Abstract
Purpose of Review
Computer-based programs for substance use prevention and intervention among youth are on the ascendancy. Whether delivered by computer per se or by electronic tablet or smartphone, technology-driven programs are harmonious with how young people access information and interact with their worlds. This review examines recent evidence on computer-based programs aimed at substance use among youth, with particular attention to results from randomized trials.
Recent Findings
Outcome studies of computer-based, substance use-related programs published over the past 5 years reveal mixed results amidst diverse intervention approaches and delivery settings. Many studies are marred by high attrition. Notable in the recent literature is the international nature of technology-driven substance use prevention and intervention programs. With some exceptions, most programs appear to not have been customized for their recipient populations. Though few in number, the highest-quality studies of computer-based programs show positive outcomes in reduced substance use rates.
Summary
Based on recent findings, considerable work needs to happen before computer-delivered approaches are a proven means for reducing substance use among youth. Original programs, expressly developed for subgroups of youth, are in short supply. Though controlled designs are becoming commonplace, too many studies of computer-based programs suffer from flaws—including high rates of attrition—that limit the discovery of positive outcomes.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
•• Marsch LA, Borodovsky JT. Technology-based interventions for preventing and treating substance use among youth. Child Adolesc Psychiatr Clin N Am. 2016;25:755–68. https://doi.org/10.1016/j.chc.2016.06.005. Providing an excellent review of technology-based substance use prevention and treatment interventions for youth. This paper considers programs that have been tested in a variety of settings and focused on commonly differentiated stages of substance use risk.
Fisoun V, Floros G, Siomos K, Geroukalis D, Navridis K. Internet addiction as an important predictor in early detection of adolescent drug use experience-implications for research and practice. J Addict Med. 2012;6:77–84. https://doi.org/10.1097/ADM.0b013e318233d637.
Golpe S, Gómez P, Braña T, Varela J, Rial A. The relationship between consumption of alcohol and other drugs and problematic internet use among adolescents. Adicciones. 2017. https://doi.org/10.20882/adicciones.959.
Gupta H, Pettigrew S, Lam T, Tait RJ. A systematic review of the impact of exposure to internet-based alcohol-related content on young peoples alcohol use behaviours. Alcohol Alcohol. 2016;51:763–71. https://doi.org/10.1093/alcalc/agw050.
Morioka H, Itani O, Osaki Y, Higuchi S, Jike M, Kaneita Y, et al. The association between alcohol use and problematic internet use: a large-scale nationwide cross-sectional study of adolescents in Japan. J Epidemiol. 2017;27:107–11. https://doi.org/10.1016/j.je.2016.10.004.
Sung J, Lee J, Noh H-M, Park YS, Ahn EJ. Associations between the risk of internet addiction and problem behaviors among Korean adolescents. Korean J Fam Med. 2013;34:115–22. https://doi.org/10.4082/kjfm.2013.34.2.115.
Perrino T, Estrada Y, Huang S, St. George S, Pantin H, Cano MA, et al. Predictors of participation in an eHealth, family-based preventive intervention for Hispanic youth. Prev Sci. 2016;17:1–12. https://doi.org/10.1007/s11121-016-0711-y.
Estrada Y, Molleda L, Murray A, Drumhiller K, Tapia M, et al. eHealth Familias Unidas: pilot study of an internet adaptation of an evidence-based family intervention to reduce drug use and sexual risk behaviors among Hispanic adolescents. Int J Environ Res Public Health. 2017;14:264. https://doi.org/10.3390/ijerph14030264.
Doumas DM. Web-based personalized feedback: is this an appropriate approach for reducing drinking among high school students? J Subst Abus Treat. 2015;50:76–80. https://doi.org/10.1016/j.jsat.2014.09.005.
Champion KE, Newton NC, Barrett EL, Teesson M. A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. Drug Alcohol Rev. 2013;32:115–23. https://doi.org/10.1111/j.1465-3362.2012.00517.x.
Tait RJ, Spijkerman R, Riper H. Internet and computer based interventions for cannabis use: a meta-analysis. Drug Alcohol Depend. 2013;133:295–304. https://doi.org/10.1016/j.drugalcdep.2013.05.012.
Rodriguez DM, Teesson M, Newton NC. A systematic review of computerised serious educational games about alcohol and other drugs for adolescents. Drug Alcohol Rev. 2013;33:129–35. https://doi.org/10.1111/dar.12102.
