The potential of the Internet for health communication: The use of an interactive on-line tool for diabetes risk prediction

Patient Education and Counseling

Volumn 83, Issue 1, 2011, Pages 106-112

  Holmberg, Christine ^a   Harttig, Ulrich ^b   Schulze, Matthias B ^b   Boeing, Heiner ^b  

^a CHARITÉ UNIVERSITÄTSMEDIZIN BERLIN   (Germany)

^b GERMAN INSTITUTE OF HUMAN NUTRITION   (Germany)

Author keywords

Diabetes mellitus type 2; Risk assessment; Risk scores; Transaction log analysis; Website use

Indexed keywords

ADULT; ARTICLE; CONTROLLED STUDY; DIABETES RISK SCORE; FEMALE; GERMANY; HEALTH BEHAVIOR; HELP SEEKING BEHAVIOR; HUMAN; INFORMATION SERVICE; INTERNET; MALE; NON INSULIN DEPENDENT DIABETES MELLITUS; PREDICTION; PRIORITY JOURNAL; RISK ASSESSMENT; RISK FACTOR; SCORING SYSTEM; SEX DIFFERENCE; WAIST CIRCUMFERENCE;

ADULT; AGED; BODY MASS INDEX; DATA INTERPRETATION, STATISTICAL; DIABETES MELLITUS, TYPE 2; FEMALE; FORECASTING; GERMANY; HEALTH BEHAVIOR; HEALTH COMMUNICATION; HUMANS; INFORMATION SEEKING BEHAVIOR; INTERNET; LIFE STYLE; MALE; MIDDLE AGED; RISK ASSESSMENT; RISK FACTORS; SEX DISTRIBUTION; YOUNG ADULT;

EID: 79952037891     PISSN: 07383991     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.pec.2010.04.021     Document Type: Article

References (58)

