Internet interventions: Moving from efficacy to effectiveness

In this paper we consider the issues involved when transporting the promising results of internet interventions in efficacy trials to clinically representative settings (effectiveness). In addition, dissemination and the use of internet treatments in stepped care models will be discussed. While there have been numerous efficacy trials there are only a few effectiveness studies, and it is not clear if the distinction between efficacy and effectiveness can be applied, as internet interventions can take place both within a clinical setting and in a more large scale public health arena. A limitation of the existing efficacy trials is that participants are often recruited via mass media and that educational level and motivation are likely to differ from ordinary clinical settings. However, with respect to internet interventions aimed at clinical target groups, evidence from efficacy trials now support the further implementation of internet interventions in effectiveness trials.