New Communication Technology and Health Behavior Change

Communication technology has been undergoing tremendous transformations since the last decade of the 20th century. By the beginning of the 21st century, there were more communication channels than ever before—face-to-face, print, telephone, radio, TV, fax, VCR, DVD, and CD-ROM, computer games, and the Internet, with both wired and wireless options. Needless to day, people now also access health information through a variety of channels. What are the potential benefits and limitations of the new communication technology? We will discuss a few innovative use of new communication technology in health behavior interventions.

Tailored Print Communication (TPC)

TPCs are printed materials created especially for an individual based on relevant information about that person through telephone interview or self-administered questionnaire. Tailoring can be based on sociodemographic characteristics such as age, sex, race/ethnicity, and education as well as health behaviors such as the level of fat intake, frequency of exercise, smoking habits etc. Theoretically, TPCs permit the reach of mass media, with content that is relevant and appropriate to recipients. More than 40 studies have been carried out so far on TPCs and the results are mixed. For example, some researchers found that tailored materials were no better than nontailored materials (e.g., Lutz et al., 1999; Lennox et al., 2001). More research is certainly needed to understand the mechanisms underlying both effective and ineffective TPCs and whether the effects of TPCs vary across diverse groups.

Telephone-Delivered Interventions (TDI)

TDIs include a range of human-delivered counseling and reminder interventions delivered using the telephone and computer-generated voice response systems (Institute of Medicine, 2002). They include components designed to motivate people, provide information, and overcome barriers to action. Substantial empirical literature documents the efficacy of TDIs across health behaviors and groups. For example, one recent study (Delichatsios et al., 2000) found that participants who received weekly counseling calls about physical activity were more likely to meet physical activity criteria at three months than those who did not receive physical activity counseling. Nonetheless, more research is needed to study the sustainability of TDIs.

Internet-Delivered Interventions

The phenomenal rise of internet has tremendous implications for health behavior interventions. In 2000, 44 percent of Americans (117 million people) reported using the Internet (U.S. Department of Commerce, 2000) and the number is increasing every day. By 2001, about 64 percent of U.S. Internet users said they had used the Internet for health information (Pew Internet & American Life Project, 2002). Another piece of good news is that the digital divide seems narrowing.

Benefits of internet-delivered interventions include access to vast amounts of latest information on given health topics, some of which was, until recently, available only to health professionals. The information can easily be customized to individual needs and characteristics. Another advantage of the Internet is that users can access information at their own pace, theoretically 24 hours a day, 7 days a week. Communication can be real time, one-to-one or in a group. Multiple presentation modes can be used, such as video, audio, text, and animation. Third, some health topics, such as HIV/AIDS and STDs, the anonymity afforded by the Internet may be a great advantage and would encourage more individuals to seek relevant health information. Fourth, internet-based programs may create online communities so that people experiencing social isolation in the communities where they live, such as adolescent mothers with young children, can obtain some social support.

Limitations of internet-delivered programs include initial high costs of hardware and software purchase and programming, lack of internet access among socially disadvantaged groups, overabundance of information, and uncertainty of the quality of information on the internet.

More research is needed to examine the effectiveness of internet-delivered health interventions.