Randomized trials on consider this, a tailored, internet-delivered smoking prevention program for adolescents

Area of Science:

• Public Health
• Health Communication
• Adolescent Health

Background:

• Internet-based interventions offer a scalable approach for youth health promotion.
• Smoking prevention programs for children face challenges in engagement and effectiveness.
• The 'Consider This' program aimed to leverage the internet for smoking prevention.

Purpose of the Study:

• To evaluate the effectiveness of the internet-based 'Consider This' program in reducing smoking prevalence and expectations among school children.
• To examine the mediating role of subjective norms in the program's impact.
• To explore the relationship between program exposure and smoking outcomes.

Main Methods:

• Group-randomized pretest-posttest controlled trials were conducted in Australian and US schools (Grades 6-9).
• Data collected from 2,077 Australian children and 1,234 US children.
• Statistical analyses examined smoking prevalence, expectations, subjective norms, and program exposure.

Main Results:

• Australian children reported reduced 30-day smoking prevalence, mediated by decreased subjective norms.
• A dose-response relationship was observed between program use and reduced smoking.
• US children reported lower future smoking expectations, but no significant change in prevalence.
• Program exposure was generally low across many classes.

Conclusions:

• The internet-based 'Consider This' program demonstrated modest benefits in smoking prevention, particularly in Australia.
• Implementation fidelity and engagement are critical for maximizing the impact of online health interventions.
• Further research is needed to optimize internet-based program delivery for practical significance in adolescent smoking prevention.