Multiple behavior interventions to prevent substance abuse and increase energy balance behaviors in middle school students

Abstract

This study examined the effectiveness of two transtheoretical model-tailored, computer-delivered interventions designed to impact multiple substance use or energy balance behaviors in a middle school population recruited in schools. Twenty middle schools in Rhode Island including sixth grade students (N=4,158) were stratified and randomly assigned by school to either a substance use prevention (decreasing smoking and alcohol) or an energy balance (increasing physical activity, fruit and vegetable consumption, and limiting TV time) intervention group in 2007. Each intervention involved five in-class contacts over a 3-year period with assessments at 12, 24, and 36 months. Main outcomes were analyzed using random effects modeling. In the full energy balance group and in subsamples at risk and not at risk at baseline, strong effects were found for physical activity, healthy diet, and reducing TV time, for both categorical and continuous outcomes. Despite no direct treatment, the energy balance group also showed significantly lower smoking and alcohol use over time than the substance use prevention group. The energy balance intervention demonstrated strong effects across all behaviors over 3 years among middle school students. The substance use prevention intervention was less effective than the energy balance intervention in preventing both smoking and alcohol use over 3 years in middle school students. The lack of a true control group and unrepresented secular trends suggest the need for further study.

Advances in multiple health behavior change research

“…Researchers have concluded that multiple simultaneous behavior change interventions are promising for addictive behaviors and for multiple cancer prevention behaviors including diet, physical activity, and obesity prevention [18][19][20][21][22][23][24]. In this Special Section, Velicer et al [25] describe a large intervention trial that examined the effectiveness of two different computer-delivered interventions designed to influence multiple behaviors in middle school students: The first intervention targeted multiple substance use behaviors; the other targeted energy balance behaviors. The energy balance intervention was found not only to have an impact on the intended energy balance behaviors but also, unexpectedly, on the substance use prevention behaviors.…”

Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review

“…The sample size in the studies varied from 71 to 5,407 (average = 1,349) participants, and included male and female participants. The average age ranged from 25, 8 to 75 years, with the exception of two studies which samples were composed by preadolescents (26) and adolescents (25) (Table II). The main inclusion criterion for the studies was the presence of an aggravating factor, such as overweight (9,10,18,20,22,27), high blood pressure (12), increased risk of cardiovascular diseases (20), and diabetes mellitus (11).…”

“…The predominant design was the randomized clinical trial (5)(6)(7)(8)(9)(10)(11)(12)14,20,22,26,28), but studies of interventions without a control group (CG) (18,26), an experimental (1) and quasi-experimental (24) group were also identified. Only 8 studies clearly described the randomization method used (10,12,14,20,22,(26)(27)(28).…”

Assessing demographic differences in decisional balance for smoking prevention and temptations to try smoking among adolescent subgroups

“…perceived benefits and perceived risks) of engaging in a behavior 28,29,31 . The TTSS is based on Bandura's Self-Efficacy model 32 and models of behavior maintenance 33 . This instrument assesses the degree to which an individual feels tempted to engage in a target behavior, as well as his or her confidence to abstain from this behavior, regardless of being in difficult or risky situations 32,33 .…”

“…The TTSS is based on Bandura's Self-Efficacy model 32 and models of behavior maintenance 33 . This instrument assesses the degree to which an individual feels tempted to engage in a target behavior, as well as his or her confidence to abstain from this behavior, regardless of being in difficult or risky situations 32,33 . These measures have shown to be important mediator variables for various TTM-based health behavior interventions [27][28][29][30] .…”