Table Of ContenteHEALTH APPLICATIONS
eHealth Applications: Promising Strategies for Behavior Change provides an overview
of technological applications in contemporary health communication research,
exploring the history and current uses of eHealth applications in disease preven-
tion and management. This volume focuses on the use of these technology-based
interventions for public health promotion and explores the rapid growth of an
innovative interdisciplinary fi eld.
The chapters in this work discuss key eHealth applications by presenting research
examining a variety of technology-based applications. Editors Seth M. Noar and
Nancy Grant Harrington summarize the latest in eHealth research, including a
range of computer, Internet, and mobile applications, and offer observations and
refl ections on this growing area, such as dissemination of programs and future
directions for the study of interactive health communication and eHealth.
Providing a timely and comprehensive review of current tools for health commu-
nication, eHealth Applications is a must-read for scholars, students, and researchers
in health communication, public health, and health education.
Dr. Seth M. Noar is an Associate Professor in the School of Journalism and
Mass Communication and a Member of the Lineberger Comprehensive Cancer
Center at the University of North Carolina at Chapel Hill. His research addresses
health behavior theories and message design, mass media campaigns, eHealth ap-
plications, and methodological topics, including meta-analysis and evaluation.
Dr. Nancy Grant Harrington is a Professor in the Department of Commu-
nication and Associate Dean for Research in the College of Communications
and Information Studies at the University of Kentucky. Her research focuses on
persuasive message design in a health behavior change context, particularly as it
relates to risk behavior prevention/health promotion and interactive health com-
munication using computer technology.
ROUTLEDGE COMMUNICATION SERIES
Jennings Bryant/Dolf Zillmann, Series Editors
Selected titles in Applied Communication ( Teresa L. Thompson, Advisory Editor)
Routledge Handbook of Health Communication, Second Edition
Thompson/Parrott/Nussbaum
Family Communication, Second Edition
Segrin/Flora
Communicating to Manage Health and Illness
Brashers/Goldsmith
Emerging Perspectives in Health Communication
Zoller/Dutta
Communication as Comfort
Ragan
Communication Perspectives on HIV/AIDS for the 21st Century
Edgar/Noar/Freimuth
Health Communication in Practice
Ray
Handbook of Family Communication
Vangelisti
eHEALTH APPLICATIONS
Promising Strategies for
Behavior Change
Edited by Seth M. Noar and
Nancy Grant Harrington
First published 2012
by Routledge
711 Third Avenue, New York, NY 10017
Simultaneously published in the UK
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2012 Taylor & Francis
The right of Seth M. Noar and Nancy Grant Harrington to be identifi ed as the author of
the editorial material, and of the authors for their individual chapters, has been asserted in
accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in
any form or by any electronic, mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered trademarks,
and are used only for identifi cation and explanation without intent to infringe.
Library of Congress Cataloging in Publication Data
eHealth applications : promising strategies for health behavior change / edited by Seth M.
Noar and Nancy Grant Harrington.
p. ; cm. — (Routledge communication series)
Developed from a pre-conference at the 2010 Kentucky Conference on Health
Communication.
Includes bibliographical references.
I. Noar, Seth M. II. Harrington, Nancy Grant. III. Kentucky Conference on
Health Communication (2010 : Lexington, Ky.) IV. Series: Routledge communication
series.
