BACKGROUND: Researchers and practitioners interested in developing online health interventions most often rely on Web-based and print resources to guide them through the process of online intervention development. Although useful for understanding many aspects of best practices for website development, missing from these resources are concrete examples of experiences in online intervention development for health apps from the perspective of those conducting online health interventions. OBJECTIVE: This study aims to serve as a series of case studies in the development of online health interventions to provide insights for researchers and practitioners who are considering technology-based interventional or programmatic approaches. METHODS: A convenience sample of six study coordinators and five principal investigators at a large, US-based land grant university were interviewed about the process of developing online interventions in the areas of alcohol policy, adolescent health, medication adherence, and human immunodeficiency virus prevention in transgender persons and in men who have sex with men. Participants were asked questions that broadly addressed each of the four phases of the User-Centered Design Process Map from the US Department of Health and Human Services' Research-Based Web Design & Usability Guidelines. Interviews were audio recorded and transcribed. Qualitative codes were developed using line-by-line open coding for all transcripts, and all transcripts were coded independently by at least 2 authors. Differences among coders were resolved with discussion. RESULTS: We identified the following seven themes: (1) hire a strong (or at least the right) research team, (2) take time to plan before beginning the design process, (3) recognize that vendors and researchers have differing values, objectives, and language, (4) develop a detailed contract, (5) document all decisions and development activities, (6) use a content management system, and (7) allow extra time for testing and debugging your intervention. Each of these areas is discussed in detail, with supporting quotations from principal investigators and study coordinators. CONCLUSIONS: The values held by members of each participating organization involved in the development of the online intervention or program, as well as the objectives that are trying to be met with the website, must be considered. These defined values and objectives should prompt an open and explicit discussion about the scope of work, budget, and other needs from the perspectives of each organization. Because of the complexity of developing online interventions, researchers and practitioners should become familiar with the process and how it may differ from the development and implementation of in-person interventions or programs. To assist with this, the intervention team should consider expanding the team to include experts in computer science or learning technologies, as well as taking advantage of institutional resources that will be needed for successful completion of the project. Finally, we describe the tradeoff between funds available for online intervention or program development and the complexity of the project.

OBJECTIVE: To evaluate whether the adoption of a local clean indoor air (CIA) policy in St. Paul, Minnesota, was associated with changes in alcohol-related crimes outside on-premises alcohol-licensed businesses. DESIGN: The enactment of a comprehensive CIA policy on 31 March 2006 was used as the intervention time point in an interrupted time-series analysis to assess changes in weekly crime frequency prior to the policy enactment compared with the period after the policy was established (n=261 weeks). SETTING: St. Paul, Minnesota, USA. SUBJECTS: On-premise alcohol-licensed business addresses were collected from St. Paul, Minnesota, for the period of January 2003 to December 2007, and geocoded. A 500-foot (152.4 m) buffer was drawn around each business. MAIN OUTCOME MEASURES: Alcohol-related crime (ie, arrest) data were obtained from the St. Paul Police Department; crimes had been geocoded by the police department. They were aggregated by week to include only those crimes that occurred within the drawn buffer. Relevant types of crimes included serious (eg, aggravated assaults, homicide, robbery, rape and theft) and less serious (eg, lesser assault, fighting, noise violations, public drunkenness/lewdness or other liquor law violations) crimes. RESULTS: Within a buffer of 500 foot of alcohol-licensed businesses, 23 978 serious alcohol-related crimes and 49 560 less serious alcohol-related crimes occurred over 5 years. Using interrupted time-series analyses to compare the weekly alcohol-related crime frequency in proximity with the bars and restaurants, we found no significant change in either type of crime associated with the local comprehensive CIA policy (p=0.13) after adjustment for seasonal differences and overall crime frequencies. CONCLUSIONS: Evidence from this study suggests that alcohol-related crimes were not significantly affected by a local comprehensive CIA policy that banned smoking in public workplaces in St. Paul, Minnesota.

