Evidence Table 8

Description of RCTs addressing KQ1b (impact of CHI applications on intermediate outcomes)

Author, yearConsumer under studyCHI Application typeLocationYear data collected/duration of interventionInclusion criteriaExclusion criteriaControlInterventionJadad score
Diet/exercise/physical activity NOT obesity
Adachi, 20071Individuals interested in their own health careTailored advice based on answers to a Computerized questionnaireHome/residence2002/January to September20–65 yr, BMI greater ≥24, BMI greater ≥ 23 with mild Hypertension, Hyperlipidemia, or DMBMI ≥30, history of major medical or psychiatric problems or orthopedic problems that prohibited exercise, received a diet and/or exercise program within 6 months, currently/previously/planned to be pregnant within 6 monthsUntailored self-help booklet with 7-month self monitoring of weight and walking;
Self-help booklet only
Computerized behavioral weight control program with 6-month weight and targeted behavior’s self-monitoring; computerized behavioral weight control program only 0
Anderson, 20012Consumers interested in their own healthInteractive computer based programKiosk based computers located in supermarketsNSNSNSNo intervention- control conditionComputerized nutrition intervention
Brug, 19983General public interested in their own healthComputer-generated feedback lettersHome basedNSNSNSGeneral InformationTailored Feedback; Tailored + Iterative Feedback
Brug, 19994Individuals interested in their own healthComputer-tailored nutrition educationComputer based; otherwise non-specifiedNSNSNSFirst intervention (comparison group) provided subjects with personal letters with tailored dietary feedback about fat, fruit and vegetables onlyThe second intervention (experimental group), tailored letters with dietary feedback was supplemented by feedback about personal outcome expectancies, perceived social influences and self-efficacy expectations
Campbell 19945Adult patients from four North Carolina family practicesindividually computer-tailored nutrition messagesHome basedBetween September and November 1991Office staff recruited participants as they checked in for any type of medical appointment.patients who were too ill or mentally unable to complete the baseline surveyMessages were mailed to participantsAn intervention group, which received tailored nutrition messages; a comparison intervention group, which received nontailored nutrition messages; The tailored intervention consisted of a one-time, mailed nutrition information packet tailored to the participant's stage of change, dietary intake, and psychosocial information.
Campbell, 19996Low income women enrolled in the Food Stamp programInteractive computer based programFacility based (food stamp office)January through April, 199518 years of age or older, spoke English and either had children under 18 living at home or were pregnantNSNo InterventionComputer-based intervention consisted of a tailored soap opera and interactive ‘info-mercials’ that provided individualized feedback about dietary fat intake, knowledge and strategies for lowering fat based on stage of change
Campbell, 20047Participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC)CDROM programClinic-basedNSBeing at least 18 years of age, receiving WIC benefits for self or child(ren), and speaking and understanding English. For those women who were pregnant or breast-feeding, it was required that they have at least one prior nutrition session with a WIC nutritionist before being referred to the computer programWomen deemed as high risk by the nutritionist (eg, owing to pregnancy complications) were excluded from the study because of the probable need for more intensive counseling and follow-up.Control group completed the surveys but did not receive the intervention until after follow-upInteractive tailored nutrition education
Haerens, 20058Middle school adolescents)Computer-tailored feedbackSchool basedMeasures were assessed at the beginning (September 2003) and repeated at the end of the school year (June 2004).NSNSNo interventionIntervention with parental support and intervention alone
Haerens, 20079Individuals interested in their own health care (students in randomly selected 7th grade class)Interactive computer-tailored interventionRemote location: schoolYear, 2005 (November)/50 minute intervention with 3 month follow up7th grade students, parental consentNo intervention50-min class (in 7th grade) using the computer tailored dietary fat intake intervention 0
Haerens, 200910Adolescent populationWeb-based computer tailored interventionHome BasedFebruary–March 2007NSNSGeneric feedback letterTailored Feedback letter
Hurling, 200611Individuals interested in their own healthInternet-based exercise motivation and action support system (Test system)Computer based; otherwise non-specifiedNSNStaking of prescription medication, known heart conditions or related symptoms and receipt of advice from a health professional not to engage in physical activity or exerciseNon-interactive Internet-based physical activity system)Interactive Internet-based physical activity system)