[DNLM: 1. Health Communication—methods—Congresses. 2. Health
Promotion— methods—Congresses. 3. Cellular Phone—Congresses. 4. Internet—
Congresses. 5. Medical Informatics—methods—Congresses. 6. Video Games—
Congresses. WA 590]
610.285—dc23 2011041240
ISBN: 978-0-415-88817-2
ISBN: 978-0-415-88818-9
ISBN: 978-0-203-14909-6
Typeset in Bembo
by Apex CoVantage, LLC
To Eva—for your spark, your sweetness, your silliness, and
most of all . . . your love. And to Elisa . . . for everything
SMN
To Troy—for your constant support, patience, and love
NGH
We dedicate this volume to Marci Campbell, who spent her
career tirelessly developing innovative eHealth applications
and making them accessible to those most in need
SMN, NGH
CONTENTS
Foreword xi
Victor J. Strecher
Acknowledgments xv
Preface xvii
Historical and Conceptual Foundations 1
1 eHealth Applications: An Introduction and Overview 3
Seth M. Noar and Nancy Grant Harrington
2 The Emergence of eHealth Applications 17
Sheana Bull
3 Interactivity: Conceptualizations, Effects, and Implications 37
Deborah S. Chung
eHealth Applications 57
4 Internet-Based Interventions for Health Behavior Change 59
David B. Buller and Anna H. L. Floyd
viii Contents
5 Virtual Interactive Interventions for Reducing Risky Sex:
Adaptations, Integrations, and Innovations 79
Lynn Carol Miller, Paul Robert Appleby, John L. Christensen,
Carlos Godoy, Mei Si, Charisse Corsbie-Massay, Stephen J. Read,
Stacy Marsella, Alexandra N. Anderson, and Jennifer Klatt
6 Avatars for Health Behavior Change 96
Jesse Fox
7 Digital Games for Health Behavior Change: Research,
Design, and Future Directions 110
Debra A. Lieberman
8 Computer-Tailored Interventions for Improving
Health Behaviors 128
Seth M. Noar and Nancy Grant Harrington
9 Mobile Phones for Health Communication to Promote
Behavior Change 147
Lorien C. Abroms, Nalini Padmanabhan, and W. Douglas Evans
10 Text Messaging Interventions for Chronic Disease
Management and Health Promotion 167
Brianna S. Fjeldsoe, Yvette D. Miller, and Alison L. Marshall
11 Interactive Voice Response Technology for Chronic Disease
Management 187
John D. Piette and Ashley J. Beard
Practice Implications and Future Directions 203
12 Using Social Media to Enhance Health
Communication Campaigns 205
Ann M. Taubenheim, Terry Long, Jennifer Wayman, Sarah Temple,
Sally McDonough, and Ashley Duncan
13 Dissemination and Implementation of eHealth Interventions 221
Borsika A. Rabin and Russell E. Glasgow
Contents ix
14 Health Information Technology Policy Issues: Relevance
and Implications for eHealth Applications 246
Cynthia Baur
15 Building an Evidence Base for eHealth Applications:
Research Questions and Practice Implications 263
Nancy Grant Harrington and Seth M. Noar
Contributors 275
Index 285
FOREWORD
Allow me to outline a brief history of eHealth research:
• Frustration with the status quo.
• Prediction that computers were going to play an increasing role in our lives.
• Research using eHealth approaches.
• Dissemination into health care, employer, school, and government sectors.
Yes, frustration was an early motive for eHealth, stemming from a growing aware-
ness that other approaches to population-based behavior change were largely inef-
fective (e.g., mass media), had very low potential to reach large populations (e.g.,
individual or group therapy programs), or were costly (e.g., telephonic coaching).
This triad—effi cacy, reach, and low cost—has always been essential to population-
based behavior change initiatives; it’s also what makes these efforts so vexing. By
the late 1990s, the historic period of the Internet’s emergence, eHealth seemed to
offer a solution to this Rubik’s Cube.
It didn’t take a rocket scientist to predict that computers were going to play an
increasing role in our lives. It’s only recently, however, that most researchers and
practitioners in our fi eld have paid much attention to the emergence of interactive
communications technologies, digital biometric devices, and computerized health
records. As a result, the research community failed to keep up with the real world.
Filling the void through the early 2000s were Wild West snake oil salesmen with
online pamphlet racks and crude search engines. The paucity of research attention
kept the bar for the quality of eHealth programs very low while also minimizing
the potential value of these programs.