OBJECTIVE: Underage alcohol compliance checks conducted by law enforcement agencies can reduce the likelihood of illegal alcohol sales at checked alcohol establishments, and theory suggests that an alcohol establishment that is checked may warn nearby establishments that compliance checks are being conducted in the area. In this study, we examined whether the effects of compliance checks diffuse to neighboring establishments. METHOD: We used data from the Complying with the Minimum Drinking Age trial, which included more than 2,000 compliance checks conducted at more than 900 alcohol establishments. The primary outcome was the sale of alcohol to a pseudo-underage buyer without the need for age identification. A multilevel logistic regression was used to model the effect of a compliance check at each establishment as well as the effect of compliance checks at neighboring establishments within 500 m (stratified into four equal-radius concentric rings), after buyer, license, establishment, and community-level variables were controlled for. RESULTS: We observed a decrease in the likelihood of establishments selling alcohol to underage youth after they had been checked by law enforcement, but these effects quickly decayed over time. Establishments that had a close neighbor (within 125 m) checked in the past 90 days were also less likely to sell alcohol to young-appearing buyers. The spatial effect of compliance checks on other establishments decayed rapidly with increasing distance. CONCLUSIONS: Results confirm the hypothesis that the effects of police compliance checks do spill over to neighboring establishments. These findings have implications for the development of an optimal schedule of police compliance checks.

OBJECTIVE: The purpose of this study was to assess the status and integration of college systems to address student alcohol use. METHOD: We conducted a survey of college leaders (campus administrators, healthcare directors, and enforcement directors) among 569 4-year colleges in the United States. We measured strategies across five key system components: policy, enforcement, education, screening, and intervention/treatment. We used latent class analyses to identify classes of colleges based on their alcohol systems. RESULTS: We identified three classes of colleges. Thirty-four percent of colleges were in a class that was characterized as having the most strategies relative to the other colleges, including high probabilities for having one of the three policy strategies, both enforcement strategies, two of the three screening strategies, and both intervention strategies. Class 2 colleges were similar to Class 1 colleges but had very low probabilities of having the intervention strategies. Thirty percent of the colleges were in Class 3; these colleges had a low probability of having any of the strategies except two of the three policy strategies. CONCLUSIONS: Many of the colleges had implemented strategies to address student alcohol use across multiple system components, although no class of colleges had implemented all of the identified strategies in each of the five components. Many colleges failed to use complementary strategies, such as having screening but no treatment or intervention services. More research is needed to assess whether class membership is associated with rates of student alcohol use and related problems.

OBJECTIVE: The purpose of this study was to assess the prevalence of college alcohol policies and practices and to identify patterns of policies/practices across colleges. METHOD: An online survey of administrators at a random sample of 351 4-year U.S. colleges was conducted in 2008. The prevalence of 31 alcohol policies and practices was assessed as well as differences across size and type of colleges. Latent class analyses identified classes of colleges based on their alcohol policies/practices. RESULTS: The majority of colleges prohibit alcohol use at sporting events, whereas less than half prohibit alcohol use at fraternity and sorority events. Less than half of the colleges also prohibit alcohol advertising in/on campus newspapers and radio stations. Small colleges are more likely than large colleges to prohibit alcohol use at tailgating events and to prohibit newspaper alcohol advertising. Public colleges are more likely than private colleges to prohibit alcohol use in dorms but less likely to prohibit alcohol advertising. We identified four classes of colleges-the largest class (38%) was characterized by having many alcohol policies/practices, the smallest class (13%) had none or few alcohol policies/practices, and the remainder fit into two middle classes that had certain policies/practices in place but lacked others. CONCLUSIONS: Most colleges report implementing some alcohol policies/ practices but are lacking others. Only two of every five colleges fit into a class that has many alcohol policies. More studies are needed to validate our findings and assess whether certain policies/practices and patterns of policies are associated with reducing student alcohol consumption and related problems.