Limitations

There are several limitations to e-health interventions. First, e-health interventions tend to have a small effect (interventions reduce weekly drinking around 2-5 standard drinks), and this may discourage some clinicians from using them as a tool. However, once developed, e-health interventions are very cheap and cost effective and even small reductions may be meaningful. Second, most e-health interventions are fully automated and self-directed. Thus, they rely on the user to be engaged and motivated to use the interventions. Finally, the main concern for e-health interventions is selecting and determining which interventions are effective. Unfortunately, most e-health interventions with evidence from research are not being made available to non-research populations as researchers may not have the opportunity or resources to make evidence-based e-health intervention available after the trial. This concern is compounded by the fact that the most alcohol related smartphone applications available for download focus a) on facilitating drinking (instead of reducing it), b) use fewer active ingredients than research applications (3 vs 6-9), c) are unlikely to be guided by any specific theory, and d) are inaccurate. Given that the specific interventions we endorse may no longer be supported at the time of publication, we include a section with websites run by researchers and experts who rate e-health interventions based on their effectiveness. These websites are being maintained and new available interventions are expected to be listed.

Website

Beacon is an Australian website that uses a panel of health experts to categorise, review, and rate websites and mobile applications e-health tools (applications and websites) used for health behaviours. Beacon publishes these reviews on their website along with information about the intervention and the link to the intervention website. The rating system is very easy to use for both clinicians and consumers, and evidence is ranked from “there is no evidence currently”, “the evidence suggests the site doesn’t work” up to “sign up”. There is currently one alcohol intervention that is highly rated on this site.

Website

Psyberguide uses a similar process to Beacon. However, they currently have very few applications for substance use. The Credibility Score represents the strength of the scientific research support for the app itself, and the therapeutic interventions the app provides.

Website

Head to health focuses more on resources and does not rate specific e-health interventions. They break down resources into 1) head to health information pages, 2) external websites, 3) apps and programs (specific resources), 4) forums for peer support, and 5) phone chat and email options. However, they do not currently provide a rating of the e-health interventions hosted on the website.