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Randomized Controlled Trial
. 2014 May 30;16(5):e143.
doi: 10.2196/jmir.3163.

Effectiveness of a Web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial

Rienke Bannink  1 , Suzanne Broeren, Evelien Joosten-van Zwanenburg, Els van As, Petra van de Looij-Jansen, Hein Raat
Affiliations
Randomized Controlled Trial

Effectiveness of a Web-based tailored intervention (E-health4Uth) and consultation to promote adolescents' health: randomized controlled trial

Rienke Bannink et al. J Med Internet Res. .

Abstract

Background: To promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems.

Objective: This study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex).

Methods: A cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects.

Results: Data from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and consultation intervention showed minor positive results in the mental health status of adolescents (SDQ: B=-0.60, 95% CI -1.17 to -0.04), but a negative effect on drug use among boys (OR 0.36, 95% CI 0.13-0.96). In the subgroup of adolescents who were at risk of mental health problems at baseline (and referred for a consultation with the nurse), the E-health4Uth and consultation group showed minor to moderate positive results in mental health status (SDQ: B=-1.79, 95% CI -3.35 to -0.22; YSR: B=-9.11, 95% CI -17.52 to -0.71) and health-related quality of life (B=7.81, 95% CI 2.41-13.21) at follow-up compared to adolescents in the control group who were at risk of mental health problems at baseline.

Conclusions: Findings from this study support the use of the E-health4Uth and consultation intervention in promoting the well-being of adolescents at risk of mental health problems. Future research is needed to further evaluate the effects of the consultation as a standalone intervention, and the dual approach of further tailored eHealth messages and a consultation.

Trial registration: Nederlands Trial Register: NTR 3596; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3596 (Archived by WebCite at http://www.webcitation.org/6PmgrPOuv).

Keywords: Internet; Web-based tailoring; adolescents; consultation; eHealth; health promotion; prevention; randomized controlled trial; youth health care.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of adolescents’ participation.
Figure 2
Figure 2
Screenshot of the Web-based tailored messages. This message was presented to adolescents who answered that they have had unsafe sex (left-most tab). The message is displayed in red, indicating unhealthy behavior. The messages on the other topics are presented when clicking on the other (colored) tabs.
See this image and copyright information in PMC

References

    1. van Dorsselaer S, de Looze M, Vermeulen-Smit E, de Roos S, Verdurmen J, ter Bogt T. Gezondheid, welzijn en opvoeding van jongeren in nederland. Utrecht: Trimbos-instituut, Universiteit Utrecht, Sociaal en cultureel planbureau; 2009.
    1. Fergusson DM, Woodward LJ. Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry. 2002 Mar;59(3):225–31. - PubMed
    1. Hofstra MB, van der Ende J, Verhulst FC. Child and adolescent problems predict DSM-IV disorders in adulthood: a 14-year follow-up of a Dutch epidemiological sample. J Am Acad Child Adolesc Psychiatry. 2002 Feb;41(2):182–9. doi: 10.1097/00004583-200202000-00012. - DOI - PubMed
    1. DeWit DJ, Adlaf EM, Offord DR, Ogborne AC. Age at first alcohol use: a risk factor for the development of alcohol disorders. Am J Psychiatry. 2000 May;157(5):745–50. - PubMed
    1. Ministerie van Volksgezondheid, Welzijn en Sport . Basistakenpakket jeugdgezondheidszorg 0-19 jaar. Den Haag: Ministerie van Volksgezondheid, Welzijn en Sport; 2002.

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