Social features in internet-based programs to prevent alcohol consumption among adolescents: a scoping review

Alcohol consumption among adolescents is a social and public health issue. School-based programs are needed to prevent the onset of alcohol consumption during adolescence. Information and communication technologies offer new promising approaches to deliver preventive programs to these populations. The most traditional, successful programs use group dynamics within the classroom. However, the usefulness of social interaction features (SIF) within internet-based interventions remains unclear. The current scoping review aims to identify and evaluate the effectiveness of online and mobile psychosocial preventive interventions that use SIF, and that target adolescents. Web of Science, Scopus and Google Scholar were electronically searched for all articles published between January 2011 and December 2020. Articles reporting on school-based, web-based interventions for adolescents to prevent alcohol consumption and that encouraged any kind of interaction between users ('social interactions') were eligible for inclusion. Fourteen articles were included in the review. These articles assessed eight preventive programs. Six programs showed positive results on outcome variables. In two of them, it was possible to determine that their success was partially due to the SIF. SIF seem to be useful to enhance the receptivity and usefulness of web-based prevention programs, but the current evidence of their effectiveness is scarce. More evidence is required to assess the effectiveness of these features and to improve programs having the objective of preventing the consumption of alcohol among young people.

Sensation Seeking and Adolescent Drinking: Do Protective Behavioral Strategies Lower Risk?

Using a cross-sectional design, we examined protective behavioral strategies (PBS) as a moderator of the relationship between sensation seeking and hazardous drinking and alcohol-related consequences among high school seniors (N = 212). Hierarchical regression analyses indicated sensation seeking was a significant predictor of binge drinking (β = .65, p < .001), pre-partying (β = .71, p < .001), gaming (β = .75, p < .001), and alcohol-related consequences (β = .69, p < .001). Further, PBS moderated these relationships such that among high sensation seeking adolescents, PBS use was associated with better outcomes, including lower levels of binge drinking (β = -.37, p < .01), pre-partying (β = -.44, p < .01), gaming (β = -.31, p < .05), and alcohol-related consequences (β = -.53, p < .001). We discuss counseling implications, including assessment and harm reduction strategies focusing on PBS to reduce hazardous drinking among high sensation seeking adolescents.

The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review

Although web-based interventions are attractive to researchers and users, the evidence about their effectiveness in the promotion of health behaviour change is still limited. Our aim was to review the effectiveness of web-based interventions used in health behavioural change in adolescents regarding physical activity, eating habits, tobacco and alcohol use, sexual behaviour, and quality of sleep. Studies published from 2016 till the search was run (May-to-June 2021) were included if they were experimental or quasi-experimental studies, pre-post-test studies, clinical trials, or randomized controlled trials evaluating the effectiveness of web-based intervention in promoting behaviour change in adolescents regarding those health behaviours. The risk of bias assessment was performed by using the Effective Public Health Practice Project (EPHPP)-Quality Assessment Tool for Quantitative Studies. Fourteen studies were included. Most were in a school setting, non-probabilistic and relatively small samples. All had a short length of follow-up and were theory driven. Thirteen showed significant positive findings to support web-based interventions' effectiveness in promoting health behaviour change among adolescents but were classified as low evidence quality. Although this review shows that web-based interventions may contribute to health behaviour change among adolescents, these findings rely on low-quality evidence, so it is urgent to test these interventions in larger controlled trials with long-term maintenance.

Insight into Selecting Adolescents for Drinking Intervention Programs: a Simulation Based on Stochastic Actor-Oriented Models

Adolescent drinking remains a prominent public health and socioeconomic issue in the USA with costly consequences. While numerous drinking intervention programs have been developed, there is little guidance whether certain strategies of participant recruitment are more effective than others. The current study aims at addressing this gap in the literature using a computer simulation approach, a more cost-effective method than employing actual interventions. We first estimate stochastic actor-oriented models for two schools from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We then employ different strategies for selecting adolescents for the intervention (either based on their drinking levels or their positions in the school network) and simulate the estimated model forward in time to assess the aggregated level of drinking in the school at a later time point. The results suggest that selecting moderate or heavy drinkers for the intervention produces better results compared to selecting casual or light drinkers. The intervention results are improved further if network position information is taken into account, as selecting drinking adolescents with higher in-degree or higher eigenvector centrality values for intervention yields the best results. Results from this study help elucidate participant selection criteria and targeted network intervention strategies for drinking intervention programs in the USA.

Reducing Alcohol Use among High School Athletes: A Randomized Controlled Trial of a Brief, Web-Based Personalized Normative Feedback Intervention

High school athletes are at risk for heavy alcohol use, which is associated with consequences that may negatively impact performance and eligibility to participate in sports. This study evaluated the efficacy of a web-based personalized normative feedback (PNF) intervention on reducing alcohol use among high school athletes in their senior year. Class periods were randomized to the intervention or an assessment-only control group. Athletes completed surveys at baseline and a 6-week follow-up. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for athletes classified as high-risk drinkers, those in the intervention group reported significantly greater reductions in quantity of weekly drinking and peak drinking quantity compared to those in the assessment-only control group. There were no significant intervention effects for frequency of alcohol use. Findings provide support the efficacy of web-based PNF intervention for reducing alcohol use among high school senior athletes.

Computer- vs. nurse practitioner-delivered brief intervention for adolescent marijuana, alcohol, and sex risk behaviors in school-based health centers

BACKGROUND

This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs).

METHODS

300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30-day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical 'assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group.

RESULTS

There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was 'dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] = .74 [.57, .97], p=.03), alcohol (3-months: IRR = .43 [.29, .64], p<.001; 6-months: IRR = .58 [.34, .98], p = .04), alcohol-specific problems (3-months: IRR = .63 [.45, .89], p=.008; 6-months: IRR = .63 [.41, .97], p = .04), and sex while intoxicated (6-months: IRR = .42 [.21, .83], p = .013).

CONCLUSIONS

CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.

Sex differences in the acceptability and short-term outcomes of a web-based personalized feedback alcohol intervention for high school seniors

Despite the escalation of alcohol use through high school, the majority of research on school-based alcohol interventions has been conducted with junior high students or first and second year high school students. Preliminary research indicates a brief, web-based personalized feedback intervention developed for college students (eCHECKUP TO GO) may be a promising program for high school seniors. Although these studies demonstrate positive intervention effects, there is some evidence for greater program efficacy for females in this age group. The current study investigates sex differences in program acceptability of the eCHECKUP TO GO and its relationship to short-term alcohol outcomes among high school seniors (N = 135). Overall, the majority of students reported they found the program to be acceptable (i.e., user-friendly and useful). However, contrary to our hypothesis, results indicated that male students reported significantly higher perceptions of program acceptability than females. Although, we did not find sex differences in alcohol outcomes, program user-friendliness was related to reductions in alcohol use for males. Results of this study add to the literature supporting the eCHECKUP TO GO for high school seniors and highlight the importance of program user-friendliness for males. Implications for implementing the program as a school-based intervention are discussed.