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Dick S, Whelan E, Davoren MP, Dockray S, Heavin C, Linehan C, Byrne M. A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. BMC Public Health 2019; 19:1244. [PMID: 31500618 PMCID: PMC6734361 DOI: 10.1186/s12889-019-7583-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/02/2019] [Indexed: 11/12/2022] Open
Abstract
Background Illicit substance misuse is a growing public health problem, with misuse peaking among 18–25 year-olds, and attendance at third-level education identified as a risk factor. Illicit substance misuse has the potential to harm mental and physical health, social relationships, and impact on academic achievements and future career prospects. Digital interventions have been identified as a vehicle for reaching large student populations and circumventing the limited capacity of student health services for delivering face-to-face interventions. Digital interventions have been developed in the area of alcohol and tobacco harm reduction, reporting some effectiveness, but the evidence for the effectiveness of digital interventions targeting illicit substance misuse is lacking. This review aims to systematically identify and critically appraise studies examining the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. Methods We systematically searched ten databases in April 2018 using keywords and database specific terms under the pillars of “mHealth,” “substance misuse,” and “student.” To be eligible for inclusion, papers had to present a measure of illicit substance misuse harm reduction. Included articles were critically appraised and included in the qualitative synthesis regardless of quality. Results A total of eight studies were included in the qualitative synthesis. Studies reported harm reduction in terms of substance misuse or initiation, as consequences or problems associated with substance misuse, or as correction of perceived social norms. Overall, five out of the eight studies reported at least one positive outcome for harm reduction. The critical appraisal indicated that the study quality was generally weak, predominantly due to a lack of blinding of study participants, and the use of self-reported substance misuse measures. However, results suggest that digital interventions may produce a modest reduction in harm from illicit substance misuse. Conclusions The results of this review are positive, and support the need for further high-quality research in this area, particularly given the success of digital interventions for alcohol and tobacco harm reduction. However, very few studies focused solely on illicit substances, and those that did targeted only marijuana. This suggests the need for further research on the effectiveness of this type of intervention for other illicit substances. Trial registration This review is registered on PROSPERO, ID number: CRD42018097203.
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Affiliation(s)
- Samantha Dick
- School of Public Health, University College Cork, Cork, Ireland.
| | - Eadaoin Whelan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Martin P Davoren
- School of Public Health, University College Cork, Cork, Ireland.,Sexual Health Centre, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ciara Heavin
- Health Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Michael Byrne
- Student Health Department, University College Cork, Cork, Ireland
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Plotnikoff RC, Costigan SA, Kennedy SG, Robards SL, Germov J, Wild C. Efficacy of interventions targeting alcohol, drug and smoking behaviors in university and college students: A review of randomized controlled trials. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:68-84. [PMID: 29652638 DOI: 10.1080/07448481.2018.1462821] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/16/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students. PARTICIPANTS College/University students. METHODS Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted. RESULTS 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed. CONCLUSIONS University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.
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Affiliation(s)
- Ronald C Plotnikoff
- a Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle , Callaghan Campus , Australia
| | - Sarah A Costigan
- a Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle , Callaghan Campus , Australia
- b School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University , Geelong , Australia
| | - Sarah G Kennedy
- a Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle , Callaghan Campus , Australia
| | - Sara L Robards
- a Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle , Callaghan Campus , Australia
| | - John Germov
- c School of Humanities and Social Science, Faculty of Education and Arts, University of Newcastle , Callaghan Campus , Newcastle , Australia
| | - Cameron Wild
- d School of Public Health, University of Alberta , Edmonton , Alberta , Canada
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Agabio R, Trincas G, Floris F, Mura G, Sancassiani F, Angermeyer MC. A Systematic Review of School-Based Alcohol and other Drug Prevention Programs. Clin Pract Epidemiol Ment Health 2015; 11:102-12. [PMID: 25834630 PMCID: PMC4378029 DOI: 10.2174/1745017901511010102] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 10/20/2014] [Accepted: 10/20/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Alcohol use in adolescents constitutes a major public health concern. Europe is the heaviest drinking region of the world. Several school-based alcohol prevention programs have been developed but it is not clear whether they are really effective. The present study was aimed at identifying the typology with the best evidence of effectiveness in European studies. METHODS A systematic search of meta-analyses and/or randomized controlled trials (RCTs) on interventions school-based prevention programs aimed at preventing alcohol consumption or changing the attitudes to consume alcohol. RESULTS A meta-analysis published in 2011 and 12 RCTs more recently published were identified. The meta-analysis evaluated 53 RCTs but only 11.3% of them were conducted in Europe. Globally, 23 RCTs (43.4%) showed some evidence of effectiveness, and 30 RCTs (56.6%) did not find significant difference between the groups. According to the conclusions of the meta-analysis, the Unplugged program should be considered as a practice option in Europe. Among the other 12 RCTs, 42% were conducted in Europe. Globally, 7 studies (58.3%) achieved positive results, and 5 studies (41.7%) did not find significant differences or produced a mixed pattern of results. Three of the 5 European trials (60%) used the Unplugged program with positive results. CONCLUSION Even if further studies should be conducted to confirm these results, Unplugged appears to be the prevention project with the best evidence of effectiveness in European studies.