1. Cancer risk prediction resources 2009, National Cancer Institute, Cancer Control and Population Sciences, URL:, [accessed 18.03.2009]. http://riskfactor.cancer.gov/cancer_risk_prediction.
2. Elmore J.G., Fletcher S.W. The risk of cancer risk prediction: " What is my risk of getting breast cancer" ?. J Natl Cancer I 2007, 98(December):1673-1675.
3. Freedman A.N., Seminara D., Gail M.H., Hartge P., Colditz G.A., Ballard-Barbash R., et al. Cancer risk prediction models: a workshop on development, evaluation, and application. J Natl Cancer I 2005, 97(May):715-723.
4. Gail M.H., Pfeiffer R.M. On criteria for evaluating models of absolute risk. Biostatistics 2005, 6(April):227-239.
5. Fosket J. Constructing " High-Risk Women": the development and standardization of a breast cancer risk assessment tool. Sci Technol Hum Val 2004, 29:291-313.
6. Lipkus I.M., Klein W.M., Rimer B.K. Communicating breast cancer risks to women using different formats. Cancer Epidem Biomar 2001, 10(August):895-898.
7. Dillard A.J., McCaul K.D., Kelso P.D., Klein W.M. Resisting good news: reactions to breast cancer risk communication. Health Commun 2006, 19:115-123.
8. Hembroff L.A., Holmes-Rovner M., Wills C.E. Treatment decision-making and the form of risk communication: results of a factorial survey. BMC Med Inform Decis Mak 2004, 4(November):20.
9. Edwards A.G., Evans R., Dundon J., Haigh S., Hood K., Elwyn G.J. Personalised risk communication for informed decision making about taking screening tests. Cochrane Database Syst Rev 2006, 4(October):CD001865.
10. Schulze M.B., Hoffmann K., Boeing H., Linseisen J., Rohrmann S., Moehlig M., et al. An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes. Diabetes Care 2007, 30(March):510-515.
11. Statistisches Bundesamt. Wirtschaftsrechnungen. Private Haushalte in der Informationsgesellschaft-Nutzung von Informations- und Kommunikationstechnologien: Statistisches Bundesamt; 2007.
12. Suggs L.S. A 10-year retrospective of research in new technologies for health communication. J Health Commun 2006, 11:61-74.
13. Lustria M.L.A., Cortese J., Noar S.M., Glueckauf R.L. Computer-tailored health interventions delivered over the web: review and analysis of key components. Patient Educ Couns 2009, 74:156-173.
14. Your Disease Risk Website; 2009. URL: [accessed 06.08.2009]. http://www.yourdiseaserisk.wustl.edu//.
15. Emmons K.M., Koch-Weser S., Atwood K., Conboy L., Rudd R., Colditz G. A qualitative evaluation of the Harvard Cancer Risk Index. J Health Commun 1999, 4(July-September):181-193.
16. Cline R.J., Haynes K.M. Consumer health information seeking on the Internet: the state of the art. Health Educ Res 2001, 16(December):671-692.
17. Eysenbach G., Kohler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. Brit Med J 2002, 324(March):573-577.
18. Schürer-Maly C., Koneczny N., Butzlaff M., Vollmar H.C. Guidepost for patients in the Internet-if you expect wise answers, you have to ask sensible questions. Z Allgemeinmed 2006, 82:549-555.
19. Roberts E.B., Ramnath R., Fallows S., Sykes K. " First-hit" heart attack risk calculators on the world wide web: implications for laypersons and healthcare practitioners. Int J Med Inform 2008, 77(June):405-412.
20. Morahan-Martin J.M. How Internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychol Behav 2004, 7(October):497-510.
21. Fairfield K.M., Chen W.Y., Colditz G.A., Emmons K.M., Fletcher S.W. Colon cancer risk counseling by health-care providers: perceived barriers and response to an Internet-based cancer risk appraisal instrument. J Cancer Educ 2004, 19(Summer):95-97.
22. Emmons K.M., Wong M., Puleo E., Weinstein N., Fletcher R., Colditz G. Tailored computer-based cancer risk communication: correcting colorectal cancer risk perception. J Health Commun 2004, 9(March-April):127-141.
23. Williams L., Jones W., Elwyn G., Edwards A. Interactive patient decision aids for women facing genetic testing for familial breast cancer: a systematic web and literature review. J Eval Clin Pract 2008, 14(February):70-74.
24. Linssen C., Schook R.M., The A.M., Lammers E., Festen J., Postmus P.E. A web site on lung cancer: who are the users and what are they looking for?. J Thorac Oncol 2007, 2(September):813-818.
25. Linke S., Murray E., Butler C., Wallace P. Internet-based interactive health intervention for the promotion of sensible drinking: patterns of use and potential impact on members of the general public. J Med Internet Res 2007, 9(May):e10.
26. Deutsches Institut für Ernährungsforschung. Deutscher Diabetes-Risiko-Test. Deutsches Institut für Ernährungsforschung:Potsdam-Rehbrücke; Leibnitz Gemeinschaft; 2009. [accessed 18.03.2009]. http://drs.dife.de/.
27. Pischon T., Boeing H., Hoffmann K., Bergmann M., Schulze M.B., Overvad K., et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008, 359(November):2105-2120.
28. Penniman W.D. A stochastic process analysis of on-line user behavior. Annual meeting of the American society for information science 1975.
