Internet-based trials and the creation of health consumers.

In this paper we document the experience of participating in novel randomised controlled trials for panic disorder - where face-to-face and Internet delivery of cognitive behavioural therapy are compared. Our analysis is based on 18 months of observation and in-depth interviews with 10 trial participants and 8 trialists in Victoria, Australia. We argue that the participants are positioned as active health consumers and approach the trial as they would other self-help practices. High levels of individual responsibility are assumed of participants in these trials, which they accept by approaching the trials reflexively and searching for information and strategies they can employ while building their health literacy on panic disorder. Although the researchers set the parameters of the treatment and interaction, increasingly the participants choose the extent to which they will comply with their defined role. For the participants the trial is one of the 'pick and mix' options of available treatment and we suggest it is a compelling example of contemporary health consumption. Copyright 2009 Elsevier Ltd. All rights reserved.