Wood SK, Eckley L, Hughes K, Hardcastle KA, Bellis MA, Schrooten J, et al. Computer-based programmes for the prevention and management of illicit recreational drug use: a systematic review. Addict Behav. 2014;39:30–8. https://doi.org/10.1016/j.addbeh.2013.09.010.
• Geckle J. Use of multimedia or mobile devices by adolescents for health promotion and disease prevention: a literature review. Pediatr Nurs. 2016;42:163–7. Covering the years 2009 through 2014. This paper carefully reviews multi-media, mobile technology, texting, and social networking approaches to health promotion and disease prevention among adolescents.
• Hoch E, Preuss UW, Ferri M, Simon R. Digital interventions for problematic cannabis users in non-clinical settings: findings from a systematic review and meta-analysis. Eur Addict Res. 2016;22:233–42. https://doi.org/10.1159/000445716. This well-executed meta-analysis of randomized clinical trials examines the effects of internet- and computer-based interventions of cannabis treatment programs implemented outside of the health care system.
Krebs P, Prochaska JO, Rossi JS. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med. 2010;51:214–21. https://doi.org/10.1016/j.ypmed.2010.06.004.
Lustria MLA, Noar SM, Cortese J, Van Stee SK, Glueckauf RL, Lee J. A meta-analysis of web-delivered tailored health behavior change interventions. J Health Commun. 2013;18:1039–69. https://doi.org/10.1080/10810730.2013.768727.
Rooke S, Thorsteinsson E, Karpin A, Copeland J, Allsop D. Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction. 2010;105:1381–90. https://doi.org/10.1111/j.1360-0443.2010.02975.x.
• MacDonell KW, Prinz R. A review of technology-based youth and family-focused interventions. Clin Child Fam Psychol Rev. 2017;20:185–200. https://doi.org/10.1007/s10567-016-0218-x. This thorough review covers a range of technology-oriented interventions for behavioral and mental health problems among children and adolescents, with particular attention to youth- and family focused programs.
Moore BA, Fazzino T, Garnet B, Cutter CJ, Barry DT. Computer-based interventions for drug use disorders: a systematic review. J Subst Abus Treat. 2011;40:215–23. https://doi.org/10.1016/j.jsat.2010.11.002.
Park E, Drake E. Systematic review: internet-based program for youth smoking prevention and cessation. J Nurs Scholarsh. 2014;47:43–50. https://doi.org/10.1111/jnu.12104.
Portnoy DB, Scott-Sheldon LA, Johnson BT, Carey MP. Computer-delivered interventions for health promotion and behavioral risk reduction: a meta-analysis of 75 randomized controlled trials, 1988–2007. Prev Med. 2008;47:3–16. https://doi.org/10.1016/j.ypmed.2008.02.014.
Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. JMIR. 2010;12:e4. https://doi.org/10.2196/jmir.1376.
Mason M, Ola B, Zaharakis N, Zhang J. Text messaging interventions for adolescent and young adult substance use: a meta-analysis. Prev Sci. 2014;16:181–8. https://doi.org/10.1007/s11121-014-0498-7.
• Badawy SM, Kuhns LM. Texting and mobile phone app interventions for improving adherence to preventive behavior in adolescents: a systematic review. JMIR Mhealth Uhealth. 2017;5:e50. https://doi.org/10.2196/mhealth.6837. Reviewing recent studies of text messaging and mobile phone apps. The authors critique the programs on their theoretical frameworks, acceptability and satisfaction, outcomes, and overall quality.
Bowen DJ, Henderson PN, Harvill J, Buchwald D. Short-term effects of a smoking prevention website in American Indian youth. JMIR. 2012;14:185–92. https://doi.org/10.2196/jmir.1682.
•• Velicer WF, Redding CA, Paiva AL, Mauriello LM, Blissmer B, Oatley K, et al. Multiple behavior interventions to prevent substance abuse and increase energy balance behaviors in middle school students. Transl Behav Med. 2013;3:82–93. https://doi.org/10.1007/s13142-013-0197-0. This study involved a very large sample and a notably long follow-up to isolate the effects of two computer-based interventions for middle-school students.
Andrews JA, Gordon JS, Hampson SH, Gunn B, Christiansen SM, Slovic P. Long-term efficacy of Click City® tobacco: a school-based tobacco prevention program. Nicotine Tob Res. 2014;16:33–41. https://doi.org/10.1093/ntr/ntt106.