29. Rice R.E., Borgman C.L. The use of computer-monitored data in information science. J Am Soc Inform Sci 1983, 34(July):247-256.
30. Lin X., Liebscher P., Marchionini G. Graphic representation of electronic search patterns. J Am Soc Inform Sci 1991, 42:469-478.
31. Jansen B.J. Search log analysis: what it is, what's been done, how to do it. Libr Inform Sci Res 2006, 28:407-432.
32. R Development Core Team A language and environment for statistical computing 2008, R Foundation for Statistical Computing, Vienna, Austria, URL:. http://www.r-project.org/.
33. Thefeld W. Prevalence of diabetes mellitus in the adult German population. Gesundheitswesen 1999, 61(December):85-89.
34. Pan X.R., Li G.W., Hu Y.H., Wang J.X., Yang W.Y., An Z.X., et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care 1997, 20:537-544.
35. Tuomilehto J., Lindstrom J., Eriksson J.G., Valle T.T., Hämäläinen H., Ilanne-Parikka P., et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001, 344(May):1343-1350.
36. Knowler W.C., Barrett-Connor E., Fowler S.E., Hamman R.F., Lachin J.M., Walker E.A., et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346(February):393-403.
37. Ramachandran A., Snehalatha C., Mary S., Mukesh B., Bhaskar A.D., Vijay V. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type-2-diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006, 49:289-297.
38. Ekman A., Hall P., Litton J.E. Can we trust cancer information on the Internet?-a comparison of interactive cancer risk sites. Cancer Causes Control 2005, 16(August):765-772.
39. Bennett M. A risk score for cardiovascular disease 2009, Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, URL:, [accessed 18.03.2009]. http://www.riskscore.org.uk/.
40. Risikotest. Action D-Diabetes Activ Vorbeugen; 2009. URL: [accessed 18.03.2009]. http://actiond.ch/de/diabetesrisiko.php.
41. NCI Breast cancer risk assessment tool 2009, National Cancer Institute, URL:, [accessed 18.03.2009]. http://www.cancer.gov/bcrisktool/.
42. Samplin-Salgado M. Press releases: 2004 releases-Harvard expands popular website to include risk assessments for cancer, heart disease, stroke, diabetes, and osteoporosis 2009, Harvard School of Public Health, URL:, [accessed 18.03.2009]. http://www.hsph.harvard.edu/news/press-releases/archives/2004-releases/press06282004.html.
43. NCI Breast cancer risk assessment tool. Survey report 2005, Office of Education and Special Initiatives, NCI.
44. Levy A.G., Sonnad S.S., Kurichi J.E., Sherman M., Armstrong K. Making sense of cancer risk calculators on the web. J Gen Intern Med 2008, 23(March):229-235.
45. Eaton L. A third of Europeans and almost half of Americans use Internet for health information. Brit Med J 2002, 325(November):989b.
46. Eysenbach G., Kohler C. What is the prevalence of health-related searches on the World Wide Web? Qualitative and quantitative analysis of search engine queries on the Internet. Proc AMIA Symp 2003, 225-229.
47. Eysenbach G., Kohler C. Health-related searches on the Internet. AMA 2004, 291(June):2946.
48. Atkinson N.L., Saperstein S.L., Pleis J. Using the Internet for health-related activities: findings from a national probability sample. J Med Internet Res 2009, 11(February):e4.
49. Fox S, Rainie L. The online health care revolution: how the web help American take better care of themselves. Washington, DC: Pew Internet and American Life Project: Online life report; 2000 November.
50. Deutsches Institut für Ernährungsforschung. Medienpräsenz. Deutsches Institut für Ernährungsforschung: Potsdam-Rehbrücke; 2009. URL: [accessed 18.03.2009]. http://www.dife.de/de/index.php?request=/de/presse/medienpraesenz.php.
51. Mayer D.K., Terrin N.C., Kreps G.L., Menon U., McCance K., Parsons S.K., et al. Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer. Patient Educ Couns 2007, 65(March):342-350.
52. Houston T.K., Allison J.J. Users of Internet health information: differences by health status. J Med Internet Res 2002, 4(April-November):e7.
53. Andreassen H.K., Bujnowska-Fedak M.M., Chronaki C.E., Dumitru R.C., Pudule I., Santana S., et al. European citizens' use of E-health services: a study of seven countries. BMC Public Health 2007, 7(April):53.
54. Hausner H., Hajak G., Spiessl H. Gender differences in help-seeking behavior on two internet forums for individuals with self-reported depression. Gend Med 2008, 5(June):181-185.
55. Robert-Koch-Institut Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes 2006, Robert Koch-Institut, Berlin.
56. Bader J.L., Strickman-Stein N. Evaluation of new multimedia formats for cancer communications. J Med Internet Res 2003, 5(July-September):e16.
57. Haigh S, Megarity J. Measuring website usage: log file analysis. Network Notes, No. 57.
58. Franck L. Enquiring minds want to know: topics requested by users of a children's health information website. Patient Educ Couns 2008, 72:168-171.