Improving planning of web-based community health interventions through human interaction and sense of community

Background: Participant convenience, flexibility, and privacy are frequently cited as benefits of Web-based community health interventions. Concomitantly, attrition rates are typically higher for such interventions, presumably due to less human interaction. To advance the feasibility and efficacy of Web-based interventions, it is necessary to identify determinants of program completion. Methods: A Web-based, pediatric obesity intervention designed for mothers was conducted. A process evaluation aggregate data form was developed to measure program fidelity and feasibility of the program. Data were collected at five intervals from program participants (n=50) by telephone over the course of an eight-week intervention. Process evaluation forms and telephone counseling scripts were assessed for face and content validity by a four-member panel of experts. Results: To assess program fidelity, participants were queried about navigability of the Web site and completion of program prescription. Responses were cross-validated against user information retrieved through data mining analysis. Participants answered a battery of questions related to program satisfaction and convenience, comprising evaluation of common Web-intervention modalities including video lectures, video tutorials, interactive worksheets, pod casts, wikis, and discussion forums. Conclusion: Web-based, community health interventions offer the potential to improve outcome measures, minimize overhead costs, foster program replication, and enable wide-scale intervention dissemination. Incorporation of human interaction through telephone counseling can increase perceived utility value of an intervention. Discussion boards that allow for user interaction can motivate behavior change. Internet-based interventions should incorporate mechanisms to instill a sense of community and human interaction to increase participant program commitment and decrease attrition rates.