Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour.
OBJECTIVE Advances in web-based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities . We developed imagery and text contents of brief , computer-based programmes about heart disease risk , with both imagery and text contents guided by the common-sense model ( CSM ) of self-regulation . The imagery depicts a three-dimensional , beating heart tailored to user-specific information . DESIGN A 2 × 2 × 4 factorial design was used to manipulate concrete imagery ( imagery vs. no imagery ) and conceptual information ( text vs. no text ) about heart disease risk in prevention-oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days , 2 weeks , and 4 weeks post-intervention . METHODS Sedentary young adults ( N= 80 ) were r and omized to view one of four programmes : imagery plus text , imagery only , text only , or control .  Participants completed measures of risk representations , worry , and physical activity and healthy diet intentions and behaviours at baseline , 2 days post-intervention ( except behaviours ) , and 2 weeks ( intentions and behaviours only ) and 4 weeks later . RESULTS The imagery contents  increased representational beliefs and mental imagery relating to heart disease , worry , and intentions at post-intervention . Increases in sense of coherence ( underst and ing of heart disease ) and worry were sustained after 1 month . The imagery contents also increased healthy diet efforts after 2 weeks . The text contents increased beliefs about causal factors , mental images of clogged arteries , and worry at post-intervention , and increased physical activity 2 weeks later and sense of coherence 1 month later . CONCLUSION The CSM-based programmes induced short-term changes in risk representations and behaviour motivation . The combination of CSM-based text and imagery appears to be most effective in instilling risk representations that motivate protective behaviour
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .