Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial
BackgroundVocational school students exhibit a high prevalence of addictive behaviors. Mobile phone–based prevention programs targeting multiple addictive behaviors and promoting life skills are promising. Tailoring intervention content to participants’ preferences, such as a...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-06-01
|
| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2025/1/e59573 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849744453061836800 |
|---|---|
| author | Diana Guertler Elaine Kraft Dominic Bläsing Anne Möhring Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf |
| author_facet | Diana Guertler Elaine Kraft Dominic Bläsing Anne Möhring Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf |
| author_sort | Diana Guertler |
| collection | DOAJ |
| description |
BackgroundVocational school students exhibit a high prevalence of addictive behaviors. Mobile phone–based prevention programs targeting multiple addictive behaviors and promoting life skills are promising. Tailoring intervention content to participants’ preferences, such as allowing them to choose behavior modules, may increase engagement and efficacy. There is limited understanding of how personal characteristics relate to module choices.
ObjectiveThis study examined the prevention needs of German vocational school students as well as their prevention preferences through self-determined module choice in the multibehavior app-based addiction prevention program ready4life.
MethodsA 2-arm cluster randomized controlled trial recruited German vocational school students aged ≥16 years. Among 376 classes from 35 schools, ready4life was introduced during a school lesson. Students were invited to download the ready4life app and completed an anonymous screening with individualized risk and competence feedback in the form of a traffic light system. Informed consent was provided by 2568 students. Intervention classes received individual app-based coaching with weekly chat contacts with a conversational agent over 4 months. They could choose 2 of 6 modules: alcohol, tobacco, cannabis, social media and gaming, stress, and social competencies. Control group classes received a link to health behavior information and could access coaching after 12 months.
ResultsPrevention need was high. For 86.2% (2213/2568), ≥2 risks were reported based on yellow or red traffic light feedback. Within the intervention group, stress (818/1236, 66.2%) and social media and gaming (625/1236, 50.6%) were the most chosen topics, followed by alcohol (360/1236, 29.1%), social competencies (306/1236, 24.8%), tobacco (232/1236, 18.8%), and cannabis (131/1236, 10.6%). Module choices closely aligned with received traffic light feedback among those with 1 or 2 risks. Multilevel regression models showed that women were significantly more likely to choose the stress module (odds ratio [OR] 2.38, 95% CI 1.69-3.33; P<.001); men preferred social media and gaming (OR 0.52, 95% CI 0.40-0.69; P<.001), alcohol (OR 0.50, 95% CI 0.37-0.67; P<.001), and cannabis (OR 0.37, 95% CI 0.21-0.63; P<.001) when holding age, educational track, and prevention need for the corresponding behavior constant. Younger students were significantly more likely to choose the cannabis module (OR 0.81, 95% CI 0.74-0.90; P<.001). Educational track also influenced module choice (eg, those with a lower educational level were more likely to choose alcohol and cannabis, suggesting a positive equity impact). Students’ prevention needs significantly influenced choice of the module (eg, higher alcohol consumption increased the likelihood of choosing the alcohol module; OR 1.31, 95% CI 1.20-1.43; P<.001).
ConclusionsOur study confirms vocational school students’ high prevention needs regarding addictive behaviors. Students’ module choices were highly congruent to their demonstrated needs, with most students being interested in the stress module. Module choice also differed by age, gender, and educational track.
