Use of a website to accomplish health behavior change: If you build it,will they come? and will it work if they do?

Purpose: this article describes the development,implementation,and effectiveness of 2 interactive websites designed to support health behavior change around healthy eating,physical activity,smoking,and use of alcohol for primary care patients. methods: patients from 6 primary care practices were recruited and randomized to a basic website (including a health assessment with feedback of the results and educational materials about health behavior change) or an enhanced website that included the features of the basic site plus an action planning component. patients were prompted to return for follow-up assessments at 3 and 6 months after enrollment. results: of 7706 participants,169 (2.2%) targeted for recruitment actually used the website. both web-based interventions seemed to assist patients with making positive changes in their behavior,especially activity level and healthful diet. there were no significant differences in the effectiveness of the basic and enhanced websites. conclusions: interactive behavior-change technology interventions can assist primary care patients and practices in health behavior change activities. difficulties with patient recruitment and the lack of added effectiveness of the enhanced website suggest that such interventions work better if integrated into the interaction between primary care clinicians and patients rather than as a standalone intervention.