The White Paper Choosing health acknowledges that there is no lack of information in the system about healthy lifestyles, but the manner of communication of risk and the level of support for lifestyle change need improvement. Action also has to be taken to address inequalities in health and to focus on securing better access to healthier choices for people in disadvantaged groups or areas. Accordingly, this randomized controlled trial examined whether access to a purpose-built health portal for heart disease could enable patients to manage better their heart conditions. We recruited 108 men and women aged 50—74 from coronary heart disease registries from a deprived area of Greater Manchester. Every participant received a new computer and one-year broadband subscription; however, only the experimental group received access to the Hearts of Salford health portal. Our results indicate that the experimental group changed their diet significantly. Specifically, they reported eating `bad foods' (such as chips, sweets, crisps, fried foods, ready meals and cakes/biscuits) significantly less often compared to the controls.
Anderson, B. and Tracey, K. (2002). Digital living. In B. Wellman and C. Haythornthwaite (Eds.), The Internet in everyday life, pp. 139-63. Oxford : Blackwell.
2.
Bliss, J., Allibone, C., Bontempo, B., Flynn, T. and Valvano, N. (1998). Creating a web site for on-line social support . Computers in Nursing, 16(4), 203-7.
3.
Bourdieu, P. (1984). Distinction: A social critique of the judgement of taste. Oxford: Blackwell.
4.
Brekke, M., Kottke, T., Brekke, L. and Wu, L. (2003). Design and development of a coronary heart disease decision support tool. International Journal of Technology Assessment in Health Care, 19(3), 555-8.
5.
British Heart Foundation. (2005). Coronary heart disease statistics. www.heartstats.org
6.
Campbell, R. and Wabby, J. (2003). The elderly and the Internet. Internet Journal of Health, 3(1), 11-21.
7.
Cotton, S. and Gupta, S. (2004). Characteristics of online and offline health information seekers and factors that discriminate between them. Social Science and Medicine, 59(8), 1795-806.
8.
Department of Health. (2001). The expert patient: A new approach to chronic disease management in the 21st century. London: Stationery Office .
9.
Department of Health. (2004). Choosing health: Making healthy choices easier. London : Stationery Office.
10.
Diaz, J., Griffith, R., Ng, J., Reinert, S., Friedmann, P. and Moulton, A. (2002). Patients' use of the Internet for medical information . Journal of General Internal Medicine, 17(3), 180-5.
11.
Dooris, M. (2004). Joining up settings for health: A valuable investment for strategic partnerships? Critical Public Health, 14(1), 49-61.
12.
Dutton, W., di Gennaro, C. and Millwood Hargrave, A. (2005). The Oxford Internet survey, report 2005: The Internet in Britain. Oxford: Internet Institute.
13.
Evans, R., Barer, M. and Marmor, T. (1994). Why are some people healthy and others not?New York: Aldine de Gruyter.
14.
Gallant, M. (2003). The influence of social support on chronic illness self-management. Health Education & Behaviour, 30(2), 170-95.
15.
Gordon, N. (2003). New methods of delivering secondary preventive services: The promise of the Internet. Journal of Cardiopulmonary Rehabilitation, 23(5), 349-51.
16.
Green, J. and Thorogood, N. (2004). Qualitative methods for health research. London: SAGE.
17.
Gustafson, D., Hawkins, R., Boberg, E., Pingree, S., Serlin, R., Graziano, F. and Chan, C. (1999). Impact of a patient-centred, computer-based health information/support system. American Journal of Preventive Medicine, 16(1), 1-9.
18.
Hampton, K. (2003). Grieving for a lost network. The Information Society, 19(5), 1-13.
19.
Hanusaik, N., O'Loughlin, J., Ryan, A., Edwards, A., West, R., Harvey, D. and Cameron, R. (2003). The G8 Heart Health Projects Database: Testing the compatibility of an Internet-based resource with health promotion planning processes. Health Promotion Practice, 4(4), 413-21.
20.
Hellawell, S. (2001). Beyond access: ICT and social inclusion. London: Fabian Society.
21.
Herbert, J., Yunsheng, M., Clemow, L., Ockene, I., Saperia, G., Stanek, E. et al. (1997). Gender differences in social desirability and social approval bias in dietary self-report. American Journal of Epidemiology, 146(12), 1046-55.
22.
Ikemba, C., Kozinetz, C., Feltes, T., Fraser, C., McKenzie, E. and Mott, A. (2002). Internet use in families with children requiring cardiac surgery for congenital heart disease. Pediatrics, 109(3), 419-22.
23.
Kirsch, S. and Lewis, A. (2004). Using the world wide web in health-related intervention research. Computers, Informatics, Nursing, 22(1), 8-18.
24.
Kleinke, J. (2000). Vaporware.com: The failed promise of the health care Internet. Health Affairs, 19(6), 57-71.
25.
Lai, C., Arthur, A. and Chau, W. (2004). Implication of Internet growth on enhancing health of disadvantaged groups in China. International Journal of Older People in Nursing, 13(S2), 68-73.
26.
Lewis, D. (1999). Computer-based approaches to patient education . Journal of the American Medical Informatics Association , 6, 272-82.
27.
Lindsay, S., Smith, S., Bell, F. and Bellaby, P. (2007). Tackling the digital divide: Exploring the impact of ICT on managing heart conditions. Journal of Information, Communication & Society, 10(1), 95-114.
28.
Link, B. and Phelan, J. (1995). Social conditions as fundamental causes of disease . Journal of Health & Social Behaviour, 35(Extra Issue), 80-94.