Trial RegistrationGerman Clinical Trials Register DRKS00022328; https://drks.de/search/en/trial/DRKS00022328
International Registered Report Identifier (IRRID)RR2-10.1024/0939-5911/a000811 |
| format | Article |
| id | doaj-art-8d75373d3b2e4ba7acbc16e921f5005d |
| institution | DOAJ |
| issn | 2291-5222 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj-art-8d75373d3b2e4ba7acbc16e921f5005d2025-08-20T03:16:25ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222025-06-0113e5957310.2196/59573Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled TrialDiana Guertlerhttps://orcid.org/0000-0002-2533-5347Elaine Krafthttps://orcid.org/0009-0007-6922-2874Dominic Bläsinghttps://orcid.org/0000-0003-0326-8574Anne Möhringhttps://orcid.org/0000-0002-5063-0479Christian Meyerhttps://orcid.org/0000-0003-4722-7109Hannah Schmidthttps://orcid.org/0000-0002-9393-5862Florian Rehbeinhttps://orcid.org/0009-0007-2330-0937Merten Neumannhttps://orcid.org/0000-0003-2761-4152Arne Dreißigackerhttps://orcid.org/0000-0003-4393-0171Anja Bischofhttps://orcid.org/0000-0003-3176-3329Gallus Bischofhttps://orcid.org/0000-0003-0432-5497Svenja Sürighttps://orcid.org/0000-0001-7006-5502Lisa Hohlshttps://orcid.org/0009-0008-6091-2374Susanne Wurmhttps://orcid.org/0000-0001-6924-8299Stefan Borgwardthttps://orcid.org/0000-0002-5792-3987Severin Haughttps://orcid.org/0000-0002-6539-5045Hans-Jürgen Rumpfhttps://orcid.org/0000-0001-6848-920X BackgroundVocational school students exhibit a high prevalence of addictive behaviors. Mobile phone–based prevention programs targeting multiple addictive behaviors and promoting life skills are promising. Tailoring intervention content to participants’ preferences, such as allowing them to choose behavior modules, may increase engagement and efficacy. There is limited understanding of how personal characteristics relate to module choices. ObjectiveThis study examined the prevention needs of German vocational school students as well as their prevention preferences through self-determined module choice in the multibehavior app-based addiction prevention program ready4life. MethodsA 2-arm cluster randomized controlled trial recruited German vocational school students aged ≥16 years. Among 376 classes from 35 schools, ready4life was introduced during a school lesson. Students were invited to download the ready4life app and completed an anonymous screening with individualized risk and competence feedback in the form of a traffic light system. Informed consent was provided by 2568 students. Intervention classes received individual app-based coaching with weekly chat contacts with a conversational agent over 4 months. They could choose 2 of 6 modules: alcohol, tobacco, cannabis, social media and gaming, stress, and social competencies. Control group classes received a link to health behavior information and could access coaching after 12 months. ResultsPrevention need was high. For 86.2% (2213/2568), ≥2 risks were reported based on yellow or red traffic light feedback. Within the intervention group, stress (818/1236, 66.2%) and social media and gaming (625/1236, 50.6%) were the most chosen topics, followed by alcohol (360/1236, 29.1%), social competencies (306/1236, 24.8%), tobacco (232/1236, 18.8%), and cannabis (131/1236, 10.6%). Module choices closely aligned with received traffic light feedback among those with 1 or 2 risks. Multilevel regression models showed that women were significantly more likely to choose the stress module (odds ratio [OR] 2.38, 95% CI 1.69-3.33; P<.001); men preferred social media and gaming (OR 0.52, 95% CI 0.40-0.69; P<.001), alcohol (OR 0.50, 95% CI 0.37-0.67; P<.001), and cannabis (OR 0.37, 95% CI 0.21-0.63; P<.001) when holding age, educational track, and prevention need for the corresponding behavior constant. Younger students were significantly more likely to choose the cannabis module (OR 0.81, 95% CI 0.74-0.90; P<.001). Educational track also influenced module choice (eg, those with a lower educational level were more likely to choose alcohol and cannabis, suggesting a positive equity impact). Students’ prevention needs significantly influenced choice of the module (eg, higher alcohol consumption increased the likelihood of choosing the alcohol module; OR 1.31, 95% CI 1.20-1.43; P<.001). ConclusionsOur study confirms vocational school students’ high prevention needs regarding addictive behaviors. Students’ module choices were highly congruent to their demonstrated needs, with most students being interested in the stress module. Module choice also differed by age, gender, and educational track. Trial RegistrationGerman Clinical Trials Register DRKS00022328; https://drks.de/search/en/trial/DRKS00022328 International Registered Report Identifier (IRRID)RR2-10.1024/0939-5911/a000811https://mhealth.jmir.org/2025/1/e59573 |
| spellingShingle | Diana Guertler Elaine Kraft Dominic Bläsing Anne Möhring Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial JMIR mHealth and uHealth |
| title | Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial |
| title_full | Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial |
| title_fullStr | Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial |
| title_full_unstemmed | Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial |
| title_short | Prevention Needs and Target Behavior Preferences in an App-Based Addiction Prevention Program for German Vocational School Students: Cluster Randomized Controlled Trial |
| title_sort | prevention needs and target behavior preferences in an app based addiction prevention program for german vocational school students cluster randomized controlled trial |
| url | https://mhealth.jmir.org/2025/1/e59573 |
| work_keys_str_mv | AT dianaguertler preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT elainekraft preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT dominicblasing preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT annemohring preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT christianmeyer preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT hannahschmidt preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT florianrehbein preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT mertenneumann preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT arnedreißigacker preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT anjabischof preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT gallusbischof preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT svenjasurig preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT lisahohls preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT susannewurm preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT stefanborgwardt preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT severinhaug preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial AT hansjurgenrumpf preventionneedsandtargetbehaviorpreferencesinanappbasedaddictionpreventionprogramforgermanvocationalschoolstudentsclusterrandomizedcontrolledtrial |