German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Institute for Therapy and Health Research, IFT-Nord, Kiel, Germany.
JMIR Mhealth Uhealth. 2024 Jul 23;12:e51307. doi: 10.2196/51307.
During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness.
The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics.
Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models.
The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high.
The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users' characteristics.
German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-022-06231-x.
在青少年时期，物质使用和数字媒体暴露通常达到高峰，可能成为主要的健康风险。预防活动主要在正规学校环境中实施，而系统外的青年则无法参与。一款名为“Meine Zeit ohne”的移动应用程序专门针对职业学生开发，鼓励参与者自愿减少或戒除自我选择的成瘾行为，包括使用物质、赌博或游戏或社交媒体使用等与媒体相关的习惯，为期两周。一项随机研究的结果表明，使用该应用程序后对促进健康的行为改变有显著影响。本探索性研究侧重于该研究的干预组，重点关注接受度和差异效果。
本研究的目的是：(1) 研究使用该应用程序的参与者的特征；(2) 探讨基于应用程序使用方式和参与者特征的移动干预的有效性；(3) 研究应用程序使用的变化如何与参与者的基线特征相关。
对干预组研究参与者的日志数据进行分析，包括应用程序使用频率（天数）、特定挑战的选择以及个人相关性（即用户在某种成瘾行为的风险评分高于预设值），挑战选择的相关性（例如，吸烟者选择与减少或戒烟相关的挑战）。过去一个月的物质使用、赌博和媒体相关行为的二分法结果（变化与不变）。使用二项、多层次、混合效应逻辑回归模型分析这些变量之间的关系。
干预组包括 2367 名职业学生，其中 1458 名（61.6%；平均年龄 19.0 岁，标准差 3.5 岁；1458 名中有 830 名/1458 名，56.9%为男性）提供了完整的数据。在这 1458 名学生中，894 名（61.3%）开始挑战，可以纳入分析（平均年龄 18.7 岁，标准差 3.5 岁；894 名中有 363 名/894 名，40.6%为女性）。在这 894 名学生中，466 名（52.1%）被认为是频繁使用应用程序的用户，在两周期间有超过 4 天的活跃使用。在分析样本中最常选择的挑战领域是与社交媒体使用相关（332/894，37.1%）。共有 894 名学生中的 407 名（45.5%）选择了与个人相关行为变化领域相关的挑战。当个人挑战选择领域与行为改变领域相同时，当挑战选择与个人相关行为相关，并且个人从事不同成瘾行为的风险较高时，应用程序使用对结果的影响就越高。
该项目的特定领域有效性得到了确认，不同行为领域之间没有溢出效应。有效性似乎取决于应用程序的使用和用户的特征。
德国临床试验注册处 DRKS00023788；https://tinyurl.com/4pzpjkmj。
国际注册报告标识符（IRRID）：RR2-10.1186/s13063-022-06231-x。
