents: Results From Formative Research

Debbe Thompson, Karen Weber Cullen, Carol Boushey, Karen Konzelmann

J Med Internet Res 2012 (Apr 26); 14(2):e59

HTML PDF XML Abstract

Background: Teens do not meet guidelines for healthy eating and physical activity. The Internet may be an effective method for delivering programs that help them adopt healthy behaviors. Objective: To collect information to design content and structure for a teen-friendly website promoting healthy eating and physical activity behaviors. Methods: Qualitative research, encompassing both focus group and interview techniques, were used to design the website. Participants were 12-17 year olds in...

Results from an Online Computer-Tailored Weight Management Intervention for Overweight Adults: Randomized Controlled Trial

Lenneke van Genugten, Pepijn van Empelen, Brigitte Boon, Gerard Borsboom, Tommy Visscher, Anke Oenema

J Med Internet Res 2012 (Mar 14); 14(2):e44

HTML PDF XML Abstract

Background: Prevention of weight gain has been suggested as an important strategy in the prevention of obesity and people who are overweight are a specifically important group to target. Currently there is a lack of weight gain prevention interventions that can reach large numbers of people. Therefore, we developed an Internet-delivered, computer-tailored weight management intervention for overweight adults. The focus of the intervention was on making small (100 kcal per day), but sustained...

Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Advice: Development, Dissemination Through General Practice, Acceptability, and Preliminary Efficacy in a Randomized Controlled Trial

Katrien De Cocker, Heleen Spittaels, Greet Cardon, Ilse De Bourdeaudhuij, Corneel Vandelanotte

J Med Internet Res 2012 (Apr 24); 14(2):e53

HTML PDF XML Abstract

Background: Computer tailoring is a relatively innovative and promising physical activity intervention approach. However, few computer-tailored physical activity interventions in adults have provided feedback based on pedometer use. Objectives: To (1) describe the development of a Web-based, pedometer-based, computer-tailored step advice intervention, (2) report on the dissemination of this tool through general practice, (3) report on its perceived acceptability, and (4) evaluate the...

A 12-Week Commercial Web-Based Weight-Loss Program for Overweight and Obese Adults: Randomized Controlled Trial Comparing Basic Versus Enhanced Features

Clare E Collins, Philip J Morgan, Penelope Jones, Kate Fletcher, Julia Martin, Elroy J Aguiar, Ashlee Lucas, Melinda J Neve, Robin Callister

J Med Internet Res 2012 (Apr 25); 14(2):e57

HTML PDF XML Abstract

Background: The development and use of Web-based programs for weight loss is increasing rapidly, yet they have rarely been evaluated using randomized controlled trials (RCTs). Interestingly, most people who attempt weight loss use commercially available programs, yet it is very uncommon for commercial programs to be evaluated independently or rigorously. Objective: To compare the efficacy of a standard commercial Web-based weight-loss program (basic) versus an enhanced version of this Web...

Internet-Based Computer Tailored Feedback on Sunscreen Use

Hein de Vries, Matti Logister, Gertruud Krekels, Frits Klaasse, Verina Servranckx, Liesbeth van Osch

J Med Internet Res 2012 (Apr 30); 14(2):e48

HTML PDF XML Abstract

Background: Skin cancer incidence rates signify the need for effective programs for the prevention of skin cancer and for helping skin cancer patients. Internet and computer tailored (CT) technology fosters the development of highly individualized health communication messages. Yet, reactions to Internet CT programs may differ per level of involvement and education level and remain understudied. Objective: First, we identified perceptions concerning sunscreen use in Dutch adults and assessed...

Mobile Health (mhealth)

Novel Technologies for Assessing Dietary Intake: Evaluating the Usability of a Mobile Telephone Food Record Among Adults and Adolescents

Bethany L Daugherty, TusaRebecca E Schap, Reynolette Ettienne-Gittens, Fengqing M Zhu, Marc Bosch, Edward J Delp, David S Ebert, Deborah A Kerr, Carol J Boushey

J Med Internet Res 2012 (Apr 13); 14(2):e58

HTML PDF XML Abstract

Background: The development of a mobile telephone food record has the potential to ameliorate much of the burden associated with current methods of dietary assessment. When using the mobile telephone food record, respondents capture an image of their foods and beverages before and after eating. Methods of image analysis and volume estimation allow for automatic identification and volume estimation of foods. To obtain a suitable image, all foods and beverages and a fiducial marker must be...

