Cameron Norman's critique [
comparatively equal effectiveness of Internet-based health interventions and intensive clinical treatment;
the methodological problem of assignment to a control condition;
high attrition at follow-up assessments.
As one of the authors of the original report I take this opportunity to respond to some of the design criticisms noted in the CATCH-IT report.
Our small pilot study was presented as a brief report; it was therefore limited in scope and not as detailed as a full manuscript. Several items such as randomization, mean time to follow-up, and measures collected (ie, other smoking strategies and cessation self-efficacy, and social support) could not be described in detail in a brief report.
Our report [
these results provide reason for further evaluations. ... However, given the lack of a control condition, we cannot conclude that quitting was a function of our Web site rather than other factors. Determining the relative contribution of a specific Web site presents difficult challenges, given that typical Internet users appear to sample various sites.
Therefore, an alternative treatment is only a click away, especially for a person seeking out a website for help in smoking cessation. We surmised that given the nature of the Internet, any assignment to a control condition would be futile. Additionally, the welcoming anonymity of the Internet combined with the transitory nature of email addresses makes follow-up difficult. Unless this methodological problem can be addressed by Internet health researchers, a true randomized trial on the open Internet is untenable and definitive results will remain elusive [
The CATCH-IT author states that no reference was made to a specific theoretical model for the intervention, while noting that our brief report did cite Lichtenstein and Glasgow [
The amount of intervention exposure (dose) was assessed and measured for each participant through the use of a fairly standard tracking system for an Internet-based intervention, namely, the number of log-ins. Our brief report [
The Web site recorded 24 252 logins (i.e., instances when a participant used a username and password to gain access to the Web site), with an average of 108 logins per day. … Most activity occurred immediately after completion of baseline assessment and on weekdays. … Considerable variation in the number of logins was noted, with 10% of the participants accounting for 79% of logins. … While the gender differences and participation rates might indicate trends, these results were not statistically significant.
The CATCH-IT author was concerned with the lack of biochemical verification of self-reported abstinence in the context of a “remotely-delivered intervention.” [
Overall, this particular CATCH-IT report (and - hopefully - future CATCH-IT reports in this new series in the