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Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Giuseppina Trincas
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Francesca Floris
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Gioia Mura
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Federica Sancassiani
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy
| | - Matthias C Angermeyer
- Department of Public Health and Clinical and Molecular Medicine and Unit of Psychosomatics and Clinical Psychiatry, University Hospital, University of Cagliari, Cagliari, Italy ; Center for Public Mental Health, Gosim, Austria
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Gulliver A, Farrer L, Chan JKY, Tait RJ, Bennett K, Calear AL, Griffiths KM. Technology-based interventions for tobacco and other drug use in university and college students: a systematic review and meta-analysis. Addict Sci Clin Pract 2015; 10:5. [PMID: 25928221 PMCID: PMC4422468 DOI: 10.1186/s13722-015-0027-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 01/30/2015] [Indexed: 11/18/2022] Open
Abstract
Background University students have high levels of tobacco and other drug use, yet they are unlikely to seek traditional care. Technology-based interventions are highly relevant to this population. This paper comprises a systematic review and meta-analysis of published randomized trials of technology-based interventions evaluated in a tertiary (university/college) setting for tobacco and other drug use (excluding alcohol). It extends previous reviews by using a broad definition of technology. Methods PubMed, PsycInfo, and the Cochrane databases were searched using keywords, phrases, and MeSH terms. Retrieved abstracts (n = 627) were double screened and coded. Included studies met the following criteria: (1) the study was a randomized trial or a randomized controlled trial (RCT); (2) the sample was composed of students attending a tertiary (e.g., university, college) institution; (3) the intervention was either delivered by or accessed using a technological device or process (e.g., computer/internet, telephone, mobile short message services [SMS]); (4) the age range or mean of the sample was between 18 and 25 years; and (5) the intervention was designed to alter a drug use outcome relating to tobacco or other drugs (excluding alcohol). Results A total of 12 papers met inclusion criteria for the current review. The majority of included papers examined tobacco use (n = 9; 75%), two studies targeted marijuana use (17%); and one targeted stress, marijuana, alcohol, and tobacco use. A quantitative meta-analysis was conducted on the tobacco use studies using an abstinence outcome measure (n = 6), demonstrating that the interventions increased the rate of abstinence by 1.5 times that of controls (Risk Ratio [RR] = 1.54; 95% Confidence Interval [CI] = 1.20–1.98). Across all 12 studies, a total of 20 technology-based interventions were reviewed. A range of technology was employed in the interventions, including stand-alone computer programs (n = 10), internet (n = 5), telephone (n = 3), and mobile SMS (n = 2). Conclusions Although technological interventions have the potential to reduce drug use in tertiary students, very few trials have been conducted, particularly for substances other than tobacco. However, the improvement shown in abstinence from tobacco use has the potential to impact substantially on morbidity and mortality. Electronic supplementary material The online version of this article (doi:10.1186/s13722-015-0027-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amelia Gulliver
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Louise Farrer
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Jade K Y Chan
- School of Psychology, University of New South Wales, Sydney, Australia.
| | - Robert J Tait
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia. .,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Kylie Bennett
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Alison L Calear
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Kathleen M Griffiths
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
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Winger JG, Christy SM, Mosher CE. Associations of health behaviors with human papillomavirus vaccine uptake, completion, and intentions among female undergraduate students. J Health Psychol 2015; 21:1949-55. [PMID: 25649428 DOI: 10.1177/1359105315569093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored associations between health behaviors and human papillomavirus vaccine receipt/intentions among female undergraduates. Participants (N = 286) completed a survey assessing human papillomavirus vaccine uptake (receiving 1-3 shots vs no shots), completion (receiving 3 shots vs 1-2 shots), and intentions as well as various health behaviors. Human papillomavirus vaccine uptake and completion were associated with receipt of other preventive medical care; completion was associated with having a regular healthcare provider. Among unvaccinated students (n = 115), increased human papillomavirus vaccine intentions were associated with flu shot and human immunodeficiency virus test receipt. Findings suggest promoting human papillomavirus vaccination with other preventive medical care might improve vaccine receipt.