Bannink R, Broeren S, Joosten-van Zwanenburg E, van As E, van de Looij-Jansen P, Raat H. Effectiveness of a web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial. JMIR. 2014;16:e143. https://doi.org/10.2196/jmir.3163.
Doumas DM, Hausheer R, Esp S, Cuffee C. Reducing alcohol use among 9th grade students: 6 month outcomes of a brief, web-based intervention. J Subst Abus Treat. 2014;47:102–5. https://doi.org/10.1016/j.jsat.2014.02.006.
Doumas DM, Esp S, Turrisi R, Hausheer R, Cuffee C. A test of the efficacy of a brief, web-based personalized feedback intervention to reduce drinking among 9th grade students. Addict Behav. 2014;39:231–8. https://doi.org/10.1016/j.addbeh.2013.10.011.
de Josselin de Jong S, Candel M, Segaar D, Cremers HP, de Vries H. Efficacy of a web-based computer-tailored smoking prevention intervention for Dutch adolescents: randomized controlled trial. JMIR. 2014;16:e82. https://doi.org/10.2196/jmir.2469.
Malmberg M, Kleinjan M, Overbeek G, Vermulst A, Monshouwer K, Lammers J, et al. Effectiveness of the ‘Healthy School and Drugs’ prevention programme on adolescents' substance use: a randomized clustered trial. Addiction. 2014;109:1031–40. https://doi.org/10.1111/add.12526.
Newton NC, Andrews G, Champion KE, Teesson M. Universal internet-based prevention for alcohol and cannabis use reduces truancy, psychological distress and moral disengagement: a cluster randomised controlled trial. Prev Med. 2014;65:109–15. https://doi.org/10.1016/j.ypmed.2014.05.003.
Vogl L, Newton N, Champion K, Teesson M. A universal harm-minimisation approach to preventing psychostimulant and cannabis use in adolescents: a cluster randomised controlled trial. Subst Abuse Treat Prev Policy. 2014;9:24. https://doi.org/10.1186/1747-597X-9-24.
Cremers H-P, Mercken L, Candel M, de Vries H, Oenema A. A web-based, computer-tailored smoking prevention program to prevent children from starting to smoke after transferring to secondary school: randomized controlled trial. JMIR. 2015;17:e59. https://doi.org/10.2196/jmir.3794.
Arnaud N, Baldus C, Elgán TH, De Paepe N, Tønnesen H, Csémy L, et al. Effectiveness of a web-based screening and fully automated brief motivational intervention for adolescent substance use: a randomized controlled trial. JMIR. 2016;18:e103. https://doi.org/10.2196/jmir.4643.
Champion KE, Newton NC, Stapinski L, Slade T, Barrett EL, Teesson M. A cross-validation trial of an internet-based prevention program for alcohol and cannabis: preliminary results from a cluster randomised controlled trial. Aust N Z J Psychiatry. 2015;50:64–73. https://doi.org/10.1177/0004867415577435.
Champion KE, Newton NC, Stapinski LA, Teesson M. Effectiveness of a universal internet-based prevention program for ecstasy and new psychoactive substances: a cluster randomized controlled trial. Addiction. 2016;111:1396–405. https://doi.org/10.1111/add.13345.
Jander A, Crutzen R, Mercken L, Candel M, de Vries H. Effects of a web-based computer-tailored game to reduce binge drinking among Dutch adolescents: a cluster randomized controlled trial. JMIR. 2016;18:e29. https://doi.org/10.2196/jmir.4708.
Drost RMWA, Paulus ATG, Jander AF, Mercken L, de Vries H, Ruwaard D, et al. A web-based computer-tailored alcohol prevention program for adolescents: cost-effectiveness and intersectoral costs and benefits. JMIR. 2016;18:e93. https://doi.org/10.2196/jmir.5223.
Kiewik M, VanDerNagel JE, Kemna LE, Engels RC, DeJong CA. Substance use prevention program for adolescents with intellectual disabilities on special education schools: a cluster randomised control trial. J Intellect Disabil Res. 2016;60:191–200. https://doi.org/10.1111/jir.12235.
Nădășan V, Foley KL, Pénzes M, Paulik E, Mihăicuță Ș, Ábrám Z, et al. The short-term effects of ASPIRA: a web-based, multimedia smoking prevention program for adolescents in Romania: a cluster randomized trial. Nicotine Tob Res. 2016;19:908–15. https://doi.org/10.1093/ntr/ntw308.
