The Internet is considered to be a promising delivery channel of interventions aimed at promoting healthful behaviors, especially for adolescents and young adults. Exposure to these interventions, however, is generally low. A more extensive exploration of methods, strategies, and their effectiveness with regard to facilitating exposure is therefore timely, because this knowledge is crucial to improve the use of such interventions and, subsequently, to increase behavioral change. Therefore, a systematic review of the literature was conducted, resulting in 838 studies based on title selection, of which 26 studies met the eligibility criteria. The systematic review resulted in an overview of methods and strategies that have been used to facilitate exposure. Patterns of effective strategies could be observed, such as the combination of tailored communication and the use of reminders and incentives. Nevertheless, exposure-specific theories need to be developed and objective exposure measures should be tracked and reported in future studies.
An, L.C., Perry, C.L., Lein, E.B., Klatt, C., Farley, D.M., Bliss, R.L., . . . Ehlinger, E.P. (2006). Strategies for increasing adherence to an online smoking cessation intervention for college students . Nicotine & Tobacco Research, 8(Suppl. 1), S7-S12.
2.
Barak, A., & Fisher, W.A. ( 2003). Experience with an Internet-based, theoretically grounded educational resource for the promotion of sexual and reproductive health. Sexual and Relationship Therapy, 18, 293-308.
3.
Bartholomew, L.K., Parcel, G.S., Kok, G., & Gottlieb, N.H. (2006). Planning health promotion programs: An intervention mapping approach. San Francisco, CA: Jossey-Bass.
4.
Bennett, G.G., & Glasgow, R.E. ( 2009). The delivery of public health interventions via the Internet: Actualizing their potential. Annual Review of Public Health , 30, 273-292.
5.
Bernhardt, J.M., & Hubley, J. ( 2001). Health education and the Internet: The beginning of a revolution. Health Education Research, 16, 643-645.
6.
Buller, D.B., Borland, R., Woodall, W.G., Hall, J.R., Hines, J.M., Burris-Woodall, P., . . . Saba, L. ( 2008). Randomized trials of Consider This, a tailored, Internet-delivered smoking prevention program for adolescents. Health Education & Behavior, 35, 260-281.
7.
Chen, H.-H., & Yeh, M.-L. (2006). Developing and evaluating a smoking cessation program combined with an Internet-assisted instruction program for adolescents with smoking. Patient Education and Counseling, 61, 411-418.
8.
Chen, H.-H., Yeh, M.-L., & Chao, Y.-H. ( 2006). Comparing effects of auricular acupressure with and without an Internet-assisted program on smoking cessation and self-efficacy of adolescents . Journal of Alternative and Complementary Medicine, 12, 147-152.
9.
Chiauzzi, E., Green, T.C., Lord, S., Thum, C., & Goldstein, M. ( 2005). My student body: A high-risk drinking prevention web site for college students. Journal of American College Health , 53, 263-274.
10.
Christensen, H., Griffiths, K.M., & Farrer, L. ( 2009). Adherence in Internet interventions for anxiety and depression: Systematic review. Journal of Medical Internet Research, 11, e13.
11.
Crutzen, R. ( 2009). Utilising exposure measures of Internet-delivered interventions . In E. Olsen (Ed.), Behaviour change & technology. Oslo: Changetech.
12.
Crutzen, R., De Nooijer, J., Brouwer, W., Oenema, A., Brug, J., & De Vries, N.K. (2008a). Internet-delivered interventions aimed at adolescents: A Delphi study on dissemination and exposure. Health Education Research, 23, 427-439.
13.
Crutzen, R., De Nooijer, J., Brouwer, W., Oenema, A., Brug, J., & De Vries, N.K. (2008b). Qualitative assessment of adolescents’ views about improving exposure to Internet-delivered interventions. Health Education, 108, 105-116.
14.
Crutzen, R., De Nooijer, J., Brouwer, W., Oenema, A., Brug, J., & De Vries, N.K. (2009). A conceptual framework for understanding and improving adolescents’ exposure to Internet-delivered interventions. Health Promotion International, 24, 277-284.
15.
Crutzen, R., De Nooijer, J., Candel, M.J.J. M., & De Vries, N.K. (2008). Adolescents who intend to change multiple health behaviours choose greater exposure to an Internet-delivered intervention. Journal of Health Psychology, 13, 906-911.
16.
Crutzen, R., De Nooijer, J., & De Vries, N.K. (2008). How to reach a target group with Internet-delivered interventions? European Health Psychologist , 10, 77-79.
17.
Danaher, B.G., Boles, S.M., Akers, L., Gordon, J.S., & Severson, H.H. (2006). Defining participant exposure measures in web-based health behavior change programs. Journal of Medical Internet Research, 8, e15.
18.
Danaher, B.G., & Seeley, J.R. ( 2009). Methodological issues in research on web-based behavioral interventions. Annals of Behavioral Medicine, 38, 28-39.
19.
