A Mobile Phone–Based Life-Skills Training Program for Substance Use Prevention Among Adolescents: Cluster-Randomized Controlled Trial

Background Life skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life. Life-skills training programs conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones may provide a more economic and scalable approach. Objective The goal of this study was to test the appropriateness (ie, acceptance, use, and evaluation) and short-term efficacy of a mobile phone–based life-skills training program to prevent substance use among adolescents within a controlled trial. Methods The study design was a two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and follow-up assessments after 6 and 18 months. This report includes outcomes measured up to the 6-month follow-up. The efficacy of the intervention was tested in comparison to an assessment-only control group. The automated intervention program SmartCoach included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management skills, social skills, and substance use resistance skills. Linear mixed models and generalized linear mixed models, as well as logistic or linear regressions, were used to investigate changes between baseline and 6-month follow-up in the following outcomes: 30-day prevalence rates of problem drinking, tobacco use, and cannabis use as well as quantity of alcohol use, quantity of cigarettes smoked, cannabis use days, perceived stress, well-being, and social skills. Results A total of 1759 students from 89 Swiss secondary and upper secondary school classes were invited to participate in the study. Of these, 1473 (83.7%) students participated in the study; the mean age was 15.4 years (SD 1.0) and 55.2% (813/1473) were female. Follow-up assessments at 6 months were completed by 1233 (83.7%) study participants. On average, program participants responded to half (23.6 out of 50) of the prompted activities. Program evaluations underlined its appropriateness for the target group of secondary school students, with the majority rating the program as helpful and individually tailored. The results concerning the initial effectiveness of this program based on 6-month follow-up data are promising, with three of nine outcomes of the intention-to-treat analyses showing beneficial developments of statistical significance (ie, quantity of alcohol use, quantity of tobacco use, and perceived stress; P<.05) and another three outcomes (ie, problem drinking prevalence, cannabis use days, and social skills) showing beneficial developments of borderline significance (P<.10). Conclusions The results showed good acceptance of this intervention program that could be easily and economically implemented in school classes. Initial results on program efficacy indicate that it might be effective in both preventing or reducing substance use and fostering life skills; however, data from the final 18-month follow-up assessments will be more conclusive. Trial Registration ISRCTN Registry ISRCTN41347061; https://doi.org/10.1186/ISRCTN41347061

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A Mobile Phone–Based Life-Skills Training Program for Substance Use Prevention Among Adolescents: Cluster-Randomized Controlled Trial (Preprint)

10.2196/preprints.26951 ◽

2021 ◽

Author(s):

Severin Haug ◽

Raquel Paz Castro ◽

Andreas Wenger ◽

Michael Patrick Schaub

Keyword(s):

Substance Use ◽

Social Skills ◽

Life Skills ◽

Intervention Program ◽

Problem Drinking ◽

Controlled Trial ◽

Skills Training ◽

Cannabis Use ◽

Life Skills Training

BACKGROUND Life skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life. Life-skills training programs conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones may provide a more economic and scalable approach. OBJECTIVE The goal of this study was to test the appropriateness (ie, acceptance, use, and evaluation) and short-term efficacy of a mobile phone–based life-skills training program to prevent substance use among adolescents within a controlled trial. METHODS The study design was a two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and follow-up assessments after 6 and 18 months. This report includes outcomes measured up to the 6-month follow-up. The efficacy of the intervention was tested in comparison to an assessment-only control group. The automated intervention program SmartCoach included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management skills, social skills, and substance use resistance skills. Linear mixed models and generalized linear mixed models, as well as logistic or linear regressions, were used to investigate changes between baseline and 6-month follow-up in the following outcomes: 30-day prevalence rates of problem drinking, tobacco use, and cannabis use as well as quantity of alcohol use, quantity of cigarettes smoked, cannabis use days, perceived stress, well-being, and social skills. RESULTS A total of 1759 students from 89 Swiss secondary and upper secondary school classes were invited to participate in the study. Of these, 1473 (83.7%) students participated in the study; the mean age was 15.4 years (SD 1.0) and 55.2% (813/1473) were female. Follow-up assessments at 6 months were completed by 1233 (83.7%) study participants. On average, program participants responded to half (23.6 out of 50) of the prompted activities. Program evaluations underlined its appropriateness for the target group of secondary school students, with the majority rating the program as helpful and individually tailored. The results concerning the initial effectiveness of this program based on 6-month follow-up data are promising, with three of nine outcomes of the intention-to-treat analyses showing beneficial developments of statistical significance (ie, quantity of alcohol use, quantity of tobacco use, and perceived stress; P<.05) and another three outcomes (ie, problem drinking prevalence, cannabis use days, and social skills) showing beneficial developments of borderline significance (P<.10). CONCLUSIONS The results showed good acceptance of this intervention program that could be easily and economically implemented in school classes. Initial results on program efficacy indicate that it might be effective in both preventing or reducing substance use and fostering life skills; however, data from the final 18-month follow-up assessments will be more conclusive. CLINICALTRIAL ISRCTN Registry ISRCTN41347061; https://doi.org/10.1186/ISRCTN41347061

