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      Content and Functionality of Alcohol and Other Drug Websites: Results of an Online Survey

      , DPsych (Clinical) , 1 , , PhD 2 , , PhD 3 , , MPsych (Health) 1 , , PhD 4 , 5 , , PhD 6 , , PhD 7 , , PhD 2 , , MPsych (Clinical) PhD 5 , , PhD 3

      (Reviewer), (Reviewer), (Reviewer)

      Journal of Medical Internet Research

      Gunther Eysenbach

      Alcohol, drugs, Internet, online survey, stress, health, website interactivity, website trustworthiness, Web-based interventions

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          Abstract

          Background

          There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood.

          Objective

          To investigate content and functionality preferences for AOD and other health websites.

          Methods

          An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences.

          Results

          Surveys were obtained from 1214 drug ( n = 766) and alcohol website users ( n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (χ² 2 = 15.8, P < .001, n = 985); prevention programs (χ² 2 = 27.5, P < .001, n = 981); tracking functions (χ² 2 = 11.5, P = .003, n = 983); self help treatment programs (χ² 2 = 8.3, P = .02, n = 984); downloadable fact sheets for friends (χ² 2 = 11.6, P = .003, n = 981); or family (χ² 2 = 12.7, P = .002, n = 983). The most preferred online treatment option for both the user groups was an Internet site with email therapist support. Explorations of demographic differences were also performed. While gender did not affect survey responses, younger respondents were more likely to value interactive and social networking features, whereas downloading of credible information was most highly valued by older respondents.

          Conclusions

          Significant deficiencies in the provision of accessible information on AOD websites were identified, an important problem since information seeking was the most common reason for accessing these websites, and, therefore, may be a key avenue for engaging website users in behaviour change. The few differences between AOD website users suggested that both types of websites may have similar features, although alcohol website users may more readily be engaged in screening, prevention and self-help programs, tracking change, and may value fact sheets more highly. While the sociodemographic differences require replication and clarification, these differences support the notion that the design and features of AOD websites should target specific audiences to have maximal impact.

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          Most cited references 24

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          How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews.

          To describe techniques for retrieval and appraisal used by consumers when they search for health information on the internet. Qualitative study using focus groups, naturalistic observation of consumers searching the world wide web in a usability laboratory, and in-depth interviews. A total of 21 users of the internet participated in three focus group sessions. 17 participants were given a series of health questions and observed in a usability laboratory setting while retrieving health information from the web; this was followed by in-depth interviews. Heidelberg, Germany. Although their search technique was often suboptimal, internet users successfully found health information to answer questions in an average of 5 minutes 42 seconds (median 4 minutes 18 seconds) per question. Participants in focus groups said that when assessing the credibility of a website they primarily looked for the source, a professional design, a scientific or official touch, language, and ease of use. However, in the observational study, no participants checked any "about us" sections of websites, disclaimers, or disclosure statements. In the post-search interviews, it emerged that very few participants had noticed and remembered which websites they had retrieved information from. Further observational studies are needed to design and evaluate educational and technological innovations for guiding consumers to high quality health information on the web.
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            The Information Architecture of Behavior Change Websites

            The extraordinary growth in Internet use offers researchers important new opportunities to identify and test new ways to deliver effective behavior change programs. The information architecture (IA)—the structure of website information—is an important but often overlooked factor to consider when adapting behavioral strategies developed in office-based settings for Web delivery. Using examples and relevant perspectives from multiple disciplines, we describe a continuum of website IA designs ranging from a matrix design to the tunnel design. The free-form matrix IA design allows users free rein to use multiple hyperlinks to explore available content according to their idiosyncratic interests. The more directive tunnel IA design (commonly used in e-learning courses) guides users step-by-step through a series of Web pages that are arranged in a particular order to improve the chances of achieving a goal that is measurable and consistent. Other IA designs are also discussed, including hierarchical IA and hybrid IA designs. In the hierarchical IA design, program content is arranged in a top-down manner, which helps the user find content of interest. The more complex hybrid IA design incorporates some combination of components that use matrix, tunnel, and/or hierarchical IA designs. Each of these IA designs is discussed in terms of usability, participant engagement, and program tailoring, as well as how they might best be matched with different behavior change goals (using Web-based smoking cessation interventions as examples). Our presentation underscores the role of considering and clearly reporting the use of IA designs when creating effective Web-based interventions. We also encourage the adoption of a multidisciplinary perspective as we move towards a more mature view of Internet intervention research.
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              Evaluation of an internet-based physical activity intervention: a preliminary investigation.

              The Internet has the potential for delivering innovative, interactive physical activity (PA) interventions to large numbers of people. This study was designed to test the efficacy of an Internet intervention that consisted of a Web site plus 12 weekly e-mail tip sheets, compared with a waiting list control group. The Internet intervention was theory based and emphasized clear, graphical presentation of PA information. Sixty-five (30 intervention and 35 control) sedentary adult employees of several large hospitals (9 men and 56 women) were randomly assigned to 1 of the 2 study arms. Of the 65 participants, 57 completed the 1-month follow-up, and 52 completed the 3-month follow-up. At both 1 and 3 months, those in the intervention group were significantly more likely to have progressed in stage of motivational readiness for PA than participants in the control group: 1 month, c2(1, N =52) =4.05, p <.05; 3 months, c2(1, N =52) =6.45, p <.01. We hypothesized that at 1 and 3 months, the intervention group would exhibit significant increases relative to the control group on the number of minutes of moderate activity. At the 1-month assessment, the intervention group did exhibit significant increases, relative to the control group in moderate minutes, F(1, 54) =5.79, p <.05; however, at the 3-month assessment this difference was no longer significant. In addition, secondary analyses were conducted to examine total number of minutes of walking reported. At 1 month, the intervention group did exhibit significant increases, relative to the control group, in walking minutes, F(1, 54) =12.1, p <.001. At the 3-month assessment, amount of time spent in walking activity continued to be significantly higher for the intervention group compared with the control group, F(1, 48) =5.2, p <.05. These findings show that a theoretically based PA Web site and weekly e-mail tip sheets can have a short-term impact on PA motivation and behavior both at 1 and 3 months. As Internet access increases, and as bandwidth and other technical attributes of this medium improve, Web site delivered health behavior interventions will become increasingly useful in public health promotion.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                1438-8871
                Oct-Dec 2010
                19 December 2010
                : 12
                : 5
                Affiliations
                7simpleSchool of Advertising, Marketing and Public Relations simpleFaculty of Business simpleQueensland University of Technology BrisbaneAustralia
                6simpleBlackDog Institute & School of Psychiatry simpleUniversity of New South Wales SydneyAustralia
                5simpleCentre for Brain and Mental Health Research simpleFaculty of Health simpleUniversity of Newcastle NewcastleAustralia
                4simpleNational Drug and Alcohol Research Centre simpleUniversity of New South Wales SydneyAustralia
                3simpleInstitute of Health and Biomedical Innovation simpleSchool of Psychology and Counselling simpleQueensland University of Technology BrisbaneAustralia
                2simpleCentre for Youth Substance Abuse Research simpleFaculty of Health Sciences simpleUniversity of Queensland BrisbaneAustralia
                1simpleNational eTherapy Centre simpleFaculty of Life and Social Sciences simpleSwinburne University MelbourneAustralia
                Article
                v12i5e51
                10.2196/jmir.1449
                3057306
                21169168
                ©Britt Klein, Angela White, David Kavanagh, Kerrie Shandley, Frances Kay-Lambkin, Judith Proudfoot, Judy Drennan, Jason Connor, Amanda Baker, Ross Young. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.12.2010  

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

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