29.
Liu, J., Maniadakis, N., Gray, A. and Rayner, A. (2002). The economic burden of coronary heart disease in the UK. Heart, 88, 597-603.
30.
McKinlay, J. and McKinlay, S. (1994). A case for refocusing upstream. In P. Conrad and R. Kern (Eds.), The sociology of health and illness, pp. 519-36. New York: St Martins.
31.
Mead, N., Varnam, R., Rogers, A. and Roland, M. (2003). What predicts patients' interest in the Internet as a health resource in primary care in England? Journal of Health Services Research and Policy, 8(1), 33-9.
32.
Milio, N. (2001). The Internet, public health, and the globalization of just about everything. Journal of Epidemiology & Community Health, 55, 74-6.
33.
National Heart Forum. (2007). Nutrition. www.heartforum.org.uk/Policy_nutrition.aspx
34.
Nettleton, S., Pleace, N., Burrows, R., Muncer, S. and Loader, B. (2002). The reality of virtual social support. In S. Woolgar (Ed.), Virtual society? Technology, cyberbole, reality, pp. 176-88. Oxford: Oxford University Press.
35.
Nguyen, H., Carrieri-Kohlman, V., Rankin, S., Slaughter, R. and Stulbarg, M. (2004). Internet-based patient education and support interventions . Computers in Biology and Medicine, 34(2), 95-112.
36.
Nie, N. and Hillygus, D. (2002). The impact of Internet use on sociability: Time-diary findings. IT & Society, 1(1), 1-20.
37.
Norris, P. (2001). Digital divide: Civic engagement, information poverty, and the Internet worldwide. Cambridge: Cambridge University Press.
38.
Peterson, S., Peto, V. and Rayner, M. (2004). Coronary heart disease statistics. Oxford: British Heart Foundation Health Promotion Research Group, University of Oxford.
39.
Pew Internet and American Life Project. (2001 ). The online health care revolution: How the web helps Americans take better care of themselves. Available at http://www.pewinternet.org
40.
Popay, J., Thomas, C., Williams, G., Bennett, S., Gatrell, A. and Bostock, L. (2003). A proper place to live: Health inequalities, agency and the normative dimensions of space. Social Science & Medicine, 57(1), 55-69.
41.
Prashar, A. (2000). Coronary heart disease in the north west, public health information report. Greater Manchester: North West Public Health Observatory.
42.
Richards, L. (1999). Using NVIVO in qualitative research. London: SAGE.
43.
Robson, M. (2001). Shipley Communities online: Becta/Ngû case study . Available at http://ferl.becta.org.uk/display.cfm?resid1606&printable¼1
44.
Salford Healthy City Forum. (2004). Health inequalities in Salford: A local strategy for action. http://www.partnersinsalford.org/health_strat_final.doc
45.
Salford Primary Care Trust (PCT). (2005). Improving the health of Salford. Salford NHS PCT. http://www.salford-pct.nhs.uk/foi/our_services.asp?id=6
46.
Scherrer-Bannerman, A., Fofonoff, D., Minshall, D., Downie, S., Brown, M., Leslie, F. and McGowan, P. (2000). Web-based education and support for patients on the cardiac surgery waiting list. Journal of Telemedicine & Telecare, 6(S1), S72-4.
47.
Seeman, T. (1996). Social ties and health: The benefits of social integration. Annals of Epidemiology, 6(5), 442-51.
48.
Shaw, J. and Baker, M. (2004). `Expert patient' - dream or nightmare? British Medical Journal, 328(7442), 723-4.
49.
Stout, P., Villegas, J. and Kim, H. (2001). Enhanced learning through use of interactive tools on health-related websites. Health Education Research, 16(6), 721-33.
50.
Tattersall, R. (2002). The expert patient: A new approach to chronic disease management for the twenty-first century. Clinical Medicine, 2(3), 227-9.
51.
Tetzlaff, L. (1997). Consumer informatics in chronic illness. Journal of the American Medical Informatics Association, 4(4), 285-300.
52.
Toobert, D., Strycker, L., Glasgow, R., Barrera, M. and Angell, K. (2005). Effects of the Mediterranean lifestyle program on multiple risk behaviors and psychosocial outcomes among women at risk for heart disease. Annals of Behavioral Medicine, 29(2), 128-37.
53.
Vingilis, E. and Lindsay, S. (2001). Development of an information and utilization evaluation model. Family Medicine Research, 18, 7.
54.
Wardle, J., Hasse, A., Steptoe, A., Nillapun, M., Jonwutiwes, K. and Bellisle, F. (2004). Gender differences in food choice: The contribution of health beliefs and dieting. Annals of Behavioral Medicine , 27(2), 107-16.
55.
Wheeler, J. (2003). Can a disease self-management program reduce health care costs? Medical Care, 41(6), 706-15.
56.
Wilkinson, R. (1996). Unhealthy societies: The affiliations with inequality . London: Routledge.
57.
Wilson, P. (2001). A policy analysis of the expert patient in the United Kingdom: Self-care as an expression of pastoral power? Health and Social Care in the Community, 9(3), 134-42.
58.
Wise, M., Woong Yun, G. and Shaw, B. (2000). Mapping use of a self-directed online heart disease education program onto health learning outcomes. Proceedings of the Adult Education Research Conference, University of British Columbia, Vancouver.
59.
Wong, B., Yung, B., Wong, A., Chow, C. and Abramson, B. (2005). Increasing Internet use among cardiovascular patients . Canadian Journal of Cardiology, 21(4), 349-54.