De Nooijer, J., Oenema, A., Kloek, G., Brug, J., De Vries, H., & De Vries, N.K. (2005). Bevordering van Gezond Gedrag via Internet: Nu en in de Toekomst [Promotion of healthy behavior through the internet: Now and in the future]. Maastricht, Netherlands: Maastricht University.
20.
De Nooijer, J., Veling, M.L., Ton, A., De Vries, H., & De Vries, N.K. (2008). Electronic monitoring and health promotion: The evaluation of the E-MOVO website by adolescents. Health Education Research, 23, 382-391.
21.
De Vries, H., Van ‘t Riet, J., Spigt, M., Metsemakers, J., Van den Akker, M., Vermunt, J.K., & Kremers, S. ( 2008). Clusters of lifestyle behaviors: Results from the Dutch SMILE study. Preventive Medicine, 46, 203-208.
22.
Escoffery, C., McCormick, L., & Bateman, K. ( 2004). Development and process evaluation of a web-based smoking cessation program for college smokers: Innovative tool for education. Patient Education and Counseling, 53, 217-225.
23.
Evers, K.E., Cummins, C.O., Prochaska, J.O., & Prochaska, J.M. (2005). Online health behavior and disease management programs: Are we ready for them? Are they ready for us?Journal of Medical Internet Research, 7, e27.
24.
Evers, W., & Carol, B. ( 2007). An Internet-based assessment tool for food choices and physical activity behaviors. Journal of Nutrition Education and Behavior, 39, 105-106.
25.
Eysenbach, G. ( 2005). The law of attrition. Journal of Medical Internet Research, 7, e11.
26.
Gilbert, L.K., Temby, J.R.E., & Rogers, S.E. ( 2005). Evaluating a teen STD prevention web site. Journal of Adolescent Health, 37, 236-242.
Göritz, A.S., & Crutzen, R. ( 2010). Reminders in web-based data collection: Increasing response rates at the price of retention. Manuscript submitted for publication.
29.
Hawkins, R.P., Kreuter, M.W., Resnicow, K., Fishbein, M., & Dijkstra, A. ( 2008). Understanding tailoring in communicating about health . Health Education Research, 23, 454-466.
30.
Higgins, J.P.T., & Green, S. ( 2006). Cochrane handbook for systematic reviews of interventions 4.2.6 [updated September 2006]. Chichester, UK: Wiley.
31.
Kelder, S.H., Perry, C.L., Klepp, K.I., & Lytle, L.L. ( 1994). Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. American Journal of Public Health, 84, 1121-1126.
32.
Kremers, S.P.J., De Bruijn, G.J., Schaalma, H., & Brug, J. ( 2004). Clustering of energy balance-related behaviours and their intra-personal determinants. Psychology & Health, 19, 595-606.
33.
Leung, L. ( 2003). Impacts of Net-generation attributes, seductive properties of the Internet, and gratifications-obtained on Internet use. Telematics and Informatics, 20, 107-129.
34.
Long, J.D., Armstrong, M.L., Amos, E., Shriver, B., Roman-Shriver, C., Feng, D., . . . Blevins, M.W. ( 2006). Pilot using World Wide Web to prevent diabetes in adolescents . Clinical Nursing Research, 15, 67-79.
35.
Lou, C.H., Zhao, Q., Gao, E.S., & Shah, I.H. ( 2006). Can the Internet be used effectively to provide sex education to young people in China? Journal of Adolescent Health, 39, 720-728.
36.
Marks, J.T., Campbell, M.K., Ward, D.S., Ribisl, K.M., Wildemuth, B.M., & Symons, M.J. ( 2006). A comparison of web and print media for physical activity promotion among adolescent girls. Journal of Adolescent Health , 39, 96-104.
37.
Mermelstein, R., & Turner, L. ( 2006). Web-based support as an adjunct to group-based smoking cessation for adolescents. Nicotine & Tobacco Research , 8, S69-S76.
38.
Michaud, P.-A., & Colom, P. ( 2003). Implementation and evaluation of an Internet health site for adolescents in Switzerland. Journal of Adolescent Health , 33, 287-290.
39.
Moher, D., Schulz, K.F., & Altman, D.G. ( 2001). The CONSORT Statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials. Annals of Internal Medicine, 134, 657-662.
40.
Morris, D.S. ( 2009). Measuring exposure to health messages in community-based intervention studies: A systematic review of current practices. Health Education & Behavior, 36, 979-998.
41.
Myung, S.-K., McDonnell, D.D., Kazinets, G., Seo, H.G., & Moskowitz, J.M. (2009). Effects of web- and computer-based smoking cessation programs. Archives of Internal Medicine , 169, 929-937.
Obermayer, J.L., Riley, W.T., Asif, O., & Jean-Mary, J. ( 2004). College smoking-cessation using cell phone text messaging . Journal of American College Health, 53, 71-78.
44.
