Effective interventions to improve health behaviors are urgently needed. Significant behavior change can prevent or delay some chronic illnesses and help manage chronic diseases. Expensive face-to-face programs with limited accessibility may be effective for participants but may not be realistically feasible beyond research studies. The use of Internet-based interventions is increasingly common. We are pleased to include the results of a trial testing an Internet-based physical activity intervention by Bosak, Yates, and Pozehl in this issue.

It is extremely difficult to implement health behavior change. The small outcome effect sizes of many face-to-face health behavior change interventions suggest that different strategies are needed to make larger changes in individuals’ behaviors. New intervention content and delivery methods are necessary to reach more people and achieve better health behavior outcomes. Internet-based interventions have many attractive attributes. As Bosak et al. note, they can be implemented in a consistent manner and allow broad access, and users’ anonymity may be preserved. The temporal flexibility and lack of geographic constraints of Internet programs may overcome some common barriers to participation. Anonymity helps avoid the social stigma that may hinder participation in face-to-face interventions. Internet-based interventions may be modified to match user attributes in multiple dimensions. Computer-based interventions can include sophisticated tailoring and feedback based on complex algorithms to increase personalization. Users may be able to control their experience by toggling among content and modality alternatives. Synchronous and asynchronous modalities may facilitate interactive components of interventions. The immediacy of instant feedback may be effective. Convenience may encourage early use of behavior change programs before significant negative health consequences occur. These alluring features and potential effectiveness have attracted entrepreneurs who are now designing Internet programs. Some profit and not-for-profit entities purchase these programs with the intent of promoting healthy behaviors and reducing health care costs. Most of these programs have not been systematically tested for effectiveness but do have marvelous graphics!