Hurling, 200712Individuals interested in their own health careInternet and mobile phone for self reported physical activityHome/residenceDuration, 3 month, September to December, 2005.30–55 yr, Body mass index 19–30, Not vigorously active, Not taking regular prescription medication, Internet and e-mail access, Mobile phone userEmployee of Unilever, 1 or more items on the PAR-Q, 1 or more items on the Rose Angina QuestionnaireNo interventionInternet and mobile phone based intervention 2
King, 200613people with type 2 diabetesInteractive CDROMFacility basedNSAt least 25 years old; diagnosed with type 2 diabetes for 6 months or more; able to read and write in English; and able to perform moderate level PANSgeneric health risk appraisal CD-ROMInteractive CD-ROM
Kristal, 200014Enrollees of a large health maintenance organizationComputer-generated personalized letter and computer generated behavioral feedbackHome-basedNSGHC enrollment, age (18–69) and an ability to complete the baseline survey in English.Living outside of area or no longer enrolled in GHCUsual Care Group (no intervention)Tailored, Self-Help Dietary Intervention
Lewis, 200815Sedentary adults interested in their own healthWeb-based computer-tailored FeedbackComputer/Home basedJanuary 2003 through May 2006NSNSStandard InternetMotivationally-Tailored Internet
Low, 200616Individuals interested in their own health careInteractive consumer website (Student Bodies,NS2001(F) first or second year college, northeast private, liberal arts collegeWomen with previous diagnosis of eating disorders or who were currently purging,ControlStudent Bodies with moderated discussion, Student Bodies with un-moderated discussion, Student Bodies with no discussion 2
Mangunkusumo, 200717Individuals interested in their own health care: student--with parental consentInternet siteRemote location (e.g. library internet cafe); at a secondary schoolNSSecondary school students of the same gradePreprinted generic advice on fruit consumption and a mailed referral where applicable after baseline assessmentTailored feedback on fruit consumption and an online referral where applicable after baseline assessment 1
Marcus, 200718Individuals interested in their own health careInteractive consumer websiteHome/residence15 Jan 2003 through 6 June 2006≥18 yr, sedentary (<90 minutes of physical activity each week)History of coronary or valvular heart disease, Hypertension, Diabetes mellitus, chronic obstructive pulmonary disease, stroke, osteoarthritis, orthopedic problems that would limit treadmill testing, or any other serious medical condition that would make physical activity unsafe or unwise, consuming 3 or more alcoholic drinks per day on 5 or more days of the week, Current or planned pregnancy, planning to move from the area within the next year, current suicidal ideation or psychosis, current clinical depression and/or hospitalization because of a psychiatric disorder in the past 6 months, current clinical depression and/or hospitalization because of a psychiatric disorder in the past 6 months, taking medication that may impair physical activity tolerance or performance , and/or previous participation in exercise trials of authorsTailored print,
Tailored internet,
Standard internet
Napolitano, 200319Individuals interested in their own health careInteractive consumer websiteHome/residence, Remote location: work place12 weeks18–65 years old, 120 minutes or less of moderate intensity physical activity per week, 60 minutes or less of vigorous intensity physical activity per weekCoronary artery disease, Stroke, Alcoholism or substance abuse, Hospitalization for a psychiatric disorder in the last 3 years, Currently suicidal or psychotic, Orthopedic problems that could limit exercise, and current or planned pregnancyWait list control groupInternet web site plus weekly email tip sheets 0
Oenema, 200120Individuals interested in their own health careInteractive consumer website,Classroom or office of adult education institutes (sites of recruitment)NSInsufficient understanding of DutchNon-tailored nutrition information letterReceived we-based tailored nutrition education program 0
Richardson, 2007 21Sedentary adults with type II DiabetesEnhanced pedometers with embedded USB ports, uploaded detailed, time-stamped step-count data to a website called Stepping Up to Health; and received automated step-count feedback, automatically calculated goals, and tailored motivational messagesHome/residenceNSAt least 18 years of age and had type 2 diabetes. Eligible participants also reported regular e-mail use, and had access to an Internet-connected computer with a Windows 2000 or XP operating system and an available USB.
Participants also had to be able to communicate in English, provide written consent, and obtain medical clearance to start a walking program from a primary care physician, endocrinologist, or cardiologist.
