Internet Based Health Interventions Successful with Rural Groups

March 18, 2005 A University of Wyoming researcher has achieved remarkable success using the Internet as a resource for rural residents to access health information.

A 2004 report by the Pew Internet and American Life Project says 31 million U.S. rural residents are online, says Anne Bowen, professor in the UW Department of Psychology. She says the Internet is especially important in Wyoming, where people may be isolated geographically or socially.

With funding from the National Institutes of Health, Bowen has conducted Internet research on rural health issues for almost four years. To date, she has recruited more than 1,000 rural men and women from across the nation to complete Internet questionnaires about their risks for AIDS. Additionally, she has developed an online intervention that "people like and use." The results show individuals are successfully learning about HIV.

"We had 80 percent of our people complete a one week intervention the best return anyone has achieved," says Bowen. "This speaks to our ability to keep Web site visitors interested. It is easy to 'click out' of a Web site and many researchers questioned whether such online research could be done.

"In other studies that have tried interventions, as many as 70 percent of respondents have dropped out before completing the project," Bowen says. "I am pleased that Wyoming is at the international forefront of online interventions for AIDS prevention."

She explains that Internet research is an efficient way to make contact with hidden populations such as battered women, HIV positive individuals, or troubled teenagers, who otherwise might be difficult to find. The Internet works because these individuals don't have to overcome their fear of being exposed, she says.

"It's a great tool for people to confidentially access information and tailor it to their interests," says Bowen. "People in rural areas can access information from their homes and choose strategies that will work within the structure of their lives. They don't need to drive many miles to a support group."

Bowen and her team of researchers have developed intervention modules on basic HIV/AIDS information, HIV treatments, and avoiding infection by the AIDS virus. The interventions, with quick download times, include online discussions and interactive parts where participants enter information based on their ideas, values and experiences. Individuals learn about important issues, and the goal is to influence them to change their attitudes and behaviors.


Simulated role plays and expressive graphics help make online interventions successful, according to Bowen. Interaction prevails over handing out pamphlets or brochures, she says. Interventions also can include "real time one on-one or group chats." She believes rural residents can't lose when they have good access to the Internet.

"We're learning what keeps people interested on the Internet," says Bowen. "We know how to recruit specific groups of people using banner ads and other tools. Now we just need to find out the types of health information rural people want, such as ideas for parents to talk to their kids about drugs and sex.

"We can reach so many people at a reasonable cost," Bowen says. "In rural areas, the Internet may become the primary tool for health resources and well being. We can empower many people at one time instead of paying for travel costs and a professional's time while only reaching one person."

Bowen says Internet research is exciting because once an intervention is done, it is inexpensive to keep it online. After the up front costs of programming, the concept pays for itself, she notes. "Everything begins to operate automatically, although the knowledge needs to be accurate and the technology upgrades need to be current."

She adds, "Users must be careful because there is a lot of bad information on the Internet. However, it can be really good to get into a pipeline where people recommend you to a reliable site. For example, UW works with the Wyoming Department of Health and other reputable organizations across the state, ensuring the information on the sites is accurate."

Bowen has conducted health prevention research in rural areas since 1992. She earned her doctorate degree in clinical psychology from West Virginia University and received master degrees from Idaho State University and the State University of New York.

Posted on Friday, March 18, 2005