Abstract
BackgroundLife-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. The main objective of the planned study is to test the efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents within a controlled trial.Methods/designThe efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with two 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 will receive up to 4 weekly text messages over 6 months in order to stimulate (1) positive outcome expectations, e.g., on using self-management skills to cope with stress, (2) self-efficacy, e.g., to resist social pressure, (3) observational learning, e.g. of interpersonal competences, (4) facilitation, e.g., of strategies to cope with negative emotions, and (5) self-regulation, e.g., by self-monitoring of stress and emotions. Active program engagement will be stimulated by interactive features such as quiz questions, message- and picture-contests, and integration of a friendly competition with prizes in which program users collect credits with each interaction. Study participants will be 1312 students between the ages of 14 and 16 years from approximately 100 secondary school classes. Primary outcome criteria will be problem drinking according to the short form of the Alcohol Use Disorders Identification Test and cigarette smoking within the last 30 days preceding the follow-up assessment at month 18.DiscussionThis is the first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention among adolescents within a controlled trial. Given that this intervention approach proves to be effective, it could be easily implemented in various settings and would reach large numbers of young people in a cost-effective way.Trial registrationISRCTN41347061 (registration date: 21/07/2018).
Highlights
Introduction in secondary school classesAssessment of inclusion criteriaMinimum age 14, possession of a mobile phone and informed consent for study participationCluster randomisation by school classIntervention group Indiviudalised mobile phone-based program for 6 monthsAssessment only control groupFollow-up assessment month 6Within the first half of the information sessions in the school classes, the junior scientist will raise awareness on the importance of life skills to effectively cope with the demands and challenges of everyday life
This is the first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention among adolescents within a controlled trial
We describe a cluster randomised controlled trial testing the efficacy of a similar mobile phone-based life-skills training program to prevent substance use among secondary school students
Summary
Substance use in adolescents and later adulthood and its related consequences represent a serious public health problem [27]. Most adolescents are familiar with how to use mobile phones and typically use them on a daily basis for texting, taking photos, playing games etc. This is the first study testing the efficacy of a mobile phone-delivered life-skills training for substance use prevention among adolescents within a controlled trial. Given that this program proves to be effective, it could be disseminated to various groups of adolescents, e.g. in schools or leisure time settings. Abbreviation AUDIT-C: Short form of the alcohol use disorders identification test
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