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.
Illicit substance use among third-level students is an issue of increasing concern. Digital behavioural change interventions have been developed to target this population, but reports of their effectiveness are mixed. The importance of end-user involvement in digital intervention development has been well established, but it appears that many interventions in this area did not engage end-users during development. This absence may have affected engagement, undermining their potential effectiveness. This paper describes the process and contributions of a persona-building approach in the development of a digital behaviour change intervention tailored to the needs of third-level students. Nine exploratory persona-building workshops were carried out with 31 students, and 7 project team members to develop personas for heavy, occasional and nonsubstance using third-level students. Early analysis has identified five archetypes which will contribute to the design of an acceptable and user-friendly intervention, and to the identification of targeted behavioural change techniques.
Background Mobile phone use and, consequently, mobile health (mHealth) interventions have seen an exponential increase in the last decade. There is an excess of 318,000 health-related apps available free of cost for consumers to download. However, many of these interventions are not evaluated and are lacking appropriate regulations. Randomized controlled trials are often considered the gold standard study design in determining the effectiveness of interventions, but recent literature has identified limitations in the methodology when used to evaluate mHealth. Objective The objective of this study was to investigate the system developers’ experiences of evaluating mHealth interventions in the context of a developing country. Methods We employed a qualitative exploratory approach, conducting semistructured interviews with multidisciplinary members of an mHealth project consortium. A conventional content analysis approach was used to allow codes and themes to be identified directly from the data. Results The findings from this study identified the system developers’ perceptions of mHealth evaluation, providing an insight into the requirements of an effective mHealth evaluation. This study identified social and technical factors which should be taken into account when evaluating an mHealth intervention. Conclusions Contextual issues represented one of the most recurrent challenges of mHealth evaluation in the context of a developing country, highlighting the importance of a mixed method evaluation. There is a myriad of social, technical, and regulatory variables, which may impact the effectiveness of an mHealth intervention. Failure to account for these variables in an evaluation may limit the ability of the intervention to achieve long-term implementation and scale.
Background: Illicit substance use by third-level students is associated with depressive symptoms, health risk, relationship strain, and legal ramifications. Prevention and intervention programmes have often been grounded in information exchange, aimed at education of students about the associated risks. However, these interventions produce only small to moderate effect sizes in promoting reduction or cessation of substance use in third-level students. Understanding what motivates third-level students to change their substance use behaviour is essential in the planning of effective behaviour change programmes. The aim of this scoping review was to determine factors that relate to student motivations to reduce or stop their illicit use of substances, and to increase understanding of the factors that may be pertinent in behaviour change interventions for substance use in this population. Method: We searched 8 databases in August 2018 using search terms based on ‘students’, ‘illicit substance use’, and ‘motivations’. We identified 86 research articles that reported on third-level students’ illicit substance use, and included reasons or motives for their usage. Results: After full-text screening, only three studies were eligible for inclusion in the qualitative synthesis. The majority of studies were excluded as they described motives for abstention, but did not describe motivation for reducing or stopping current patterns of use of illicit substances. Conclusion: Few efforts have been made to identify motivations of third-level students to decrease or cease substance use. Promising avenues for future research on motivations to change in relation to substance use include the social contextual factors, perceptions of effects on social relationships, and actions of friends and family members to prompt contemplations of change.
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