Rik Crutzen, Maastricht University, The Netherlands

Nowadays, people use the Internet all the time and for a wide range of activities: from buying groceries to showing a funny cat-picture to a friend on the other side of the world. It is all possible. Also, the Internet is used more and more within the domain of health – often referred to as e-health.

What is e-health?

‘E-health’ refers to health services and information delivered or enhanced through the Internet and related technologies. Within health psychology, e-health targets a wide range of lifestyle behaviours like, for example, being more physically active or quitting smoking. Based on an overview of the literature that has been around since the turn of the century, we can conclude that these Internet-delivered interventions can be effective. It is important, however, that the development process of these interventions is guided by available theory and evidence.

Advantages of Internet-delivered interventions

Using the Internet and related technologies can have several advantages. For example, people might feel more anonymous in comparison to interventions that are delivered face-to-face. This anonymity might be favourable for interventions regarding behaviours that might involve shame (e.g. condom use, or alcohol moderation). Additionally, interventions can make use of GPS satellite navigation to provide location-specific information about healthy nutrition options that are immediately available. Note, however, that both examples provided here should be seen as possibilities and do not imply that this is advantageous for all Internet-delivered interventions. They are only useful if it appears that lack of anonymity or availability of healthy nutrition options are indeed contributing to people behaving unhealthily. In other words, characteristics of the medium and the opportunities it offers should be seen as a tool, not a magic bullet.

Investigating intervention use

One advantage for all Internet-delivered interventions is that they provide the opportunity to investigate intervention use: for example, they can provide a detailed insight into where users either leave an intervention website or have come to a standstill. This can be used to adapt interventions to a user’s needs and increase exposure and probability of positive intervention outcomes. Furthermore, it provides insight into how intensively visitors use the intervention (e.g. frequency and duration) and what they are interested in (e.g. topics).

In conclusion

E-health interventions have certain characteristics that offer opportunities that can be very useful within the field of health psychology. However, it is not a magic bullet. Behaviour change is a complex process and we should rely on all the available theory and evidence-base to increase the likelihood of our interventions being effective – both online and offline.

Recommendations for practice:

• E-Health can be used as a tool to change behaviour. However, it is important to systematically develop Internet-delivered interventions, just like all other types of behaviour change interventions
• Do not use e-health just for the sake of it: characteristics of the medium and the opportunities that it offers should only be used purposefully; always think about why you wish to use a certain media and/or the opportunities it offers
• If you use e-health, investigate intervention use. This can help you to gain insight into how your intervention is used and at the same time can be used to improve your intervention.