Internet interventions: Moving from efficacy to effectiveness
In this discussion paper we consider the issues involved when moving the field of Internet interventions from trials of efficacy to effectiveness in representative settings. In addition, the future of Internet interventions as well as research and clinical implications are discussed. Several systematic reviews are now available, but there is a lack of consensus on what to include and exclude under the term ‘Internet interventions’. While there have been numerous efficacy trials there are only a few effectiveness studies, and it is not clear if the distinction between efficacy and effectiveness can be applied, as Internet interventions can take place both within a clinical setting and in a more large scale public health arena. A limitation of the existing efficacy trials is that participants often are recruited via mass media and that educational level and motivation are likely to differ from ordinary clinical settings. However, with respect to Internet interventions aimed at clinical target groups, evidence from efficacy trials now support the further implementation of Internet interventions in effectiveness trials.
Efficacy, effectiveness, guided internet-delivered treatment