A Systematic Review and Meta-Analysis Evaluating the Efficacy of Stand-Alone Digital Interventions to Prevent...

Stand-alone digital interventions-digital interventions delivered without provider or teacher involvement-hold promise for improving access to substance use prevention services for adolescents. We conducted a systematic review and meta-analysis to determine the efficacy of stand-alone digital interventions to prevent substance use among adolescents.

A systematic literature search yielded 35 randomized controlled trial studies. Meta-analysis revealed significant reductions in alcohol (d = 0.4, 95% CI: 0.2, 0.5, n = 27), cannabis (d = 0.2, 95% CI: 0.1, 0.4, n = 19), and tobacco (d = 0.2, 95% CI: 0.1, 0.3, n = 18) use. Interventions with booster sessions were more likely to be effective in preventing substance use (p < 0.05). Interventions that offered multiple sessions yielded larger effect sizes for alcohol (0.5 vs. 0.2) and cannabis (0.3 vs. 0.2) use, and interventions that involved parents yielded larger effect sizes for alcohol use (0.7 vs. 0.2). Among studies that reported on racial/ethnic distributions, there was an extremely low representation of American Indian or Alaskan and Native Hawaiian or Other Pacific Islander groups compared to other racial/ethnic groups (Asian, Black, Hispanic, and White).

Stand-alone digital interventions were effective at preventing alcohol, cannabis, and tobacco use with small but significant effect sizes among adolescents. However, studies including Native American adolescents are lacking and needed.