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 .
Effect of Preventive Messages Tailored to Family History on Health Behaviors: The Family Healthware Impact Trial
PURPOSE We wanted to determine the impact of automated family history assessment and tailored messages for coronary heart disease , stroke , diabetes , colorectal , breast , and ovarian cancer on preventive behaviors compared with a st and ard preventive message . METHODS The study was a cluster-r and omized clinical trial that included 41 primary care practice s , the majority in the Midwest , using Family Healthware  , a self-administered , Web-based tool that assesses familial risk for the diseases and provides personalized risk-tailored messages . Patients in the control group received an age- and sex-specific health message related to lifestyle and screening . Smoking cessation , fruit and vegetable intake , physical activity , aspirin use , blood pressure , and cholesterol and blood glucose screening  were assessed at baseline and 6 months after the intervention . RESULTS Of 4,248 participants , 3,344 ( 78 % ) completed the study . Participants were white ( 91 % ) , female ( 70 % ) , and insured ( 97 % ) , and had a mean age of 50.6 years ( range 35–65 years ) . Intervention participants were more likely to increase daily fruit and vegetable consumption  from 5 or fewer servings a day to 5 or more servings a day ( OR = 1.29 ; 95 % confidence interval [ CI ] , 1.05–1.58 ) and to  increase physical activity ( OR = 1.47 ; 95 % CI , 1.08–1.98 ) to 5 to 6 times a week for 30 minutes or more a week . The absolute differences in proportion were 3 % and 4 % , respectively . Intervention participants were less likely to move from not having cholesterol screening in the last 5 years to having their cholesterol measured within 5 years ( OR = 0.34 ; 95 % CI , 0.17–0.67 ) , with an absolute difference of 15 % . CONCLUSIONS Messages tailored to an individual ’s familial risk for 6 common diseases modestly increased self-reported physical activity and fruit and vegetable intake but reduced the likelihood of receiving cholesterol screening
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 .