| Author | Cond/ IHCA | Country | Methods | PPT Characteristics | Follow Up Rate | Details of IHCA | Intervention Group | Control Group | Outcome Measures* |
| | | | | | | | | * Outcome measures in capitals were selected for data synthesis. |
| Andrewes 1996 | Eating Disorder / DIET | Australia | RCT, 2 arms: intervention versus control | 54 patients with Diagnostic and Statistical Manual (3rd ed., rev.) (DSM‐III‐R) diagnosed eating disorders: 14 with anorexia, 9 with bulimia, 4 with both in each group. Mean age 22 years. Intervention group n = 27, control group n = 27. | 54/54 = 100% | A computer based psychoeducation programme containing 11 information modules about eating disorders plus personal stories. | Completed the DIET programme twice in a healthcare setting with an interval of 7 days between the 1st and 2nd sessions. | Non‐directional computer based counselling programme | Eating Disorders Attitude Questionnaire, EATING DISORDERS KNOWLEDGE QUESTIONNAIRE, evaluation of computer programme |
| Bartholomew 2000 | Asthma / Watch Discover Think Act ( WDTA) | USA | RCT, 2 arms: intervention versus control | 171 children with asthma and their primary caregivers, recruited from inner‐city asthma clinics. 112 males, 59 females; mean age 10.9 years (range 7 to 17 years); 42% Hispanic, 53% African‐American. Of the 133 children who completed the study the intervention group n = 70, control group n = 63. | 133 / 171 = 78%. No information about distribution of dropouts. | An interactive multimedia computer game delivered via CD‐ROM, provides tailored information on asthma self‐management for children with asthma. The programme game functions incorporate decision support and behaviour change support. It utilises text, graphics, animation, sound, video clips. Data input = child's personal asthma symptoms, environmental triggers, medications, PEFR. | Played the game during scheduled visits to asthma or community pediatric clinics. Participation time in the study was from 4 to 15.6 months, mean = 7.6 months. | Received no intervention. | CHILD KNOWLEGE OF ASTHMA, CHILD SELF MANAGEMENT, CHILD SELF EFFICACY, symptoms, FUNCTIONAL STATUS and HOSPITALISATION/ ER VISITS |
| Brennan 1995 | Alzhemier's disease / ComputerLink | USA | RCT, 2 arms: intervention versus control | 102 caregivers with primary responsibility for a person with Alzheimer's disease. Intervention group n = 51, control group n = 51; 67% female; 72% white participants; median age = 64 years; education = completed high school. | 96 / 102 = 94%. 4 dropouts in intervention group; 2 in comparison group. | A specialised computer network, ComputerLink. ComputerLink provides factual information in the form of an electronic encyclopaedia and peer and decision support via online discussion groups and self defined decision problem analysis. | Received in‐home access to ComputerLink via a provided computer link for 12 months. | Received a monthly telephone call. | Decision confidence, decision‐making skill, SOCIAL ISOLATION, DEPRESSION, ECONOMIC ANALYSIS |
| Brennan 1998 | AIDS & HIV / ComputerLink | USA | RCT, 2 arms: intervention versus control | 57 people living with AIDS. Mean age = 33 years; 93% male; 61% white participants; 34% working; mean years of education = 13.5. Intervention group n = 31, control group n = 26 | 48 / 57 = 84%. 6 dropouts from intervention group; 3 from control group. | A specialised computer network , ComputerLink ComputerLink provides information in the form of an electronic encyclopaedia. Peer support and decIsion support is provided via online discussion groups and a decision support system based on decision modelling. | Received in‐home access to ComputerLink via a provided computer terminal for 6 months. | Received printed brochures and a monthly telephone call to maintain contact with research staff. | Decision making skill, decision confidence, SOCIAL ISOLATION, DEPRESSION, PATIENT HEALTH STATUS |
| Brown 1997 | Diabetes / Packy and Marlon | USA | RCT, 2 arms: intervention versus control | 59 children with Diabetes Mellitus, aged 8 to 16, recruited from two paediatric endocrinology outpatient clinics. Intervention group n = 31, control group n = 28 | Not stated specifically; results tables suggest 100% follow up. | Interactive computer programme in video game format. The game follows the adventures of two adolescent elephant friends at diabetes summer camp facing threats to their well‐being. Information about self‐care is provided in the form of multiple choice quizzes and behaviour change support is provided through role playing within the game ‐ the characters must engage in specific behaviours to stay healthy. The ability of two players to interact within the camp helps facilitate peer support. | Received in‐home access to a video game system and the video game Packy and Marlon to play on it for a period of 6 months. | Received in‐home access to a video game system and an entertainment video game to play on it for a period of 6 months. | Enjoyment of game scale, SELF EFFICACY MEASURE, SOCIAL SUPPORT, KNOWLEDGE SCORE, DIABETES SELF‐CARE RATING SCALE, HBA1C, NUMBER OF URGENT CARE VISITS |
| Dragone 2002 | Cancer / Kidz with Leukemia | USA | RCT, 2 arms: intervention versus control | 41 children aged 4 to 11 with acute lymphoblastic leukaemia or acute myeloid leukaemia in first remission. 41 children recruited, 31 completed study, (14 x 4 to 6 year olds; 17 x 7 to 11 year olds); 25/31 white, 3/31 Latino; 1/31 African American; 1 / 31 Asian; 1/31 Other. Of the 31 children completing the study the intervention group n = 15, control group n= 16 | 31/41 = 76% | An interactive CD‐ROM, delivered via compute to educate children with leukaemia. Information is provided on areas such as treatment, tests, blood cells, anatomy physiology and expert explanations . Behaviour change support is provided with in the Help Yourself module. Miscellaneous topics include sibling view of leukaemia, living with leukaemia. | Received CD‐ROM to use for a 3 month period. Participants could access the CDROM only if they already had a computer at home or had access to one at school or elsewhere . | Received conventional leukaemia information in book format. | Health locus of control, LEUKAEMIA EVENT KNOWLEDGE INTERVIEW, satisfaction and use of computer questionnaires (children and parents) |
| Glasgow 2003 | Diabetes / D‐NET 2003 | USA | RCT, 4 arms (control; coach; social support; social support + coach)
For the purpose of systematic review the comparison used = control (information only) vs information + social support. | 320 adults with Type II Diabetes Mellitus. 47% male; mean age 59 (SD 9.2 years); 83% had no or very limited Internet experience; mean time since diagnosis 8 years. | 264/320 = 82%; 'n' in each arm of trial and follow up numbers by group is not presented. An overall follow up rate of 82% is reported by authors with no significant difference between groups reported. Assuming equal numbers were assigned to each group with an 82 % follow up rate = 80 x 82% = 66 completers per trial arm. | A computer system giving in home access via a providing Internet connection to electronic information on diabetes. Additional modules contain peer support and behaviour change support. | Received information + e‐mail forum (Diabetes Support Conference ‐ peer led but professionally mediated) and some e‐mail focus forums. Home access for 10 months. | Received computer access to electronic articles providing information only about medical, nutritional and lifestyle aspects of diabetes. | DIABETES SUPPORT SCALE, Kristal ffb scale, grams daily fat, AVERAGE MINUTES PER DAY OF PHYSICAL ACTIVITY, CENTRE FOR EPIDEMIOLOGICAL STUDIES ‐ DEPRESSION SCALE, lipid ratio, HBA1C, block nci fat screener |
