Derickx Katleen, van Roozendaal Hanna, Ponnet Koen, Deforche Benedicte, Thienpondt Annelies, Van Hal Guido
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Department of Communication Sciences, Faculty of Political & Social Sciences, Imec-Mict-Ghent University, Ghent, Belgium.
Arch Public Health. 2025 Jun 6;83(1):145. doi: 10.1186/s13690-025-01603-6.
Students are increasingly engaging in the nonmedical use of prescription stimulants (NMUPS) to enhance their study performance. However, little research has been conducted on the effectiveness of interventions to reduce NMUPS. This study assessed the effect of a social norms approach (SNA) intervention on NMUPS and the perception of NMUPS for study performance among Flemish students. Additionally, a process evaluation of the intervention was performed.
A social media campaign, containing social norm messages based on data from 'Head in the Clouds?' (HITC) survey edition 2021, ran from December 2022 to April 2023 at the University of Antwerp. Data from the HITC survey was also used as baseline measurement (Antwerp: n = 2,963, Ghent: n = 8,598). Afterward, a post-intervention survey was conducted among the students of the University of Antwerp (n = 1,827) and Ghent University (n = 3,333), the latter serving as the control group. A quantitative process evaluation among the intervention group was conducted according to the guidance of the Medical Research Council for process evaluation of complex interventions.
A difference-in-difference approach showed that students of the intervention group at endline estimated NMUPS for study performance among peers significantly lower (P < .0001; Est. = -3.792; SE = 0.805)-and thus closer to the real social norm. There was no significant influence (P = 0.421; OR = 1.10; 95% CI = 0.87 to -1.39) of the intervention on NMUPS for study performance. The process analysis showed that 18.7% of the intervention group had seen the campaign. Most of them found the campaign credible (83.6%) and clear (website: 90.8%; videos 94.7%; images: 92.4%). The overall satisfaction was 6.38 (SD 1.68) out of 10. Very few students (3.1%) had seen the campaign via TikTok, compared to Facebook (64.0%) and Instagram (53.3%), although 35.7% of the total budget had been spent on TikTok.
The results of this study confirm that an SNA intervention could reduce the misperceptions of NMUPS among students. However, the hypothesis that the behavior of NMUPS for study performance would be reduced subsequently could not be demonstrated. Follow-up research is needed to investigate long-term effects. The implementation of the intervention might be improved by making more optimal use of the campaign budget.
学生越来越多地将处方兴奋剂用于非医疗用途（NMUPS）以提高学习成绩。然而，关于减少NMUPS的干预措施有效性的研究很少。本研究评估了社会规范方法（SNA）干预对弗拉芒学生NMUPS以及对NMUPS用于学习成绩的认知的影响。此外，还对该干预进行了过程评估。
2022年12月至2023年4月，安特卫普大学开展了一场社交媒体活动，其中包含基于2021年“云端之上？”（HITC）调查数据的社会规范信息。HITC调查的数据也用作基线测量（安特卫普：n = 2963，根特：n = 8598）。之后，对安特卫普大学（n = 1827）和根特大学（n = 3333）的学生进行了干预后调查，后者作为对照组。根据医学研究理事会对复杂干预过程评估的指导，对干预组进行了定量过程评估。
差异-in-差异方法表明，干预组学生在终点时估计同龄人将NMUPS用于学习成绩的比例显著更低（P <.0001；估计值 = -3.792；标准误 = 0.805），因此更接近实际社会规范。干预对将NMUPS用于学习成绩没有显著影响（P = 0.421；比值比 = 1.10；95%置信区间 = 0.87至1.39）。过程分析表明，18.7%的干预组学生看过该活动。他们中的大多数人认为该活动可信（83.6%）且清晰（网站：90.8%；视频：94.7%；图片：92.4%）。总体满意度为6.38（标准差1.68）（满分10分）。与通过脸书（64.0%）和照片墙（53.3%）看到该活动的学生相比，很少有学生（3.1%）通过抖音看到该活动，尽管总预算的35.7%用于抖音。
本研究结果证实，SNA干预可以减少学生对NMUPS的误解。然而，随后将NMUPS用于学习成绩的行为会减少这一假设未能得到证实。需要进行后续研究以调查长期影响。通过更优化地使用活动预算，可能会改善干预措施的实施。
