title: Planning locally relevant Internet programs for secondary prevention of cardiovascular disease.
abstract: BACKGROUND
  Although the Internet has been shown to be an effective tool for supporting behavioural change in other chronic diseases, less in known about the efficacy of, or need for, Internet-based interventions in the prevention of coronary heart disease (CHD).
  
  
  OBJECTIVE
  We investigated computer literacy, consumer need and perceived usefulness of the Internet as a secondary prevention tool in people with CHD.
  
  
  METHODS
  A two-step mixed-method process was used that included a survey and two focus groups. The 12-item survey explored participants' access and confidence using the Internet. For the focus groups, we used standard methodology.
  
  
  RESULTS
  We recruited 66 (88% response rate) consecutive cardiac patients; age 36-73 years (mean 64±13), mostly male (85%), whose primary language was predominantly English (67%). Seventy percent had a home computer with Internet access but only 20% reported researching their heart-health online. There was polarity between those with and without Internet access. Further, we found less women than men could complete online forms (p=0.03) and that participants aged over 65 years were less likely to access the Internet (p<0.01) and had lower confidence (p<0.01) than younger counterparts. Focus groups revealed challenges of an online secondary prevention service, but participants valued relevant, practical advice and placed strong emphasis on simple web design.
  
  
  CONCLUSIONS
  Using a mixed-methods process we collected locally sensitive information about Internet usage and recommendations for future online health-management strategies. Some patients have more confidence using the Internet, therefore a range of multi-technological secondary prevention interventions should be considered based on individual need.
authors.affiliation: Faculty of Medicine, University of Sydney, and ANZAC Research Institute, Concord Hospital, Sydney, Australia. lis.neubeck@sydney.edu.au
authors.forename: Lis
authors.initials: L
authors.lastname: Neubeck
authors.forename: Rhoda
authors.initials: R
authors.lastname: Ascanio
authors.forename: Adrian
authors.initials: A
authors.lastname: Bauman
authors.forename: Tom
authors.initials: T
authors.lastname: Briffa
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Clark
authors.forename: Ben
authors.initials: B
authors.lastname: Freedman
authors.forename: Julie
authors.initials: J
authors.lastname: Redfern
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011314:Preventive Health Services; D012040:Regional Health Planning; D011795:Surveys and Questionnaires; D014584:User-Computer Interface