| Gorman 1995 | Urinary Incontinence / UICS | USA | RCT, 3 arms: UICS versus booklet (AHCPR patient guideline with handout) vs. control. For purposes of systematic review, UICS is compared with control. | 60 ambulatory, alert community dwelling women with urinary incontinence defined as accidental urine loss at least twice a week. Mean age = 55, Intervention (UICS) group n = 22, booklet group n= 18, control group n = 20. | 60 / 60 = 100% | Computer based expert interactive system containing information about urinary incontinence. Behavioural support provided through bladder training and pelvic muscle exercises. | Used the expert system at a single session arranged by research staff. | Watched a general health video. | EPISODES OF URINARY INCONTINENCE, Incontinence Impact on Life Questionnaire |
| Guendelman 2002 | Asthma / Health Buddy | USA | RCT, 2 arms: intervention versus control | 134 children with asthma, recruited from primary care clinic; aged 8 to 16 years, 57% male; 76% African‐American; 93% public insurance. Intervention group n = 66, control group n = 68. | 128 / 134 = 96% at 6 weeks; 120/134 = 90% at 12 weeks. Dropouts equally distributed between groups. | A personal, interactive computer programme linked to a secure web site. The programme gives information on asthma via core questions, asthma facts and trivia functions. Behaviour change support is provided immediate feedback giving praise or encourage on answers to questions on asthma self management. query clinical outcome | Accessed the programme at home via a provided telecommunications device for a period of 90 days. | Used a standard asthma diary. | LIMITATION IN ACTIVITY, pefr:50‐80% or <50% of personal best, asthma symptoms, missed school days, functional status, URGENT CALLS TO HOSPITAL, VISITS TO ER, HOSPITALISATION, TAKES ASTHMA MEDICATION WITHOUT REMINDER, reminded to use Health Buddy |
| Gustafson 1999 | AIDS & HIV / CHESS | USA | RCT, 2 arms: CHESS versus control | 204 HIV‐positive patients; 90% male; 84% white participants; 65% experiencing HIV‐related symptoms; average education = some college. Intervention group n = 107, control n = 97. | 183/204 = 90% (92% in control group; 88% in intervention). | A computer based health support system which provides breast cancer patients with information on their illness via functions such as question and answer facilities and the instant library. Decision support is provided via a decision aid service and peer support via online discussion groups. Behaviour support is delivered in the form of assessment and action plan facilities. | Received in‐home access to CHESS via a provided PC for either 6 (1st cohort) or 3 months (2nd and 3rd cohorts). | Received usual care only. | Cognitive function, negative emotions, DEPRESSION‐MOS SUBSCALE, PHYSICAL FUNCTION, active life, energy, SOCIAL SUPPORT, PARTICIPATION IN HEALTH CARE, USE OF AMBULATORY CARE SERVICES AND HOPITALISATION |
| Gustafson 2001 | Cancer / CHESS | USA | RCT, 2 arms: intervention versus control | 295 women with newly diagnosed breast cancer, under age 60. Mean age 44.4 years; 74% white participants; 85% private insurance. Intervention group n = 147, control group n= 148. | 246 / 295 = 83% (84% in control group; 82% in intervention group). | A computer based health support system which provides HIV‐positive patients with information on their illness via functions such as question and answer facilities and the instant library. Decision support is provided via a decision aid service and peer support via online discussion groups. Behaviour support is delivered in the form of health plan, assessment and action plan facilities. | Received in‐home access to CHESS via a provided PC for 6 months. | Received a copy of Dr Susan Love's Breast Book. | SOCIAL SUPPORT, information competence, unmet information needs, PARTICIPATION ‐ BEHAVIOURAL INVOLVEMENT IN HEALTH CARE, participation level of confidence, confidence in doctors, EMOTIONAL WELLBEING ‐ FACT B, breast cancer concerns |
| Homer 2000 | Asthma / Asthma Control | USA | RCT, 2 arms: intervention versus control | 137 children aged 3 to 12, with physician‐diagnosed asthma, recruited from hospital (118) and community clinic (19).
Mean age 7.4 years; 30.7% female; 60.5% African‐American, 5.3% Hispanic. Intervention group n = 76, control group n = 61. | 106 / 137 = 77% (80% of control group; 75% of intervention group). | An interactive educational computer programme in game format. Children help a superhero complete all 6 levels of game while keeping his asthma under control. General asthma information is provided by the programme as well as behaviour change and decision support facilities. | Used the programme over 3 sessions at either a primary care clinic or a neighbourhood health center. The average time to complete the game for a first time player was 45 to 60 minutes. | Received an asthma education book and played a non‐educational computer game. | CHILD KNOWLEDGE, TOTAL NUMBERS OF EMERGENCY DEPARTMENT AND ACUTE OFFICE VISITS DURING STUDY PERIOD, child's average ASTHMA SPECIFIC SYMPTOM SEVERITY, satisfaction, PEFR METER AVAILABLE, use of pefr meter, monitoring number of common triggers and allergens in home environment |
| Horan et al 1990 | Diabetes / DISC | USA | RCT, 2 arms: intervention versus control | 20 adolescents aged 12 to 19 with Type 1 Diabetes Mellitus for > 1 year. 30% male; 80% white participants. Recruited from paediatric endocrinologists in private practice and from customers at a store for people with diabetes. Intervention group n = 10, control group n = 10. | 20/20 = 100% | A microcomputer based system giving in‐home access via a provided computer terminal. DISC contains 3 components. Information is provided via factual and applied diabetes education; behaviour change support is provided via goal setting; and problem solving functions and facilities for reviewing self monitored data on blood glucose, exercise, diet, emotional stress etc. | Used the computer at home for a period of 15 weeks, spending 7 weeks on the diabetes education model and focusing on the goal‐setting and problem solving module for the last 8 weeks. | Received conventional diabetes education via an education booklet. | HBA1C, blood glucose levels, frequency of smbg, APPLIED DIABETES KNOWLEDGE SCORE, BEHAVIOUR CHANGE ‐ EXERCISE, diet, insulin, emotional stress, physical stress, weight, hormones, alcohol and drugs |
| Huss 2003 | Asthma / Wee Willie Wheezie | USA | RCT, 2 arms: intervention versus control | 148 children, recruited from hospital discharge records and local pediatric allergy and asthma clinics. Mean age 9.6 y; 44% male; 21% non‐Hispanic White; 78% non‐Hispanic Black. Intervention group n = 78, control group n = 70. | 101 / 148 = 68%. Intervention group = 56/78 = 72%; control group = 45/70 = 64%. | An interactive computer programme in game format where children negotiate Wee Willie through various home‐like environments and hazards. Information is provided via quizzes. Behaviour change support is provided in the form of Wee Willie 'healthline' which responds to environmental triggers or missed medication. An onscreen nurse provides guidance on incorrect answers. | Received conventional education (written asthma materials and a non‐asthma‐related computer programme) and the computer based instructional asthma game ‐ Wee Willie Wheezie. Children played the asthma game for 20 minutes during a scheduled home visit. | Received conventional education: written asthma materials and a non‐asthma‐related computer programme. | SPIROMETRY used to measure pulmonary function, asthma severity measured using NAEPP criteria, Pediatric Asthma Quality of Life, ASTHMA KNOWLEDGE TEST, Air control questionnaire |
| Krishna 2003 | Asthma / Impact | USA | RCT, 2 arms: intervention versus control | 246 children (under 18 years) with asthma attending a pediatric pulmonary clinic. 65% male; 86% white participants. Intervention group n = 119, control group n = 127. Only children in the age group 7 to 17 years used the programme independently of carers. | 228/246 = 93% (intervention group = 107/119 = 90%; control group = 121/127 = 95%). | An internet‐enabled, interactive multimedia asthma education programme incorporating information and self management skills. Provides behavior change and decision support in its graphic templates containing interactive vignettes. | Received conventional asthma education and used IMPACT during 3 routine visits to an asthma clinic. The program takes approximately 1 hour 20 minutes to complete. | Received conventional asthma education, including verbal and written asthma information on the disease and concepts related to its control. | PEDIATRIC ASTHMA CARE KNOWLEDGE SURVEY FOR CHILDREN (7‐17), caregivers 0‐6, caregivers 7‐17, DAYS WITH ASTHMA SYMPTOMS, days of activity limitation, days of sleep disturbance, school days missed, URGENT VISITS TO THE PHYSICAN, ER VISITS, HOSPITALISATION, DAYS OF STAYS IN HOSPITAL, days of quick relief medicine, use of inhaled steroids |
