Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial

Abstract

BackgroundMid to late adolescence is characterised by a vulnerability to problematic substance use since the consumption of alcohol and illicit drugs is frequently initiated and increased in this life period. While the detrimental long- and short-term effects of problematic consumption patterns in adolescence pose a major public health concern, current prevention programs targeting alcohol- and other substance-using adolescents are scarce. The study described in this protocol will test the effectiveness of a web-based brief intervention aimed at reducing problematic alcohol use and promoting abstinence from illegal drugs in adolescents with risky substance use aged 16 to 18 years old in four EU-countries.Methods/designTo determine the effectiveness of our web-BI, we apply a two-arm randomized controlled trial (RCT) study design, with baseline assessment at study entry and a three month follow-up assessment. Adolescents aged 16 to 18 years from Belgium, the Czech Republic, Germany, and Sweden will be randomly assigned to either the fully electronically delivered brief intervention group (N = 400) or an assessment only control group (N = 400) depending on their screening for risky substance use (using the CRAFFT). Recruitment, informed consent, randomization, intervention and follow-up will be implemented online. Primary outcomes are reductions in frequency and quantity of use of alcohol and drugs other than alcohol over a 30 day period, as well as consumption per typical occasion. Secondary outcomes concern changes in substance use related cognitions including the constructs of the Theory of Planned Behaviour, implementation intentions, and stages of change. Moreover the study addresses a number of moderator variables, including age of first use, general psychopathology and quality of parent–child relationship.DiscussionThe trial is expected to contribute to the growing literature on theory- and web-based brief interventions for adolescents. We will explore the potential of using web-based technologies as means of delivering preventive interventions. In doing so we are among the first to target the relevant group of young poly-drug users in Europe.Trial registrationCurrent Controlled Trials ISRCTN95538913

Effectiveness of a Web-Based Screening and Fully Automated Brief Motivational Intervention for Adolescent Substance Use: A Randomized Controlled Trial

“…Ethical approval was granted by the responsible Ethics Committees in all participating countries: Chamber of Physicians Hamburg (Germany), Prague Psychiatric Centre (Czech Republic), University Hospital of Antwerp and the University of Antwerp (Belgium), and the Regional Ethics Board in Stockholm (Sweden). The trial design was published [ 54 ], and the study was registered in a public database. No content or methodological modifications were made after trial commencement.…”

“…Intervention content, dialogue tone, and style was based on MI [ 40 ] and consisted of the following 6 components (see Multimedia Appendix 3 for screenshots), with the first three applying to alcohol but not illegal drug use and polydrug use: (1) feedback for individual drinking patterns with information on associated health and developmental risks, (2) normative feedback to descriptive drinking norms about sex- and age-matched peer drinking levels using graphed comparative information, (3) feedback for blood alcohol concentration (BAC) and associated health and other risks (ie, traffic crash, unintended sex) for the peak drinking episode in the last 2 weeks, (4) importance and confidence rulers with a short summary and feedback to encourage change readiness and exploration of personal strengths, resources, and volitional strategies for goal attainment, (5) decisional balance for selection of personal costs and benefits of current substance use and a subsequent graphical display of comparative gains and losses of behavior change in a balance sheet to illustrate ambivalence, and (6) identification and selection of personal high-risk situations for substance use and provision of behavioral strategies, for example, to resist peer pressure (the assumed mechanisms for change are displayed in Multimedia Appendix 4 ; for a more detailed description, see [ 54 ]).…”

Perceived risk of heroin use among nonmedical prescription opioid users

“…Impulsivity appears to be uniquely and additively associated with the initiation of substance use (Arria et al, 2008; Ryb, Dischinger, Kufera, & Read, 2006), and thus higher levels of impulsivity might contribute to the initiation of substance use, even among those with high perceived risk. Among adolescents, the protective effect of perceived risk is attenuated by living in a neighborhood with more opportunities for substance use (Zimmerman & Farrell, 2016), and peer influences have been shown to increase risk-taking more generally (Arnaud, Broning, Drechsel, Thomasius, & Baldus, 2012; Foxcroft, Ireland, Lister-Sharp, Lowe, & Breen, 2002). Future research examining additional moderators of perceived risk could clarify this discrepancy between perceived risk of heroin and its use.…”

Protocol for the ENCODE trial: evaluating a novel online depression intervention for persons with epilepsy

“…In the development process, several steps were taken to ensure the quality and safety of the software: (1) The program was developed by an experienced team consisting of clinical psychologists, CBT therapists, physicians, software engineers, graphic artists, speakers, and sound engineers, among others. This team has already developed several other programs with demonstrated safety and efficacy in clinical trials [ 28 , 32 , 47 – 51 ], (2) volunteers (PwE) were involved continuously throughout the development process to test preliminary versions and provide feedback, consistent with development guidelines [ 52 , 53 ], (3) expert feedback was sought from several physicians specializing in the treatment of epilepsy, who reviewed the program, participated in informal discussion rounds with the developers, and provided written feedback. Additionally, literature on previous CBT developments among PwE was reviewed [ 10 , 54 – 56 ].…”