Carey et al. [1] conducted a randomized trial to compare brief motivation interventions (BMIs) with computer-delivered interventions (CDIs). Face-to-face BMIs appeared to be more effective in comparison with two CDIs. Cunningham [2] commented on this study that it is time to start discussing what type of CDIs are being employed. He suggested at least making a distinction between brief interventions derived from clinical settings and education-orientated interventions.

I would like to take this suggestion one step further and plead for future research to focus on the actual content of CDIs; that is, to look at intervention techniques or active ingredients to unravel what works (in line with previous discussions in Addiction, e.g. [3]). An excellent systematic review and meta-analysis by Webb et al. [4], for example, revealed that providing information on the consequences of behaviour, prompting self-monitoring and identifying barrier and/or problem solving were most commonly used, but the largest effects on behaviour were observed for CDIs addressing stress management and communication skills. These intervention techniques, however, were used in different combinations within different interventions. Nowadays, advanced software (e.g. LifeGuide [5]) provides the opportunity to work with modules containing certain intervention techniques. This makes it possible to study the added value of using an intervention technique in addition to other intervention techniques in existing interventions. Future research should focus on the added value of certain intervention techniques to determine what content is needed to result in more effective CDIs.

Cunningham [2] concluded his letter by pleading for research to test whether the state-of-the-art version of face-to-face interventions is superior to a computerized substitute. Although this is an interesting research question, I feel that a focus on content is more important to move the field of behavioural sciences forward than the mode of intervention delivery. After all, ‘interactive technologies are a tool, not a panacea’[6].


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