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Background: Addictive behaviors such as tobacco/e-cigarette smoking, at-risk alcohol consumption, cannabis use or compulsive internet use are common among apprentices. ready4life is a mobile app-based preventive intervention program for apprentices that promotes life skills and reduces risky behavior. The present study tested the efficacy of ready4life for addiction prevention among apprentices in Switzerland within a controlled trial. Methods: Two-arm, cluster-randomized controlled trial including assessments at baseline and follow-up after 6 months. Participants of the intervention group received coaching by a conversational agent for 16 weeks. The main outcome measure was a composite score for addictive behaviors, which included (1) at-risk drinking, (2) tobacco/e-cigarette smoking, (3) cannabis use and (4) problematic internet use. Results: A total of 2275 students from 159 vocational school classes in Switzerland, were invited for study participation. Of these, 1351 (59.4%) students with a mean age of 17.3 years and a male proportion of 56.6% provided informed consent to participate. The follow up assessment at month 6 was completed by 962 (71.2%) study participants. The results concerning the primary outcome showed a stronger decrease of addictive behaviors between baseline and follow up in the intervention group compared to the control group. In particular, significant effects were observed for at-risk drinking and problematic Internet use, while no significant effects were observed for tobacco/e-cigarette smoking and cannabis use. Conclusions: The majority of apprentices invited for program participation within vocational schools participated in the ready4life program for addiction prevention. The mobile app-based coaching was effective in reducing risk behaviors such as at-risk drinking and problematic Internet use in a group of adolescents who have an especially high risk of engaging in addictive activities.

A global problem, mobile phone dependence causes physical and psychological problems for college students. We trial and assess a simple intervention strategy, the daily recording of mobile phone use to mitigate mobile phone dependency among Chinese college students. A randomized controlled trial was conducted among 110 college students, with the daily recording of mobile phone use over two weeks in the intervention group. Using Wilcoxon rank sum test and multivariate linear regression analysis, the effect of the daily recording intervention on reducing mobile phone dependence was assessed. After the daily recording intervention, the mobile phone dependence score of the intervention group decreased from 30.64 ± 9.9 to 24.44 ± 10.31, significantly lower than the control group (32.11 ± 8.51, P  < 0.01). The total mobile phone using time declined from 6.22 ± 2.81 to 5.05 ± 2.85 h and was also lower than that of the control group (6.83 ± 2.98, P  < 0.05). The mobile phone time watching videos and playing games dropped from 1.96 ± 1.70 to 1.09 ± 1.35 h and was lower than that of the control group (1.96 ± 1.4, P  < 0.01). The results of linear regression indicate that daily recording intervention and regular exercise reduced mobile phone dependence significantly ( P  < 0.05). Daily recording of mobile phone use was a simple, but highly effective, effective intervention strategy reducing mobile phone dependence among Chinese college students. Daily exercise also reduced mobile phone dependence.

