Juliann Cortese

Computer-tailored health interventions delivered over the web: Review and analysis of key components

OBJECTIVE This systematic review explores how computer-tailored, behavioral interventions implemented and delivered via the Web have been operationalized in a variety of settings. METHODS Computer-tailored, online behavioral intervention studies published from 1996 to early 2007 were selected and reviewed by two independent coders. RESULTS Of 503 studies screened, 30 satisfied the selection criteria. The level of sophistication of these interventions varied from immediate risk/health assessment, tailored web content to full-blown customized health programs. The most common variables for tailoring content were health behaviors and stages of change. Message tailoring was achieved through a combination mechanisms including: feedback, personalization and adaptation. CONCLUSIONS Tailored, self-guided health interventions delivered via the Web to date have involved a great diversity of features and formats. While some programs have been relatively brief and simple, others have involved complex, theory-based tailoring with iterative assessment, tools for development of self-regulatory skills, and various mechanisms for providing feedback. PRACTICE IMPLICATIONS Our ability to fully optimize the use of computer-assisted tailoring will depend on the development of empirically based guidelines for tailoring across populations, health foci, health behaviors and situations. Further outcome research is needed to enhance our understanding of how and under what conditions computer-tailoring leads to positive health outcomes in online behavioral interventions.

A Meta-Analysis of Web-Delivered Tailored Health Behavior Change Interventions

Web-based tailored intervention programs show considerable promise in effecting health-promoting behaviors and improving health outcomes across a variety of medical conditions and patient populations. This meta-analysis compares the effects of tailored versus nontailored web-based interventions on health behaviors and explores the influence of key moderators on treatment outcomes. Forty experimental and quasi-experimental studies (N =20,180) met criteria for inclusion and were analyzed using meta-analytic procedures. The findings indicated that web-based tailored interventions effected significantly greater improvement in health outcomes as compared with control conditions both at posttesting, d =.139 (95% CI = .111, .166, p <.001, k =40) and at follow-up, d =.158 (95% CI = .124, .192, p <.001, k =21). The authors found no evidence of publication bias. These results provided further support for the differential benefits of tailored web-based interventions over nontailored approaches. Analysis of participant/descriptive, intervention, and methodological moderators shed some light on factors that may be important to the success of tailored interventions. Implications of these findings and directions for future research are discussed.

Uses and Gratifications of Television Home Shopping

The purpose of this study was to understand television shopping through examining media use motives. Based on the uses-and-gratifications (U&G) perspective, we examined how social/psychological antecedents (i.e., parasocial interaction and compulsive buying) and buying outcomes (i.e., buying frequency and impulse buying) relate to television-shopping viewing motives. Findings suggest that viewers watch television shopping because they want a convenient, time- and cost-effective way to shop and learn about products and want to be entertained. Factor analysis revealed two motive factors: TV Viewing Motives are associated with traditional U&G motive statements similar to those found in past studies, and Shopping Motives are those that reference motives associated with shopping. The host appeal dimension of parasocial interaction predicted both factors. Compulsive buying was a significant predictor of only the TV Viewing Motives factor. Those who purchased more items were motivated to watch by the shopping aspects of the medium. Compulsive buying was the only significant predictor of impulse buying. Those who made more planned purchases, however, watched because of the shopping aspects of the medium but not because of an interpersonal connection to the hosts.

Distributed knowledge in an online patient support community: Authority and discovery

Amyotrophic lateral sclerosis (ALS) is a progressively debilitating neurodegenerative condition that occurs in adulthood and targets the motor neurons. Social support is crucial to the well‐being and quality of life of people with unpredictable and incurable diseases such as ALS. Members of the PatientsLikeMe (PLM) ALS online support community share social support but also exchange and build distributed knowledge within their discussion forum. This qualitative analysis of 1,000 posts from the PLM ALS online discussion examines the social support within the PLM ALS online community and explores ways community members share and build knowledge. The analysis responds to 3 research questions: RQ1: How and why is knowledge shared among the distributed participants in the PLM‐ALS threaded discussion forum?; RQ2: How do the participants in the PLM‐ALS threaded discussion forum work together to discover knowledge about treatments and to keep knowledge discovered over time?; and RQ3: How do participants in the PLM‐ALS forum co‐create and treat authoritative knowledge from multiple sources including the medical literature, healthcare professionals, lived experiences of patients and “other” sources of information such as lay literature and alternative health providers? The findings have implications for supporting knowledge sharing and discovery in addition to social support for patients.

The Role of Social Presence in Opinion Expression During FtF and CMC Discussions

This study sought to examine the process of talk and opinion expression in face-to-face (FtF) and text-based, synchronous, computer-mediated communication (TBS-CMC) discussions. A model was tested in which it was proposed that communication environment and communication apprehension (CA) would affect perceived social presence, which would, in turn, be related to the amount of talk and opinion expression in discussions. An experimental design using an adult sample who engaged in real discussions revealed that the data were a good fit to the model. All hypotheses were supported in that those in the FtF condition experienced more social presence than those in TBS-CMC; those high in CA experienced less social presence than those low in CA; those who experienced high social presence talked more in the discussion than those who experienced low social presence; and those who experienced low social presence expressed more opinions than those who experienced high social presence.

Looking Back as We Prepare to Move Forward: US Presidential Candidates' Adoption of YouTube

As the United States prepares for the 2012 Presidential Election, we reflect on how the 2008 candidates and the voting public adopted social computing technology with specific focus on YouTube. Using the Social Influence Model as a framework, this article sought to examine how candidates adopted YouTube to determine what types of messages were disseminated via YouTube and what kind of response from viewers videos received. We conducted a content analysis of candidate YouTube sites, focusing on video characteristics and content. Findings indicate that the candidates did not use YouTube to its fullest extent and that there were significant differences between the candidates in terms of the types of videos posted and the content posted and that constituents did adopt the medium as demonstrated in viewership numbers and responses.