Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2010 Sep-Oct;51(3-4):214-21.
doi: 10.1016/j.ypmed.2010.06.004. Epub 2010 Jun 15.

A meta-analysis of computer-tailored interventions for health behavior change

Paul Krebs  1 , James O Prochaska, Joseph S Rossi
Affiliations
Meta-Analysis

A meta-analysis of computer-tailored interventions for health behavior change

Paul Krebs et al. Prev Med. 2010 Sep-Oct.

Abstract

Objective: Computer-tailored interventions have become increasingly common for facilitating improvement in behaviors related to chronic disease and health promotion. A sufficient number of outcome studies from these interventions are now available to facilitate the quantitative analysis of effect sizes, permitting moderator analyses that were not possible with previous systematic reviews.

Method: The present study employs meta-analytic techniques to assess the mean effect for 88 computer-tailored interventions published between 1988 and 2009 focusing on four health behaviors: smoking cessation, physical activity, eating a healthy diet, and receiving regular mammography screening. Effect sizes were calculated using Hedges g. Study, tailoring, and demographic moderators were examined by analyzing between-group variance and meta-regression.

Results: Clinically and statistically significant overall effect sizes were found across each of the four behaviors. While effect sizes decreased after intervention completion, dynamically tailored interventions were found to have increased efficacy over time as compared with tailored interventions based on one assessment only. Study effects did not differ across communication channels nor decline when up to three behaviors were identified for intervention simultaneously.

Conclusion: This study demonstrates that computer-tailored interventions have the potential to improve health behaviors and suggests strategies that may lead to greater effectiveness of these techniques.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement James O. Prochaska is founder of and consultant to ProChange Behavior Systems, Inc., which develops and disseminates tailored interventions.

Figures

Figure 1
Figure 1
Trends in effect size over outcome time point
Figure 2
Figure 2
Trends in effect size over outcome time point by tailoring method
See this image and copyright information in PMC

Comment in

References

    1. Bauman A, Bull F, Chey T, Craig CL, Ainsworth BE, Sallis JF, Bowles HR, Hagstromer M, Sjostrom M, Pratt M, Díaz CG, Bazan N, Kunic H, Merom D, Smith B, De Bourdeaudhuij I, Lefevre J, Philippaerts R, Matsudo SM, Matsudo VR, Cameron C, Yang L, Hua F, Gómez LF, Fromel K, Mitas J, Macfarlane D, Bacon-Shone J, Reddy SK, Joshi P, Goenka S, Prabhakaran D, Katsumura T, Murase N, Volbekiene V, Baubliene R, McLean G, Carr H, Tomten H, Anderssen SA, Sardinha L, Mota J, Al-Hazzaa HM, Serra Majem L, Roman B, Sjöström M, Hagströmer M, Bergman P, Yiing ML, Yung-Tai H, Hipp D. The international prevalence study on physical activity: Results from 20 countries. Int J Behav Nutr Phys Act. 2009;6 - PMC - PubMed
    1. Biostat. Comprehensive meta-analysis. Englewood, NJ: 2006.
    1. Borenstein M, Hedges L, Higgins J, Rothstein H. Introduction to meta-analysis. Wiley; Chichester, UK: 2009.
    1. Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P. Extending the consort statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration. Ann Intern Med. 2008;148:295–309. - PubMed
    1. Breen N, Cronin KA, Meissner HI, Taplin SH, Tangka FK, Tiro JA, McNeel TS. Reported drop in mammography: Is this cause for concern? Cancer. 2007;109:2405–2409. - PubMed

Studies Included for Analysis

    1. Anderson ES, Winett RA, Wojcik JR, Winett SG, Bowden T. A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits and vegetables, self-efficacy and outcome expectations among food shoppers. Ann Behav Med. 2001;23:88–100. - PubMed
    1. Armitage CJ, Conner M. Efficacy of a minimal intervention to reduce fat intake. Soc Sci Med. 2001;52:1517–1524. - PubMed
    1. Ausems M, Mesters I, van Breukelen G, de Vries H. Effects of in-school and tailored out-of-school smoking prevention among Dutch vocational school students. Health Educ Res. 2004;19:51–63. - PubMed
    1. Aveyard P, Griffin C, Lawrence T, Cheng KK. A controlled trial of an expert system and self-help manual intervention based on the stages of change versus standard self-help materials in smoking cessation. Addiction. 2003;98:345–354. - PubMed
    1. Bastani R, Maxwell AE, Bradford C, Das IP, Yan KX. Tailored risk notification for women with a family history of breast cancer. Prev Med. 1999;29:355–364. - PubMed

References for Excluded Studies

    1. Blalock SJ, DeVellis BM, Patterson CC, Campbell MK, Orenstein DR, Dooley MA. Effects of an osteoporosis prevention program incorporating tailored educational materials. Am J Health Promot. 2002;16:146–156. - PubMed
    1. Brinberg D, Axelson ML. Increasing the consumption of dietary fiber: A decision theory analysis. Health Educ Res. 1990;5:409–420.
    1. Brinberg D, Axelson ML, Price S. Changing food knowledge, food choice, and dietary fiber consumption by using tailored messages. Appetite. 2000;35:35–43. - PubMed
    1. Brug J, van Assema P. Differences in use and impact of computer-tailored dietary fat-feedback according to stage of change and education. Appetite. 2000;34:285–293. - PubMed
    1. Brug J, Glanz K, Kok G. The relationship between self-efficacy, attitudes, intake compared to others, consumption, and stages of change related to fruit and vegetables. Am J Health Promot. 1997;12:25–30. - PubMed

Publication types