Improving Exposure to Internet-Delivered Health Behaviour Change Interventions: An exploration of determinants and dissemination strategies

The Internet has become the key medium to obtain health information for many people. This makes the Internet an attractive and increasingly used medium for the delivery of health behaviour change programs aiming to contribute to the primary prevention of chronic diseases. Although in theory Internet applications hold great promise for the delivery of health promotion and behaviour change interventions, evidence suggests that the use of such Internet interventions is disappointingly low, especially when these interventions are implemented for use by the general public. Until recently, research on Internet-delivered health behaviour change interventions primarily focused on the effect evaluation of such interventions in more or less controlled research settings. Considerably less research attention has been directed at exploring or promoting, the dissemination, reach and use of such interventions after they have become available for use by the public. In order to improve overall impact of these interventions, more insight is needed in how to improve dissemination, reach and use of Internetdelivered health promotion interventions. This thesis reports on six studies that identify which factors can contribute to a better dissemination of and exposure to Internet-delivered health behaviour change interventions (from now on referred to as 'Internet interventions') for adult target populations. The focus will be on Internet interventions aimed to promote health behaviours that contribute to the primary prevention of chronic diseases, such as obesity, cardiovascular diseases, diabetes mellitus, and cancer. Such interventions include programs that promote healthy eating and physical activity, that encourage smoking cessation and discourage alcohol consumption. The thesis focuses on interventions aiming to reach the general adult public and on implementation in real-life settings (i.e., outside of a study setting). This introductory chapter describes the trends in access and use of the Internet, the background of Internet interventions, the study aims, the theoretical frameworks used in this thesis, and presents an overview of the individual studies within this thesis.

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