Doumas DM, Esp S, Johnson J, Trull R, Shearer K. The eCHECKUP TO GO for high school: impact on risk factors and protective behavioral strategies for alcohol use. Addict Behav. 2017;64:93–100. https://doi.org/10.1016/j.addbeh.2016.08.030.
Voogt CV, Kleinjan M, Poelen EAP, Lemmers LACJ, Engels RCME. The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15–20 years with a low educational background: a two-arm parallel group cluster randomized controlled trial. BMC Public Health. 2013;13:694. https://doi.org/10.1186/1471-2458-13-694.
Walton MA, Resko S, Barry KL, Chermack ST, Zucker RA, Zimmerman MA, et al. A randomized controlled trial testing the efficacy of a brief cannabis universal prevention program among adolescents in primary care. Addiction. 2014;109:786–97. https://doi.org/10.1111/add.12469.
Marsch LA, Guarino H, Grabinski MJ, Syckes C, Dillingham ET, Xie H, et al. Comparative effectiveness of web-based vs. educator-delivered HIV prevention for adolescent substance users: a randomized, controlled trial. J Subst Abus Treat. 2015;59:30–7. https://doi.org/10.1016/j.jsat.2015.07.003.
Mason MJ, Campbell L, Way T, Keyser-Marcus L, Benotsch E, Mennis J, et al. Development and outcomes of a text messaging tobacco cessation intervention with urban adolescents. Subst Abus. 2015;36:500–6. https://doi.org/10.1080/08897077.2014.987946.
Cunningham RM, Chermack ST, Zimmerman MA, Shope JT, Bingham CR, Blow FC, et al. Brief motivational interviewing intervention for peer violence and alcohol use in teens: one-year follow-up. Pediatrics. 2012;129:1083–90. https://doi.org/10.1542/peds.2011-3419.
Walton MA, Chermack ST, Blow FC, Ehrlich PF, Barry KL, Booth BM, et al. Components of brief alcohol interventions for youth in the emergency department. Subst Abus. 2015;36:339–49. https://doi.org/10.1080/08897077.2014.958607.
Cunningham RM, Chermack ST, Ehrlich PF, Carter PM, Booth BM, Blow FC, et al. Alcohol interventions among underage drinkers in the ED: a randomized controlled trial. Pediatrics. 2015;136:783–93. https://doi.org/10.1542/peds.2015-1260.
Fang L, Schinke SP. Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls. Psychol Addict Behav. 2013;27:788–98. https://doi.org/10.1037/a0030925.
Schwinn TM, Schinke SP, Hopkins JE, Keller B, Liu X. An online drug abuse prevention program for adolescent girls: posttest and 1-year outcomes. J Youth Adolesc. 2017; https://doi.org/10.1007/s10964-017-0714-4.
Schwinn TM, Thom B, Schinke SP, Hopkins J. Preventing drug use among sexual-minority youths: findings from a tailored, web-based intervention. J Adolesc Health. 2015;56:571–3. https://doi.org/10.1016/j.jadohealth.2014.12.015.
• Tebb KP, Erenrich RK, Jasik CB, Berna MS, Lester JC, Ozer EM. Use of theory in computer-based interventions to reduce alcohol use among adolescents and young adults: a systematic review. BMC Public Health. 2016;16 https://doi.org/10.1186/s12889-016-3183-x. Examining published work on computer-based interventions through 2014. The authors critique studies on the neglect of theory to inform programs aimed at reducing alcohol use among adolescents and young adults.
Harris SK, Knight JJR, Hook SV, Sherritt L, Brooks TL, Kulig JW, et al. Adolescent substance use screening in primary care: validity of computer self-administered versus clinician-administered screening. Subst Abus. 2015;37:197–203. https://doi.org/10.1080/08897077.2015.1014615.
Funding
This work was supported in part by the National Institute on Drug Abuse, grant award R01DA031782 (to TMS) and grant award R01DA031477 (to SS).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Steven Schinke and Traci Marie Schwinn declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
All studies described in this paper that were performed by the authors were approved by Columbia University’s Morningside Institutional Review Committee.
Additional information
This article is part of the Topical Collection on Adolescent / Young Adult Addiction
Rights and permissions
About this article
Cite this article
Schinke, S., Schwinn, T.M. Computer-Based Prevention and Intervention to Reduce Substance Use in Youth. Curr Addict Rep 4, 410–421 (2017). https://doi.org/10.1007/s40429-017-0171-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40429-017-0171-x