The Science of Internet Interventions

Over the past decade, there has been an explosion in research focused on the development and evaluation of health-based treatment and prevention programs delivered via the Internet. A plethora of terms have been used to both categorize the related field (e.g., e-therapy, online treatment, Internet therapy, and interactive health communication), as well as the specific applications (e.g., web-based programs, Internet applications, and web systems). The programs or “Internet interventions,” as they are more apt to be called, typically target behavioral or mental health problems. Prior to these Internet-based programs, computer-based applications to change behavior or treat mental disorders had been created and tested intermittently during the previous two decades as computers were popularized. The breadth of literature on these systems, particularly those that utilize the Internet, has become quite substantive 1. Outcome trials of Internet interventions have consistently demonstrated greater symptom improvements or changes in behavior compared with controls, and for some problems, outcomes from Internet interventions rival those seen in face-to-face interventions. Hundreds of peer-reviewed papers have now been published in this area, most since the year 2000. There is already quite a number of review articles focused specifically on Internet intervention research. Some of these reviews are now older, highlighting early, but important findings in the field 2; some are systematic and fairly detailed 3; and some are large scale, comprehensive reviews 1, 4. There are many reviews focused on specific areas, such as pediatrics 5; physical activity 6; obesity 7; alcohol and tobacco use 8, 9; cardiac disease 10; depression and anxiety 11; and traumatic stress 12. There are also a surprising number of published meta-analyses for such a young field 13–15. The conclusion drawn from most reviews and metaanalyses is that Internet interventions yield positive treatment outcomes, symptom reduction, and improved quality of life. However, despite considerable attention devoted to Internet intervention research, there is remarkably little literature on the underlying science of the field. This special series aims to build the scientific foundation of Internet interventions and provide a structurally sound basis from which this field can continue to expand. While the outcome literature has helped establish Internet interventions as a viable and important prevention and treatment option, the papers here will focus on conceptual and methodological issues facing the field, including the development of definitions and categories to classify these interventions; a proposal of a model to guide creation and evaluation of Internet interventions; research and design challenges; and L. M. Ritterband (*) Department of Psychiatry and Neurobehavioral Sciences, Behavioral Health and Technology, University of Virginia Health System, P.O. Box 801075, Charlottesville, Virginia 22908, USA e-mail: LEER@virginia.edu