Improving Adherence to Antiretroviral Therapy for Youth Living with HIV/AIDS: A Pilot Study Using Personalized, Interactive, Daily Text Message Reminders

Nadia Dowshen, Lisa M Kuhns, Amy Johnson, Brian James Holoyda, Robert Garofalo

J Med Internet Res 2012 (Apr 05); 14(2):e51

HTML PDF XML Abstract

Background: For youth living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), nonadherence to antiretroviral therapy (ART) can lead to poor health outcomes and significantly decreased life expectancy. Objective: To evaluate the feasability, acceptability, and preliminary efficacy of short message service (SMS) or text message reminders to improve adherence to ART for youth living with HIV/AIDS. Methods: We conducted this prospective pilot study using a...

Using Smartphone Technology to Monitor Physical Activity in the 10,000 Steps Program: A Matched Case–Control Trial

Morwenna Kirwan, Mitch J Duncan, Corneel Vandelanotte, W Kerry Mummery

J Med Internet Res 2012 (Apr 20); 14(2):e55

HTML PDF XML Abstract

Background: Website-delivered physical activity interventions are successful in producing short-term behavior change. However, problems with engagement and retention of participants in these programs prevent long-term behavior change. New ways of accessing online content (eg, via smartphones) may enhance engagement in these interventions, which in turn may improve the effectiveness of the programs. Objective: To measure the potential of a newly developed smartphone application to improve...

Internet-based Survey & Research Methodology

Validation of an Informant-Reported Web-Based Data Collection to Assess Dementia Symptoms

Kenneth Rockwood, An Zeng, Chris Leibman, Lisa Mucha, Arnold Mitnitski

J Med Internet Res 2012 (Mar 12); 14(2):e42

HTML PDF XML Abstract

Background: The Web offers unprecedented access to the experience of people with dementia and their care partners, but data gathered online need to be validated to be useful. Objective: To test the construct validity of an informant Web-based data collection to assess dementia symptoms in relation to the 15-point Dependence Scale (DS). Methods: In an online survey posted on the DementiaGuide website, care partners of people with dementia built individualized profiles from the 60-item...

Medicine 2.0: Social Media, Open, Participatory, Collaborative Medicine

Crowdsourced Health Research Studies: An Important Emerging Complement to Clinical Trials in the Public Health Research Ecosystem

Melanie Swan

J Med Internet Res 2012 (Mar 07); 14(2):e46

HTML PDF XML Abstract

Background: Crowdsourced health research studies are the nexus of three contemporary trends: 1) citizen science (non-professionally trained individuals conducting science-related activities); 2) crowdsourcing (use of web-based technologies to recruit project participants); and 3) medicine 2.0 / health 2.0 (active participation of individuals in their health care particularly using web 2.0 technologies). Crowdsourced health research studies have arisen as a natural extension of the activities...

Online Doctor Reviews: Do They Track Surgeon Volume, a Proxy for Quality of Care?

Jeffrey Segal, Michael Sacopulos, Virgil Sheets, Irish Thurston, Kendra Brooks, Ryan Puccia

J Med Internet Res 2012 (Apr 10); 14(2):e50

HTML PDF XML Abstract

Background: Increasingly, consumers are accessing the Internet seeking health information. Consumers are also using online doctor review websites to help select their physician. Such websites tally numerical ratings and comments from past patients. To our knowledge, no study has previously analyzed whether doctors with positive online reputations on doctor review websites actually deliver higher quality of care typically associated with better clinical outcomes and better safety records....

Medicine 2.0'10 (Full Paper of Conference Presentation)

Development of Web-Based Computer-Tailored Advice to Promote Physical Activity Among People Older Than 50 Years

Denise A Peels, Maartje M van Stralen, Catherine Bolman, Rianne HJ Golsteijn, Hein de Vries, Aart N Mudde, Lilian Lechner

J Med Internet Res 2012 (Mar 02); 14(2):e39

HTML PDF XML Abstract

Background: The Active Plus project is a systematically developed theory- and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the RE-AIM framework. The RE-AIM model is often used to evaluate the potential public health impact of an intervention and distinguishes...

