title: Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review.
abstract: BACKGROUND
  One relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web.
  
  
  OBJECTIVE
  Our aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy.
  
  
  METHODS
  Web keyword searches were carried out on three major search engines (Google, Bing, and Yahoo-UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool.
  
  
  RESULTS
  The search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access fee. Half of the programs offered some form of paid therapist or professional support. Programs varied in treatment length and number of modules and employed a variety of presentation modes. Relatively few programs had published research evidence of the intervention's efficacy.
  
  
  CONCLUSIONS
  This review represents a snapshot of available Web-based intervention programs for anxiety that could be found by consumers in March 2015. The consumer is confronted with a diversity of programs, which makes it difficult to identify an appropriate program. Limited reports and existence of empirical evidence for efficacy make it even more challenging to identify credible and reliable programs. This highlights the need for consistent guidelines and standards on developing, providing, and evaluating Web-based interventions and platforms with reliable up-to-date information for professionals and consumers about the characteristics, quality, and accessibility of Web-based interventions.
authors.affiliation: Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London, United Kingdom. miriam.ashford@city.ac.uk.
authors.forename: Miriam Thiel
authors.identifier: http://orcid.org/0000-0003-4045-6435
authors.initials: MT
authors.lastname: Ashford
authors.forename: Ellinor K
authors.identifier: http://orcid.org/0000-0001-7792-9895
authors.initials: EK
authors.lastname: Olander
authors.forename: Susan
authors.identifier: http://orcid.org/0000-0002-6153-2460
authors.initials: S
authors.lastname: Ayers
keywords: Anxiety; access to health care; consumer; internet; mental health; technology; web-based interventions