A recent review (Aalbers et al., 2011) has found that there is a need for more systematic research on Internet-based interventions that help older adults make healthy lifestyle changes. At the same time, the limited research that does exist suggests that such interventions hold great potential—particularly when they include multiple techniques and components that engage participants.
The authors of the review—based in the Netherlands—evaluated and summarized studies that targeted healthy lifestyle changes through Internet-based communication, such as physical activity or disease management, for participants age 50 and older. The researchers searched the PubMed database for English or Dutch articles published between 1995 and late 2010. They excluded studies that did not include a control or comparison group, only looking at those with a community-based participant sample that could provide some form of outcome evaluation—those that could gauge the effectiveness and feasibility of the intervention.
A total of ten different studies fit the criteria, nine of which were found to be feasible and effective. The studies varied in outcome measures, number of participants, and specific goals. Studies included social network forums, online self-monitoring, combined online and in-person methods, and e-mail advice. Each study recruited participants offline (through newspapers and postal mail.) The goals of the interventions included weight loss, physical activities, nutrition, and diabetes.
The authors identified limitations within all the studies, such as biases in randomization and limited generalizability. Generalizability is particularly difficult to achieve in studies on Internet-based interventions, as there are accessibility issues (to computers and Internet) for certain socioeconomic groups—especially among older adults. It can be a struggle for researchers to localize a representative proportion of older adults with lower levels of education in studies of online interventions.
Despite these current research challenges, the reviewers were able to identify a few patterns that can be useful for designing interventions and for further efficacy research. First, there are several studies that have shown that online interventions can successfully encourage healthy lifestyle changes among older adults. Interventions that provide information specifically tailored to users were rated as more interesting, and had a slightly lower attrition rate, than interventions that provided general health information, though both tailored and general interventions were effective. Social networking forums were not popular among users in any of the studies. Overall, studies that included multiple components—features such as e-mail feedback and messaging, online goal-tracking, and access to articles and other information—were more successful than interventions using only one component.
For researchers, the authors suggest that more rigorous data is needed to better understand the effectiveness of specific components. The researchers also suggest that qualitative studies of users would be particularly helpful to understand the usefulness of different online methods. Overall, the review indicates that multi-component online interventions for lifestyle changes are supported by evidence, but that more research is needed before it can be stated which types of online interventions are most useful for specific populations.