| Lehmann 2001 | Diabetes / AIDA | Italy | RCT, 2 arms intervention versus control. Partial cross‐over design. | 24 adults with Type I Diabetes Mellitus; 50% male. Intervention group n = 12, control group n = 12. | 18 / 24 = 75% (67% in control group; 83% in intervention group). | An interactive computer programme accessible via the world wide web. It contains information, behaviour change support and decision support. | Received 6 sessions using AIDA. Sessions lasted an average of 104 minutes. Participants did not interact directly with the computer but via a 'facilitator' as the programme software was written in English. | Received 6 sessions of conventional education (slides) on the same topics. After completing post‐test questionnaires they crossed over to receive 6 sessions on AIDA. | KNOWLEDGE SCORE, social and emotional impact of diabetes on lifestyle, self‐monitoring of blood glucose, forward thinking, well‐being and self‐confidence, hypoglycaemic attacks, HbA1C, empowerment |
| Mahoney 2002 | Alzheimer's disease / Memory Loss CD | USA | RCT, 2 arms: intervention versus control | 113 adults concerned about memory loss in a family member; intervention group n = 56, control group n = 57. | 113 / 113 = 100% | A computer programme, delivered via a multimedia CD‐ROM. Decision support and peer support are contained within modules on 'Making Plans' and 'Common Family Experiences'. | Used the programme on a project laptop during a home interview with research staff. | Received no intervention and were offered the opportunity to view the CD‐ROM at the end of the research project. | KNOWLEDGE ABOUT MEMORY LOSS IN FAMILY MEMBERS; user satisfaction with the programme; CONTACTS WITH CLINICIANS |
| Ritterband 2003 | Encopresis / U Can Poop Too | USA | RCT, 2 arms: intervention versus control | 24 encopretic children; 19 boys; mean age 8.46 years (SD 1.81 years). Intervention group n = 12, control group n = 12. | 24 / 24 = 100% | A computer programme delivered via the internet containing three core modules. Two provide information on encopresis and medication. The third provides behaviour change support via a detailed animated tutorial and a personalised instruction sheet. | Received in‐home access to the programme via a provided computer and internet connection. They received the programme for 3 weeks and accessed the website an average of 14 times per participant during that time. | Received phone calls only from research staff. | Bowel habits (child information form), ENCOPRESIS KNOWLEDGE QUESTIONNAIRE (EKQ), VECAT (assesses bowel‐specific problems related to encopresis), NUMBER OF BOWEL ACCIDENTS PER WEEK, use of internet programme |
| Shegog 2001 | Asthma / Watch Discover Think Act ( WDTA) | USA | RCT, 2 arms: intervention versus control | 76 children recruited from clinics and schools; mean age 10.7 years; 47.9% white, non‐Hispanic participants; 40.8% African‐American participants; 7% Hispanic participants; 46 boys. 71 children completed the study of which intervention group n = 38, control n = 33. | 71 / 76 = 93%; distribution of dropouts between groups not given. | An interactive multimedia computer game delivered via CD‐ROM. The programme provides intensive, tailored information on self‐management for children with asthma. Text, graphics, animation, sound and video clips are utilised, and behaviour support delivered via verbal reinforcement, guided practice, feedback goal setting and incentives. Data input = child's personal asthma symptoms, environmental triggers, medications, PEFR. | Participants in the intervention group played the game during a session organised at a university‐linked medical centre. | Received no intervention. | KNOWLEDGE QUESTIONNAIRE ON ASTHMA MANAGEMENT, SELF‐EFFICACY FOR ASTHMA MANAGEMENT, causal attributions, attribution classification, demographic and health information, computer experience, motivation, attitude toward CAL, process of use |
| Smith 2000 | Diabetes / WTW | USA | RCT, 2 arms: intervention versus control | 30 women with Diabetes Mellitus (Type I or II); aged 35 to 60 years; with a telephone and living at least 25 miles outside the 6 major cities of Montana. Intervention group n = 15, control group n = 15. | Follow up rate not stated. | A computer programme accessed via a PC with modem connection. The software contained 4 components: conversation (online support group providing peer support ); mailbox (private e‐mail correspondence between group members); HealthChat (formal diabetes education); and Resource Rack (bulletin board). | Received in‐home access to the programme via a provided laptop for 5 months. They also received a notebook of health information regarding women's health in general and specific diabetes information. | Received paper copies of all the information materials that the intervention group received; that is, health information notebook and hard copies of computer‐generated information. | HBA1C, health status, sources of support, PERSONAL RESOURCE QUESTIONNAIRE, Quality of Life Index, Social Readjustment Rating Scale PSYCHOSOCIAL ADAPTION TO ILLNESS SCALE, usage of computer programme |
| Turnin 1992 | Diabetes / Diabeto | France | RCT, 2 arms: intervention versus control. Crossover design. | 105 patients with diabetes. 59% male; 72% Type I Diabetes Mellitus; 74% working; mean age 45 years. Intervention group n = 54, control group = 51. | Follow up rate not stated. | Interactive dietary information and individualised counselling delivered via a Minitel videotext terminal. The programme provides dietetic information for diabetic patients. Behaviour change support is provided via an individualised dossier containing energy requirements calculation and individualised meal analysis options, adapted menus, personalised advice and dietary and cardiovascular information. | Received in‐home access to Diabeto for 6 months. | No intervention for 6 months then crossed over to the intervention arm. | DIETETIC KNOWLEDGE SCORES, eating habits ‐ caloric excess, % of carbohydrate, carbohydrate deficit, REDUCTION OF % FAT OF CALORIFIC INTAKE, fat excess, changes in body weight, HBA1C |
| Turnin 2001 | Obesity / Nutri‐Expert | France | RCT, 2 arms: intervention versus control | 557 obese patients: BMI > or equal to 33.3kg / m2. Mean age 41.2 y; 92.3% female; salaried workers 36.5%, unemployed or retired 23.1%, teaching or health care professions 14.1%. Of the 341 participants who completed the study intervention group n = 169, control group n = 172. | 341 / 557 = 61%. Dropouts equally distributed between intervention and control group (88 from control group and 91 from intervention group) | Nutrition education software programme on obesity delivered via a Minitel videotext terminal containing information on nutrition for obese patients. Behavior change support is provided by energy requirements calculation and individualised meal analysis options, adapted menus and personalised advice. A discussion forum provides peer support. | Received usual care (7 medical/dietetic visits) plus in‐home access to the software programme via a provided terminal for 12 months. | Received usual care ( 7 medical/dietetic visits). | BMI, waist circumference, weight, DIETETIC KNOWLEDGE SCORES, dietary intake (CALORIFIC INTAKE, carbohydrate, sugar, protein and fat intake), fasting plasma insulin and lipids ‐ cholesterol |
| Wydra 2001 | Cancer / Coping with Cancer | USA | RCT, 2 arms: intervention versus control | 174 patients with cancer; 51% male; 81% white participants; age range = 21 to 82 years. Intervention group n = 86, control group n = 88. | 160 / 174 = 92%; distribution of dropouts between groups not given. | Interactive Video Disc delivered via a video disc player. Provides information on fatigue, saving and maintaining energy, managing stress and sleeping better. Behaviour change support was provided by self‐management content of the modules eg. exercises to identify side effects, causes and patterns of problems such as fatigue. | Participants in the intervention group used the video disc at a single session in a cancer treatment centre. | Received usual care. | SELF CARE ACTIVITIES, wide range achievement test, self care ability |
| Wylie‐Rosett 2001 | Obesity / CD‐ROM | USA | RCT, 3 arms: workbook only versus workbook + computer programme vs workbook + computer programme + staff counselling. For purposes of systematic review, intervention = computer programme + workbook; control = workbook only. | 588 people; mean BMI = 35.6 kg/m2; 82% female; 83% white; 84%> 1yr of college; recruited from a managed care organisation. Workbook only (control group ) n = 116, workbook+computer group (intervention group) n = 236, workbook+computer+staff counselling n= 236. Sample size and n in each arm arrived at by authors in the light of data from studies. | Raw data not given; overall study completion rate given as 81% with dropout rates of 16% (n = 19), 22% (n = 53) and 17% for the least, intermediate and most intensive intervention groups respectively. | A multimedia computer programme providing information on nutrition and fitness. Behavior change support is delivered via psychobehavioural content such as the setting, reviewing and evaluation of chosen tailored behaviour goals on food intake and physical activity. | Participants in the intervention group accessed the programme via touchscreens in kiosks situated within a medical waiting room over a 12 month period. During the first 3 months, participants were asked to log on to the computer system at least once a week and thereafter at least once a month. | Received a workbook containing 20 sections with self‐help sheets. | KCAL PER DAY, % Kcal from fat, blocks walked daily, minutes walked continuously, weight, BMI, waist circumference, % of body fat, cholesterols, triglicerides, glucose, blood pressure, COST ANALYSIS, diabetes and cardiovascular risk, medication usage and evaluation of computer programme |
| | | | | | | | | * Outcome measures in capitals were selected for data synthesis. |
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