On Monday, a quick post was made in response to Esther Dyson’s question to me: “Is there any quantifiable evidence on the efficacy of Web-based tools to modify health-related behaviors.” Chilmark received a significant amount of comments to that post and our thanks goes out to one and all who have contributed.

Now, in appreciation and thanks, Chilmark went out and looked at a number of the links provided in those comments as well as doing a little research on our own.  The result is the following list of papers that are most representative of some of the trends in this research area.

By no means is this list meant to be all inclusive as there is a significant body of literature/research on the subject.  If you have personal favorites that address the question at hand (quantifiable results of efficacy of behavioral change through use of web-based tools), by all means, add them to the comments section and ideally, follow the same format we have provided here.

The Next Step: Achieving Health Behavior Change Through Technology. Pub. 2008. A Geisinger study that attempted to look at efficacy of a web-based behavior change app (by HealthMedia, Inc.) offered to patients with chronic disease.  Project basically failed, but did point out that having patients use the Geisinger PHR, MyGeisinger, does not automatically translate to use of specific behavioral change apps offered by Geisinger.

Why are Health Care Interventions Delivered Over the Internet? A Systematic Review of the Published Literature. Pub. 2006.  A systematic review out of the UK that looks at 37 interventions (research papers) published between 1990-2003 (hmm, pretty dated) on the use of the Internet for healthcare interventions.  Found that there may be risks to such approaches if one assumes that web-based tools replace face-to-face interactions.  Also looks like they found the research to be highly variable in reporting, thus difficut to draw substantive conclusions.

Rates and Determinants of Repeated Participation in a Web-Based Behavior Change Program for Healthy Body Weight and Healthy Lifestyle. Pub. 2007  Study out of Amsterdam, begun in 2004, that infers it is difficult to get engagement, though did see a glimmer of hope among the obese (non-stigmatizing way Internet allows them to address their weight problem).

A Field Test of a Web-Based Workplace Health Promotion Program to Improve Dietary Practices, Reduce Stress, and Increase Physical Activity: Randomized Controlled Trial. Pub. 2004.  Comparison of paper-based vs. web-based methods to address nutrition, diet, stress and physical activity.  For the most part, no difference in efficacy found between traditional and web-based methods.

The Effectiveness of Web-Based vs. Non-Web-Based Interventions: A Meta-Analysis of Behavioral Change Outcomes. Pub. 2004.  Another review/aggregation of various research studies.  There seem to be a ton of these types of reports out there. Across the mulitple studies reviewed (aggregate ~12,000 participants) they investigators claim that web-based tools are proving effective in changing behaviors.

Computer-Tailored Physical Activity Behavior Change Interventions Targeting Adults: A Systematic Review. Pub. 2009. Yet another review, this one from Australia, of previously reported research on efficacy of web-based tools in support of behavioral change for exercise and diet.  Their conclusion: more research needed as evidence is promising, but inconclusive.

Effectiveness of a Novel Integrative Online Treatment for Depression (Deprexis): Randomized Controlled Trial. Pub. 2009.  Research paper out of Germany that found significant improvements in both severity of depressive episodes and social functioning through use of web-based intervention tools.

Note: Now, they are a number of comments in that previous post that reference other activities (e.g., a West Virginia eHealth initiative or the Nike/iPod article in Wired) but these do not answer the original question of seeking quantifiable data on eHealth’s efficacy, thus not included here.