Medicine 2.0'11 (Full Paper of Conference Presentation)

Health Care Professionals’ Beliefs About Using Wiki-Based Reminders to Promote Best Practices in Trauma Care

Patrick Michel Archambault, Andrea Bilodeau, Marie-Pierre Gagnon, Karine Aubin, André Lavoie, Jean Lapointe, Julien Poitras, Sylvain Croteau, Martin Pham-Dinh, France Légaré

J Med Internet Res 2012 (Apr 19); 14(2):e49

HTML PDF XML Abstract

Background : Wikis are knowledge translation tools that could help health professionals implement best practices in acute care. Little is known about the factors influencing professionals’ use of wikis. Objectives : To identify and compare the beliefs of emergency physicians (EPs) and allied health professionals (AHPs) about using a wiki-based reminder that promotes evidence-based care for traumatic brain injuries. Methods : Drawing on the theory of planned behavior, we conducted...

e-Learning and Medical Education

Breakeven, Cost Benefit, Cost Effectiveness, and Willingness to Pay for Web-Based Versus Face-to-Face Education Delivery for Health Professionals

Stephen Maloney, Romi Haas, Jenny L Keating, Elizabeth Molloy, Brian Jolly, Jane Sims, Prue Morgan, Terry Haines

J Med Internet Res 2012 (Apr 02); 14(2):e47

HTML PDF XML Abstract

Background: The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. Objective: To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals....

Participatory Medicine & E-Patients

Internet-Based HIV and Sexually Transmitted Infection Testing in British Columbia, Canada: Opinions and Expectations of Prospective Clients

Travis Salway Hottes, Janine Farrell, Mark Bondyra, Devon Haag, Jean Shoveller, Mark Gilbert

J Med Internet Res 2012 (Mar 06); 14(2):e41

HTML PDF XML Abstract

Background: The feasibility and acceptability of Internet-based sexually transmitted infection (STI) testing have been demonstrated; however, few programs have included testing for human immunodeficiency virus (HIV). In British Columbia, Canada, a new initiative will offer online access to chlamydia, gonorrhea, syphilis, and HIV testing, integrated with existing clinic-based services. We presented the model to gay men and other men who have sex with men (MSM) and existing clinic clients...

Demographics of Users, Social & Digital Divide

Online Schools and Children With Special Health and Educational Needs: Comparison With Performance in Traditional Schools

Lindsay A Thompson, Rick Ferdig, Erik Black

J Med Internet Res 2012 (Apr 30); 14(2):e62

HTML PDF XML Abstract

Background: In the United States, primary and secondary online schools are institutions that deliver online curricula for children enrolled in kindergarten through 12th grade (K-12). These institutions commonly provide opportunities for online instruction in conjunction with local schools for students who may need remediation, have advanced needs, encounter unqualified local instructors, or experience scheduling conflicts. Internet-based online schooling may potentially help children from...

Ethics, Privacy, and Legal Issues

A Conceptual Framework and Principles for Trusted Pervasive Health

Pekka Sakari Ruotsalainen, Bernd Gerhard Blobel, Antto Veikko Seppälä, Hannu Olavi Sorvari, Pirkko Anneli Nykänen

J Med Internet Res 2012 (Apr 06); 14(2):e52

HTML PDF XML Abstract

Background: Ubiquitous computing technology, sensor networks, wireless communication and the latest developments of the Internet have enabled the rise of a new concept—pervasive health—which takes place in an open, unsecure, and highly dynamic environment (ie, in the information space). To be successful, pervasive health requires implementable principles for privacy and trustworthiness. Objective: This research has two interconnected objectives. The first is to define pervasive...

eHealth Literacy

Analysis of eHealth Search Perspectives Among Female College Students in the Health Professions Using Q Methodology

Michael Stellefson, Bruce Hanik, J. Don Chaney, Bethany Tennant

J Med Internet Res 2012 (Apr 27); 14(2):e60

HTML PDF XML Abstract

Background: The current “Millennial Generation” of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. Objective: To systematically identify health professional college student perspectives of...

