title: Identifying factors for optimal development of health-related websites: a delphi study among experts and potential future users.
abstract: BACKGROUND
  The Internet has become a popular medium for offering tailored and targeted health promotion programs to the general public. However, suboptimal levels of program use in the target population limit the public health impact of these programs. Optimizing program development is considered as one of the main processes to increase usage rates.
  
  
  OBJECTIVE
  To distinguish factors potentially related to optimal development of health-related websites by involving both experts and potential users. By considering and incorporating the opinions of experts and potential users in the development process, involvement in the program is expected to increase, consequently resulting in increased appreciation, lower levels of attrition, and higher levels of sustained use.
  
  
  METHODS
  We conducted a systematic three-round Delphi study through the Internet. Both national and international experts (from the fields of health promotion, health psychology, e-communication, and technical Web design) and potential users were invited via email to participate. During this study an extensive list of factors potentially related to optimal development of health-related websites was identified, by focusing on factors related to layout, general and risk information provision, questionnaire use, additional services, and ease of use. Furthermore, we assessed the extent to which experts and potential users agreed on the importance of these factors. Differences as well as similarities among experts and potentials users were deduced.
  
  
  RESULTS
  In total, 20 of 62 contacted experts participated in the first round (32% response rate); 60 of 200 contacted experts (30% response rate) and 210 potential users (95% response rate) completed the second-round questionnaire, and 32 of 60 contacted experts completed the third round (53% response rate). Results revealed important factors consented upon by experts and potential users (eg, ease of use, clear structure, and detailed health information provision), as well as differences regarding important factors consented upon by experts (eg, visual aids, self-monitoring tool, and iterative health feedback) or by potential users only (eg, bread crumb navigation and prevention of receiving spam).
  
  
  CONCLUSIONS
  This study is an important first step in determining the agreed-upon factors that should be taken into account when developing online health promotion programs. The public health impact of these programs will be improved by optimizing the development process in line with these factors.
authors.affiliation: CAPHRI, Department of Health Promotion, Maastricht University, Maastricht, Netherlands. francine.schneider@maastrichtuniversity.nl
authors.forename: Francine
authors.initials: F
authors.lastname: Schneider
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van Osch
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
mesh_terms: D003697:Delphi Technique; D006266:Health Education; D020407:Internet; D016730:Program Development; D011795:Surveys and Questionnaires