Patten, C.A., Croghan, I.T., Meis, T.M., Decker, P.A., Pingree, S., Colligan, R.C., . . . Gustafson, D.H. (2006). Randomized clinical trial of an Internet-based versus brief office intervention for adolescent smoking cessation. Patient Education and Counseling, 64, 249-258.
45.
Patten, C.A., Rock, E., Meis, T.M., Decker, P.A., Colligan, R.C., Pingree, S., . . . Gustafson, D.H. (2007). Frequency and type of use of a home-based, Internet intervention for adolescent smoking cessation. Journal of Adolescent Health, 41, 437-443.
46.
Peters, L.W.H., Wiefferink, C.H., Hoekstra, F., Buijs, G.J., Ten Dam, G.T.M., & Paulussen, T.G.W.M. (2009). A review of similarities between domain-specific determinants of four health behaviors among adolescents . Health Education Research, 24, 198-223.
47.
Portnoy, D.B., Scott-Sheldon, L.A.J., Johnson, B.T., & Carey, M.P. ( 2008). Computer-delivered interventions for health promotion and behavioral risk reduction: A meta-analysis of 75 randomized controlled trials, 1988-2007. Preventive Medicine, 47, 3-16.
48.
Reinaerts, E., De Nooijer, J., & De Vries, N.K. (2007). Fruit & vegetable distribution program versus a multi component program to increase F&V consumption: Which should be recommended for implementation? Journal of School Health, 77, 679-686.
49.
Roberto, A.J., Zimmerman, R.S., Carlyle, K.E., & Abner, E.L. ( 2007). A computer-based approach to preventing pregnancy, STD, and HIV in rural adolescents. Journal of Health Communication , 12, 53-76.
50.
Roberts, D.F., & Foehr, U.G. ( 2008). Trends in media use. The Future of Children , 18, 11-37.
51.
Rogers, E.M. ( 2003). Diffusion of innovations. New York, NY: Free press.
52.
Saitz, R., Palfai, T.P., Freedner, N., Winter, M.R., MacDonald, A., Lu, J., . . . Dejong, W. ( 2007). Screening and brief intervention online for college students: The iHealth study. Alcohol and Alcoholism, 42, 28-36.
53.
Southwell, B.G., Barmada, C.H., Hornik, R.C., & Maklan, D.M. ( 2002). Can we measure encoded exposure? Validation evidence from a national campaign. Journal of Health Communication , 7, 445-453.
54.
Steele, R.M., Mummery, W.K., & Dwyer, T. ( 2009). A comparison of face-to-face or Internet-delivered physical activity intervention on targeted determinants. Health Education & Behavior, 36, 1051-1064.
55.
Suminski, R.R., & Petosa, R. ( 2006). Web-assisted instruction for changing social cognitive variables related to physical activity. Journal of American College Health, 54, 219-225.
56.
Te Velde, S.J., Twisk, J.W.R., & Brug, J. ( 2007). Tracking of fruit and vegetable consumption from adolescence into adulthood and its longitudinal association with overweight. British Journal of Nutrition, 98, 431-438.
57.
Thombs, D.L., Olds, R.S., Osborn, C.J., Casseday, S., Glavin, K., & Berkowitz, A.D. (2007). Outcomes of a technology-based social norms intervention to deter alcohol use in freshman residence halls . Journal of American College Health, 55, 325-332.
58.
Vandelanotte, C., Spathonis, K.M., Eakin, E.G., & Owen, N. ( 2007). Website-delivered physical activity interventions: A review of the literature. American Journal of Preventive Medicine , 33, 54-64.
59.
Walters, S.T., Vader, A.M., & Harris, T.R. ( 2007). A controlled trial of Web-based feedback for heavy drinking college students. Prevention Science, 8, 83-88.
60.
White, M.A., Martin, P.D., Newton, R.L., Walden, H.M., York-Crowe, E.E., Gordon, S.T., . . . Williamson, D.A. (2004). Mediators of weight loss in a family-based intervention presented over the Internet. Obesity Research, 12, 1050-1059.
61.
Williamson, D.A., Martin, P.D., White, M.A., Newton, R., Walden, H., York-Crowe, E., . . . Ryan, D. ( 2005). Efficacy of an Internet-based behavioral weight loss program for overweight adolescent African-American girls. Eating and Weight Disorders, 10, 193-203.
62.
Williamson, D.A., Walden, H.M., White, M.A., York-Crowe, E., Newton, R.L., Alfonso, A., . . . Ryan, D. ( 2006). Two-year Internet-based randomized controlled trial for weight loss in African-American girls. Obesity, 14, 1231-1243.
63.
Woodruff, S.I.,Conway, T.L., & Edwards, C.C. ( 2008). Sociodemographic and smoking-related psychosocial predictors of smoking behavior change among high school smokers. Addictive Behaviors, 33, 354-358.
64.
Woodruff, S.I., Conway, T.L., Edwards, C.C., Elliott, S.P., & Crittenden, J. (2007). Evaluation of an Internet virtual world chat room for adolescent smoking cessation. Addictive Behaviors, 32(9), 1769-1786.