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Tomasone JR, Meikle N, Bray SR. Intentions and trait self-control predict fruit and vegetable consumption during the transition to first-year university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2015; 63:172-179. [PMID: 25581783 DOI: 10.1080/07448481.2014.1003375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To examine the independent and combined effects of Theory of Planned Behavior (TPB) variables and trait self-control (TSC) in the prediction of fruit and vegetable consumption (FVC) among first-year university students. PARTICIPANTS Seventy-six first-year undergraduate university students. METHODS In their first week of class (September 2011), participants completed baseline measures of TSC, attitudes, subjective norms, perceived behavioral control, and intentions about their FVC. One week later, students completed a 7-day food recall, from which daily FVC was calculated. RESULTS Baseline attitudes and perceived behavioral control predicted intentions (adjR(2) = .58). Intentions and TSC predicted FVC (adjR(2) = .24). CONCLUSIONS The TPB may be a useful framework on which to base a FVC intervention for first-year undergraduate students; however, focusing solely on increasing positive intentions to consume FVC will not necessarily translate into FVC behavior, as other personal- and environmental-level variables may play a role.
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Luo J, Agley J, Hendryx M, Gassman R, Lohrmann D. Risk Patterns Among College Youth. Health Promot Pract 2014; 16:132-41. [DOI: 10.1177/1524839914520702] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose. This study identified underlying subgroups among college students in terms of lifestyle characteristics and health risk behaviors and then investigated how demographic factors were associated with the underlying risk patterns to bolster health promotion efforts and interventions. Method. College students ( N = 996) enrolled at Indiana University during 2009-2010 participated in a multidimensional online survey. Latent class analysis was used to identify underlying risk patterns based on seven lifestyle and health behaviors, including frequent alcohol use, binge drinking, smoking, low physical activity, low vegetable intake, low fruit intake, and poor sleep. Results. Four distinct risk behavior patterns were identified for both males and females including a “healthy” class, “low substance use but poor other health behaviors” class, “high substance use” (males)/“high alcohol use” (females) class, and a risk class characterized by elevated probability of all seven indicators. The highest risk class included 34% of the males and 22% of the females; they tended to be older or in more advanced undergraduate classes. Among males, compared with the “healthy” class, the “high substance use” class was more likely to contain non-Hispanic White students and students in advanced classes. Among females, the “low substance use but poor other health behaviors” class was associated with racial/ethnic minority status and lower levels of parental education. Conclusions. Our data suggest that risky health behaviors may tend to cluster in some students and that health promotion techniques might effectively be targeted to identifiable student subgroups.
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Affiliation(s)
- Juhua Luo
- Indiana University, Bloomington, IN, USA
| | - Jon Agley
- Indiana University, Bloomington, IN, USA
- Indiana Prevention Resource Center, Bloomington, IN, USA
| | | | - Ruth Gassman
- Indiana University, Bloomington, IN, USA
- Indiana Prevention Resource Center, Bloomington, IN, USA
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Internet and computer based interventions for cannabis use: a meta-analysis. Drug Alcohol Depend 2013; 133:295-304. [PMID: 23747236 DOI: 10.1016/j.drugalcdep.2013.05.012] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 05/10/2013] [Accepted: 05/10/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Worldwide, cannabis is the most prevalently used illegal drug and creates demand for prevention and treatment services that cannot be fulfilled using conventional approaches. Computer and Internet-based interventions may have the potential to meet this need. Therefore, we systematically reviewed the literature and conducted a meta-analysis on the effectiveness of this approach in reducing the frequency of cannabis use. METHODS We systematically searched online databases (Medline, PubMed, PsychINFO, Embase) for eligible studies and conducted a meta-analysis. Studies had to use a randomized design, be delivered either via the Internet or computer and report separate outcomes for cannabis use. The principal outcome measure was the frequency of cannabis use. RESULTS Data were extracted from 10 studies and the meta-analysis involved 10 comparisons with 4,125 participants. The overall effect size was small but significant, g=0.16 (95% confidence interval (CI) 0.09-0.22, P<0.001) at post-treatment. Subgroup analyses did not reveal significant subgroup differences for key factors including type of analysis (intention-to-treat, completers only), type of control (active, waitlist), age group (11-16, 17+ years), gender composition (female only, mixed), type of intervention (prevention, 'treatment'), guided versus unguided programs, mode of delivery (Internet, computer), individual versus family dyad and venue (home, research setting). Also, no significant moderation effects were found for number of sessions and time to follow-up. Finally, there was no evidence of publication bias. CONCLUSIONS Internet and computer interventions appear to be effective in reducing cannabis use in the short-term albeit based on data from few studies and across diverse samples.
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Salameh P, Jomaa L, Issa C, Farhat G, Zeghondi H, Gerges N, Sabbagh M, Chaaya M, Barbour B, Waked M, Salamé J, Saadallah-Zeidan N, Baldi I. Assessment of health risk behaviours among university students: a cross-sectional study in Lebanon. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2012. [DOI: 10.1080/02673843.2012.733313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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