Upfront

Poverty and lack of access to care weave a tangled web of mental health problems, but Ricardo Muñoz, PhD, is using the Web to help untangle it. The University of California, San Francisco, psychology professor is developing ways to bring Internet-based behavioral health interventions to the world, including poor, rural places.
Automated Internet interventions are practical because a single site can simultaneously serve an almost unlimited number of people. And because of the world's rapidly growing Internet infrastructure — even rural villages often have Internet cafés — these interventions can reach people who otherwise would receive no help.

"The idea sounds reasonable," Muñoz said. "The question is, will it work?"

To find out, Muñoz and his colleagues conducted a study with 4,000 English- and Spanish-speaking smokers in 74 countries who enrolled in an Internet-based smoking-cessation program (available at www.stopsmoking.ucsf.edu). Muñoz hoped the participants would achieve a success rate for seven-day abstinence comparable to that of the nicotine patch, which yields 14 percent to 22 percent abstinence at six months. After a year, the Internet interventions had a 20 percent to 23 percent success rate, according to a 2006 study published in Nicotine and Tobacco Research (Vol. 8, No. 1).

Internet-based interventions could work with depression, alcohol, obesity, pain management and other health problems, he believes, though he does recognize some hurdles, such as the need to translate interventions into multiple languages and cultures. To fund such interventions, Muñoz is looking for grants from the World Health Organization, as well as foundations and corporations interested in global health issues. However it happens, the result for poor, rural populations would be access to care that didn't exist before.

"The field of psychology," Muñoz said, "should take the lead in evidence-based Internet intervention technology."

-M. Price