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Effectiveness and Outcome Moderators of Computer-Based Health Education for an Adult Population

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This review of meta-analyses of outcome studies of adults receiving Computer-Based Health Education (CBHE) has two goals. The first is to provide an overview of the efficacy of CBHE interventions, and the second is to identify moderators of these effects. A systematic literature search resulted in 15 meta-analyses of 278 controlled outcome studies. The meta-analyses were analysed with regard to reported (overall) effect sizes, heterogeneity and interaction effects. The results indicate a positive relationship between CBHE interventions and improvements in health-related outcomes, with small overall effect sizes compared to non-computer-based interventions. The sustainability of the effects was observed for up to six months. Outcome moderators (31 variables) were studied in 12 meta-analyses and were clustered into three categories: intervention features (20 variables), participant characteristics (five variables) and study features (six variables). No relationship with effectiveness was found for four intervention features, theoretical background, use of internet and e-mail, intervention setting and self-monitoring; two participant features, age and gender; and one study feature, the type of analysis. Regarding the other 24 identified features, no consistent results were observed across meta-analyses. To enhance the effectiveness of CBHE interventions, moderators of effects should be studied as single constructs in high-quality study designs.

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