If they had used a pedometer in the past 30 days or were pregnant.Participants randomized to receive LG were instructed to focus on total accumulated steps.Participants randomized to receive SG were instructed to focus on bout steps. They were encouraged to set their pedometer to display bout steps (labeled aerobic steps on the Omron pedometers), and they were assigned weekly automatically calculated bout steps goals based only on bout-step data uploaded from the previous week.
Smeets, 200722Individuals interested in their own health careTailored newsletter computer generated based on information about the IndividualsHome/residence15 months18–65 yr,Control group receiving one general information letterIntervention group, receiving one tailored letter -1
Spittaels, 200723Healthy adults interested in their own healthWeb basedHome basedNS20 and 55 years of age, had no history of cardiovascular diseases, and had access to the InternetNSNo interventionwebsite-delivered physical activity intervention –with or without computer tailored feedback
Spittaels, 200724Individuals interested in their own health careInteractive consumer websiteWorkNS25–55 yr, internet access at home or workHistory of cardiovascular diseaseOnline non-tailored standard physical activity adviceOnline tailored physical activity advice + email,
Online tailored physical activity advice only
Tan, 200525Individuals interested in their own health careInteractive consumer websiteHome/residence,
Remote location: work place,
NS18–65 yr, Command of Dutch language, Access to computer with a CD-ROMNo informationTailored information,
Generic information
Vandelanotte, 200526Individuals interested in their own health careInteractive computer-tailored interventionUniversity computer labNS20–60 yrComplaints related to physical activity, Complaints related to fat intake (cardiovascular disease, diabetes, anorexia, problems with stomach, liver, gallbladder or intestine)Tailored physical activity and fat intake Interventions after 6 month FUTailored physical activity and fat intake intervention at baseline,
Tailored physical activity intervention at baseline and tailored fat intake intervention at 3 months, Tailored fat intake at baseline, and tailored physical activity at 3 months
Verheijden, 200427Individuals interested in their own health careInteractive consumer websiteHome/residenceDuration, Baseline collected between September 2002 to December 2002 with 8 month follow upGreater than or equal to 40 years old, Diabetes mellitus type 2, Hypertension, DyslipidemiaNo internet accessUsual careUsual care plus web-based nutrition counseling and social support program 0
Wylie-Rosett, 200128Individuals (BMI > 25 kg/m2) in a freestanding health maintenance organizationComputerized tailoringKiosk basedNSBMI > 25 kg/m2+ one cardiovascular risk factorIntention to move beyond commuting distanceWork book onlyComputer tailored feedback; computer tailored feedback plus staff consultation
Eating disorder
Winzelberg, 200029Individuals interested in their own health careInteractive consumer websiteHome/residenceNS(F), West coast public university students
Desire to improve body image satisfaction
History of Bulimia or anorexia, currently engaged in purging activities, BMI below 18No interventionInteractive consumer web site 0
Nutrition intervention
Bruge, 199630Individuals interested in their own health careInteractive consumer websiteNSNSEmployees of Royal Shell laboratory in Amsterdam, NetherlandsNon-tailored group; general nutrition informationTailored group; computer generated feedback letters 2
Silk, 200831Individuals interested in their own health care
Mothers or pregnant
Interactive consumer websiteHome/residence,
Remote location: community agency or extension service office
2 weeks18–50 years, (F), one or more children or pregnant, poverty (yearly income less than or equal to 185% of the federal poverty indexPamphletWebsite
Video Game
Overweight and binge eating
Jones, 200832Individuals interested in their own health careInteractive consumer websiteNS2005; 16 weeks≥85th percentile for age-adjusted BMI, binge eating or overeating behaviors at a frequency of ≥1 times per week in the previous 3 months, access to a computer and the Internet, not currently enrolled in a formal binge eating or weight loss program (eg, Weight Watchers), absence of any medical condition in which the actual condition or treatment affects weight and/or appetite, absence of anorexia nervosa and bulimia nervosaWait list control groupSB2-BED 1

NS = not specified, yr = year

Reference List


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From: Appendix G

Cover of Impact of Consumer Health Informatics Applications
Impact of Consumer Health Informatics Applications.
Evidence Reports/Technology Assessments, No. 188.
Gibbons MC, Wilson RF, Samal L, et al.

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