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Published on 30.12.16 in Vol 2, No 1 (2016): December

This paper is in the following e-collection/theme issue:


    A Review of the Influence of Interactivity on Health-Related Outcomes and Recommendations for Future Study

    Edward R. Murrow College of Communication, Washington State University, Pullman, WA, United States

    Corresponding Author:

    Jessica Fitts Willoughby, PhD

    Edward R. Murrow College of Communication

    Washington State University

    PO Box 642530

    Pullman, WA, 99164-2530

    United States

    Phone: 1 509 335 7926

    Fax:1 509 335 3772



    Background: Interactivity is a foundational characteristic of mediated communication that may influence persuasion and attention. Interactivity refers to the two-way exchange of information contingent on previous input, meaning that websites and mobile systems can be more or less interactive depending on system affordances. There are multiple types of interactivity, including functional interactivity, which is based on the affordances of the system, and perceived interactivity, which is based on users’ perceptions of the responsiveness of the system as opposed to actual system features. Previous research has suggested that interactivity may be vital to the success of technologically driven health communication interventions.

    Objective: The purpose of this project was to examine how interactivity has been assessed in relation to health outcomes, including what types of interactivity are discussed, how interactivity is measured, and the influence of interactivity on health-related outcomes.

    Methods: We conducted a systematic review of the published literature in PubMED and EBSCO in fall 2015. Search terms included “interactivity” and “health” as well as a variety of words related to media and new media (eg, media, electronic, SMS, communication). To be included in the review, articles needed to (1) focus on studying the impact of interactivity (content analyses and intervention descriptions that did not explicitly assess interactivity effects were not included) and (2) examine outcomes related to health (eg, health knowledge, comprehension, attitudes, intentions, or behaviors). After articles had been located, we conducted backward and forward searches. Of the more than 1200 articles examined, 11 articles met the inclusion criteria.

    Results: Studies that assess the role of interactivity on health-related outcomes varied greatly in the types of interactivity assessed as well as health outcome variables. All studies used an experimental design. Health topics included mental health, physical activity, skin cancer, fibromyalgia, appendicitis, allergies, and smoking. Interactivity was defined differently in many of the studies, but most focused on the functional features as opposed to perceptions of interactivity. If assessed, perceived interactivity was used primarily as a manipulation check or mediator. Effects of interactivity on health-related outcome variables were mixed, with effects mainly appearing in the connection between interactivity and attitudes toward the health topic. Knowledge was directly related to interactivity in one study, but no significant effects were found in three other studies that assessed the connection between interactivity and knowledge.

    Conclusions: This study highlights that definitions of interactivity in the literature are inconsistent and ambiguous, as some scholars did not define interactivity, and others’ definitions varied. Scholars should work to clearly operationalize what they mean by interactivity so that work can be compared and expanded upon. While all studies focused on functional interactivity, some also looked at perceptions as a mediator or manipulation check. With some outcomes, such as attitudes, interactivity did have an effect. Future research should continue to examine the role of interactivity and potential mediating variables on health outcomes. Interactivity may work as one technological attribute that is part of a larger system impacting the effectiveness of health behavior interventions and influencing health outcomes.

    iproc 2016;2(1):e41



    This poster was presented at the Connected Health Symposium 2016, October 20-21, Boston, MA, United States. The poster is displayed as an image in Figure 1 and as a PDF in Multimedia Appendix 1.

    Figure 1. Poster.
    View this figure

    Multimedia Appendix 1


    PDF File (Adobe PDF File), 315KB

    Edited by T Hale; submitted 03.06.16; peer-reviewed by CHS Scientific Program Committee; accepted 02.08.16; published 30.12.16

    ©Jessica Fitts Willoughby, Zhaomeng Niu. Originally published in Iproceedings (, 30.12.2016.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.