Evaluating the Effectiveness of a Web-Based Program (POP4Teens) to Prevent Prescription Opioid Misuse Among Adolescents: Randomized Controlled Trial

Abstract

Background Prescription opioid (PO) use is common among adolescents in the United States. Despite recent declines from unprecedented peaks in adolescent PO use (eg, in 2012-2013), there is seemingly paradoxical evidence that PO-related consequences (eg, opioid use disorder and overdoses) are increasing. These trends and their possible consequences emphasize the importance of prevention efforts targeting PO misuse. To our knowledge, we have developed the first interactive web-based program (POP4Teens [P4T]) focused specifically on the prevention of PO misuse among adolescents. Objective This study aimed to evaluate the effectiveness of P4T, a web-based program designed to prevent adolescent PO misuse, in comparison with JustThinkTwice (JTT), an active control website, on PO-related attitudes, knowledge, risk perception, and intentions to use. Methods We conducted a web-based randomized controlled trial in 2018. A total of 406 adolescents (aged 12-17 years) were randomly assigned to either P4T or JTT. The outcome variables were attitudes, knowledge, and risk perceptions associated with PO misuse, intentions to use POs, and program feedback. Data were collected at baseline and at 1, 3, and 6 months. Results Both programs resulted in significant and sustained improvements in intention to use POs, increased perceived risk, impacted expectancies consistent with prevention, and improved PO refusal skills. P4T produced significantly greater increases in PO-related knowledge than JTT did, and it was reportedly easier to use and more liked. Baseline scores for youth reporting past-year medical use of POs, friends who engage in nonmedical use of POs, and/or poor mental health underscored their at-risk status compared with youth from the other groups. Conclusions P4T positively impacted all study variables that are known to prevent PO misuse among teens. Moreover, its web-based nature simplifies the dissemination and implementation of this novel tool designed to help meet the challenges of the evolving national opioid crisis. Trial Registration ClinicalTrials.gov NCT02737696; https://clinicaltrials.gov/ct2/show/NCT02737696

Digital interventions for substance use disorders in young people: rapid review

“…follow-up (H1 confirmed) Geisner, 2015 [ 68 ] USA Alcohol Risky alcohol use intervention Brief, personalized, web-based feedback intervention for college students with both elevated alcohol use and depressed mood; customized programming with intervention material based on responses to screening and baseline surveys; info on referral College students with AUDIT scores ≥ 8; and BDI-II score ≥ 14 ( n = 311); mean age: 20.14 (SD: 1.34) range 18–24 Personalized normative feedback (Social norms approach); Psychoeducation; Skills/protective strategies Randomized trial: No sig. main effects; moderation effects: participants in alcohol and integrated conditions with lower depressed mood or alcohol problems at baseline had greater reduction in alcohol-related problems at follow-up vs. controls Marsch, 2021 [ 69 ] USA Opioids POP4Teens P4T: digital, interactive, activity-oriented program, unique in integrating knowledge about risk factors; education and skills training; JTT (Just Think Twice): active control condition Adolescents ( n = 406); age range 12–17 Psychoeducation; Social influence; Skills training RCT: Sig. sustained improvements in intention to use prescription opioids (PO), increased perceived risk, and improved PO refusal skills for both programs.…”

“…The Walukevich-Dienst [ 77 ] intervention, an early intervention with screening and personalized feedback, was the only web-based intervention for cannabis. Another, POP4Teens, was a web-based intervention for opioid use prevention based on psychoeducation, social influence, and skills training [ 69 ]. Other web-based interventions (2/14) targeted multiple, or any, substances: the Climate School courses [ 63 – 65 ] and RealTeen , tested in two studies by Schwinn et al [ 72 , 73 ].…”

Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study

“…In addition, novel interventions have been developed in recent years, such as a web-based program (POP4Teens) aimed at preventing prescription opioid use among adolescents and young adults. 23…”

Programas de intervención y prevención en trastornos por abuso de sustancias en población infanto-juvenil. Una revision sistemática

“…Dentro de los artículos seleccionados en la Tabla 1 un 68 % corresponde a estudios realizados en Estados Unidos (3,7,9,13,19,23,25,(27)(28)(29)33,37,38,41,46) , un 18% a N: 28 familias hispánicas con adolescentes de 14 a 17 Efectos de tratamiento estadísticamente significativos por tiempo tanto en el uso de drogas autoinformado (marihuana + cocaína),F (1, 22) = 10.59, p <.01, η 2 = .33 e informes de adolescentes sobre prácticas parentales, F (1, 22) = 9.01, p <.01, η 2 = .29. Ambos conjuntos de análisis favorecieron a los participantes de CIFFTA.…”