Abstract and Introduction
Abstract
Purpose of review The aim of this paper is to provide an updated review of recent controlled trials of Internet interventions for health conditions and how the Internet is used to promote health.
Recent findings We identified 18 published trials including studies on diabetes, cancer, pain conditions, obesity, irritable bowel syndrome, stress management, hypertension, metabolic syndrome, cerebral palsy, infertility, HIV infection, and fruit/vegetable consumption. Of the 18 trials, one-third targeted children and adolescents. Two cancer studies investigated the role of peer support in an online environment that failed to result in any major improvements. Overall, several trials did not result in any substantial significant improvements, but there are exceptions, such as treatment of irritable bowel syndrome, headache, and chronic pain. Although a few of the reviewed studies had sufficient sample sizes, the majority were small and underpowered. In particular, this was the case for the studies on children and adolescents.
Summary This review suggests that Internet interventions hold some promise as a complement to other treatments such as cognitive behavior therapy. The benefits from participating in online peer support groups are not clear. Although studies on children and adolescents have emerged, there is a lack of studies on older adults with health problems.
Introduction
The Internet is increasingly used to deliver treatment and promote health, both in clinical practice and in research. Defining Internet interventions is difficult, as several different approaches have been developed. However, most Internet interventions include text in the form of web pages (or downloadable pdf files) and interactive online features. Some programs also include video and audio files. Treatment length and content are often similar to previously developed face-to-face or bibliotherapy treatments, but increasingly Internet interventions use novel approaches, such as a video game format for children, or Internet support groups. Systematic reviews and meta-analyses indicate that guided self-help delivered via the Internet can result in positive outcomes for symptoms of anxiety, depression, and various health conditions. Indeed, there are controlled trials suggesting that guided Internet treatment can be as effective as face-to-face treatments, but so far comparative studies have mostly been in the field of anxiety disorders. In a systematic review on Internet-delivered cognitive behavior therapy for health conditions, the authors concluded that the studies they reviewed showed effects similar to those found in face-to-face treatments. However, the authors only include cognitive behavioral therapy (CBT) studies, and since the review several new controlled trials have been published. In this review we will cover the more recent research on the use of the Internet in the treatment of health conditions. Studies on psychiatric conditions will not be included in this review. The review will include studies on children and also non-CBT studies in which the effects of online peer support has been investigated.