Research Instruments, Questionnaires, and Tools

How is an Electronic Screening and Brief Intervention Tool on Alcohol Use Received in a Student Population? A Qualitative and Quantitative Evaluation

Jessica Fraeyman, Paul Van Royen, Bart Vriesacker, Leen De Mey, Guido Van Hal

J Med Internet Res 2012 (Apr 23); 14(2):e56

HTML PDF XML Abstract

Background: A previous study among Antwerp college and university students showed that more male (10.2%–11.1%) than female (1.8%–6.2%) students are at risk for problematic alcohol use. The current literature shows promising results in terms of feasibility and effectiveness for the use of brief electronic interventions to address this health problem in college and university students. We evaluated this type of intervention and cite existing literature on the topic. Objective: To...

From interactive Journal of Medical Research (ISSN 1929-073X)

Can Consumers Trust Web-Based Information About Celiac Disease? Accuracy, Comprehensiveness, Transparency, and Readability of Information on the Internet

Shawna L McNally, Michael C Donohue, Kimberly P Newton, Sandra P Ogletree, Kristen K Conner, Sarah E Ingegneri, Martin F Kagnoff

Interact J Med Res 2012 (Apr 04); 1(1):e1

HTML PDF XML Abstract

Background: Celiac disease is an autoimmune disease that affects approximately 1% of the US population. Disease is characterized by damage to the small intestinal lining and malabsorption of nutrients. Celiac disease is activated in genetically susceptible individuals by dietary exposure to gluten in wheat and gluten-like proteins in rye and barley. Symptoms are diverse and include gastrointestinal and extraintestinal manifestations. Treatment requires strict adherence to a gluten-free diet....

From JMIR Research Protocols (ISSN 1929-0748)

Wikis and Collaborative Writing Applications in Health Care: A Scoping Review Protocol

Patrick Michel Archambault, Tom H. van de Belt, Francisco J. Grajales III, Gunther Eysenbach, Karine Aubin, Irving Gold, Marie-Pierre Gagnon, Craig E. Kuziemsky, Alexis F. Turgeon, Julien Poitras, Marjan J. Faber, Jan A.M. Kremer, Marcel Heldoorn, Andrea Bilodeau, France Légaré

JMIR Res Protoc 2012 (Apr 11); 1(1):e1

HTML PDF XML Abstract

The rapid rise in the use of collaborative writing applications (eg, wikis, Google Documents, and Google Knol) has created the need for a systematic synthesis of the evidence of their impact as knowledge translation (KT) tools in the health care sector and for an inventory of the factors that affect their use. While researchers have conducted systematic reviews on a range of software-based information and communication technologies as well as other social media (eg, virtual communities of...

Internet-Based Intervention to Promote Mental Fitness in Mildly Depressed Adults: Design of a Randomized Controlled Trial

Linda Bolier, Merel Haverman, Jeannet Kramer, Brigitte Boon, Filip Smit, Heleen Riper, Ernst Bohlmeijer

JMIR Res Protoc 2012 (Apr 26); 1(1):e2

HTML PDF XML Abstract

Background: Investing in mental well-being is considered a supplement to current mental health service delivery in which the treatment and prevention of mental disorders are core components. It may be possible for people to enhance their well-being by boosting their “mental fitness.” Objective: Psyfit, an online, multi-component, fully automated self-help intervention, was developed with the aim of improving well-being and reducing depressive symptoms. The efficacy and...

From Medicine 2.0 (ISSN 1923-2195)

ePatients on YouTube: Analysis of Four Experiences From the Patients' Perspective

Beni Gómez-Zúñiga, Luis Fernandez-Luque, Modesta Pousada, Eulàlia Hernández-Encuentra, Manuel Armayones

Med 2.0 2012 (Apr 25); 1(1):e1

HTML PDF XML Abstract

Background: Many patients share their personal experiences and opinions using online video platforms. These videos are watched by millions of health consumers and health care professionals. Although it has become a popular phenomenon, little is known about patients who share videos online and why they do so. Objective: We aimed to explore the motivations and challenges faced by patients who share videos about their health and experiences on YouTube. As part of a conference discussion, we...