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First results on the efficacy of a digital life-skills program for substance use prevention

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1031 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Paz Castro ◽

S Haug

Keyword(s):

Substance Use ◽

Secondary School ◽

Mobile Phone ◽

Life Skills ◽

Intervention Group ◽

Skills Training ◽

Text Messages ◽

Substance Use Prevention ◽

Life Skills Training

Abstract Background Life-skills trainings conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones might represent a more economic and scalable approach. Methods The efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents is currently tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with follow-up assessments after 6 and 18 months. The fully automated program is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Participants of the intervention group receive up to 4 individually-tailored text messages per week for a period of 6 months. The study started in 2019 and aims for 1,312 study participants between the ages of 14 and 16 years from approx. 100 secondary school classes in Switzerland. Outcomes are 1) problem drinking, 2) cigarette smoking, 3) perceived stress and 4) interpersonal competences. Results So far, 1'611 students within 88 secondary school classes were invited to participate in the study. Of these, 1,450 (90.0%) consented to participate. To date, 24 out of 726 (3.3%) participants of the intervention group discontinued the program and 945 (65.2%) were invited for 6-month follow-up. Of these, 752 (79.6%) completed the assessment. Preliminary analyses showed a beneficial effect of the intervention for the subscale negative assertion, assessed by the brief version of the Interpersonal Competence Questionnaire. Conclusions A large proportion of adolescents participated in this first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention and the majority of them participated at 6-month follow-up. Key messages A novel, mobile phone-based life-skills training seems widely accepted by secondary students. Given its effectiveness, it could be economically implemented within secondary schools.

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Effects of a Brief Web-Based “Social Norms”-Intervention on Alcohol, Tobacco and Cannabis Use Among German University Students: Results of a Cluster-Controlled Trial Conducted at Eight Universities

Frontiers in Public Health ◽

10.3389/fpubh.2021.659875 ◽

2021 ◽

Vol 9 ◽

Author(s):

C. R. Pischke ◽

S. M. Helmer ◽

H. Pohlabeln ◽

S. Muellmann ◽

S. Schneider ◽

...

Keyword(s):

Substance Use ◽

University Students ◽

Social Norms ◽

Controlled Trial ◽

Cannabis Use ◽

Intervention Effects ◽

Web Based ◽

Peer Substance Use ◽

Peer Use

Background and Aim: “Social norms” (SN)-interventions are aimed at changing existing misperceptions regarding peer substance use by providing feedback on actual norms, thereby affecting personal substance use. It is unknown whether SN-intervention effects previously demonstrated in US students can be replicated in German students. The aim of the INSIST-study was to examine the effects of a web-based SN-intervention on substance use.Design: Cluster-controlled trial.Setting: Eight Universities in Germany.Participants and Measurements: Students were recruited at four intervention vs. four delayed intervention control Universities. 4,463 students completed baseline, 1,255 students (59% female) completed both baseline and 5-months follow-up web-based surveys on personal and perceived peer substance use. Intervention participants received feedback contrasting personal and perceived peer use with previously assessed use and perceptions of same-sex, same-university peers. Intervention effects were assessed via multivariable mixed logistic regression models.Findings: Relative to controls, reception of SN-feedback was associated with higher odds for decreased alcohol use (OR: 1.91, 95% CI 1.42-2.56). This effect was most pronounced in students overestimating peer use at baseline and under or accurately estimating it at follow-up (OR: 6.28, 95% CI 2.00-19.8). The OR was 1.33 (95% CI 0.67-2.65) for decreased cannabis use in students at intervention Universities and was statistically significant at 1.70 (95% CI 1.13-2.55) when contrasting unchanged and decreased with increased use. Regarding tobacco use and episodes of drunkenness, no intervention effects were found.Conclusions: This study was the first cluster-controlled trial suggesting beneficial effects of web-based SN-intervention on alcohol and cannabis use in a large sample of German University students.Clinical Trial Registration: The trial registration number of the INSIST-study is DRKS00007635 at the “German Clinical Trials Register.”

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