Digital interventions have been successfully used to address addictive behaviors in adolescents and young adults. However, maintaining consistent usage remains a challenge. There is limited evidence on the determinants of usage with multiple behavioral interventions among vocational students. This paper aims to describe how vocational school students used the app-based addiction prevention program \"ready4life\" and to analyze student characteristics as potential determinants of intervention usage. A 2-arm cluster randomized trial evaluated \"ready4life\" among German vocational students aged ≥16 years. After downloading the app during class, students completed an anonymous screening and received individual risks and competencies feedback. Intervention participants (n=1286) received 4 months of individual app-based coaching, with weekly chat contacts with a conversational agent. They were asked to choose 2 of 6 modules: alcohol, tobacco, cannabis, social media and gaming, stress, and social competencies that were delivered sequentially in a random order. In addition to the weekly chats, users could self-initiate chat dialogues at any time. Chats included media (videos, images, or links), quizzes, and contests. Control participants (n=1282) received a link to health behavior information and could access coaching after 12 months. Usage was low among intervention participants who received their assigned intervention (n=1266; females n=569, 44.9%; mean age 19.53, SD 3.57 years). On average, participants started 4.8 (SD 5.1) and completed 4.3 (SD 5.2) of 16 weekly in-app chats. Most students (n=903, 71.3%) completed no self-initiated chats, and 50.2% (n=636) stopped using the app before week 3. Unadjusted negative binomial multilevel regression models showed that females completed significantly more weekly dialogues (P<.001; incidence rate ratio [IRR] 1.55, 95% CI 1.33-1.80), while fewer were completed by individuals with higher self-efficacy (P=.04; IRR 0.96, 95% CI 0.93-0.998), higher social competencies (P<.001; IRR 0.97, 95% CI 0.95-0.98), and individuals engaging in more addictive behaviors (P<.001; IRR 0.87, 95% CI 0.82-0.93). Concerning specific educational tracks, professionals, technicians, associate professionals, and vocational grammar school students had the highest number of completed weekly dialogues. Determinants of completed self-initiated chats and usage time largely aligned with the findings for weekly dialogues. Additionally, those with higher perceived stress completed significantly more self-initiated chats (P<.001; IRR 1.19, 95% CI 1.08-1.31). Age and year of education were not significantly associated with any of the usage parameters. Our study supports the existing evidence that maintaining consistent usage among adolescents and young adults is a major challenge for digital interventions. An important finding was that students with higher needs for support in terms of self-efficacy, social competence, and perceived stress showed higher intervention usage. In terms of health equity, additional efforts should be made to increase intervention usage among males, those with lower levels of education, and those with higher levels of addictive behaviors.

Research on electronic cigarette (e-cigarette) warnings has primarily focused on addiction warnings, such as the one soon to be required by the Food and Drug Administration (FDA) in the United States. However, reduced-risk warnings, similar to the warnings recently proposed for smokeless tobacco products, remain a future possibility for e-cigarettes. Thus, this brief report compares e-cigarette health risk perceptions based on reduced-risk warnings and the FDA addiction risk warning, and considers whether these warnings differ in believability, ease of comprehension, and perceptions about the clarity of risk communication. A quota sample of 672 smokers, e-cigarette users, dual users, and nonusers participated in this between-subjects experiment. Study participants were randomly assigned to one of three warning conditions, including the FDA-mandated addiction warning and two reduced-risk warnings. After exposure to the warning statement, participants responded to measures of health risk perceptions, believability, ease of comprehension, and perception about the clarity of risk communication. Results reveal that the addiction warning is perceived as more believable, easier to comprehend, and more clearly communicating the health risks of e-cigarettes use compared with the reduced-risk warnings. In addition, overall health risk perceptions and addiction risk perceptions based on the addiction warning are greater than health risk perceptions based on the reduced-risk warnings. In contrast, specific disease-related risk perceptions such as cancer, heart disease, lung disease, and harm to an unborn baby are greater for the reduced-risk warnings. This study provides a comparison of the forthcoming FDA-mandated e-cigarette addiction warning and reduced-risk warnings that have begun to be considered in the literature on a number of critical outcomes. This research provides a greater understanding of how variations of e-cigarette warnings, including addiction and reduced-risk warnings, are perceived by smokers, e-cigarette users, dual users, and nonusers. Specifically, findings show that overall health risk perceptions and addiction risk perceptions based on the addiction warning are greater than risk perceptions based on the reduced-risk warnings. In contrast, specific disease-related risk perceptions, such as cancer and heart disease, are greater for the reduced-risk warnings.

Since the inclusion of gaming disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition for further study, there has been an increasing consensus that problematic gaming can be detrimental to mental health, yet efforts in preventing such problems from emerging have been limited. To address this gap, we developed the Game Over Intervention (GOI), a parent-based program designed based on the frameworks of ecological systems theory and self-determination theory. This study aimed to test the efficacy of the new program using the method of a randomized controlled trial, with the control condition being a program for effective learning. Participants were the parents of upper primary school students, with 163 (77% women; Mage = 42.70) and 199 (83% women; Mage = 41.82) partaking in the intervention and the control conditions, respectively. Participants rated their children’s gaming time, exposure to violent video games, and symptoms of gaming disorder at three time points: baseline, one week after intervention, and three months after intervention. The results indicate a general reduction in these three criteria across the three-month period. Our study provides tentative evidence demonstrating the effectiveness of the GOI in mitigating some gaming-related problems.

Background A large proportion of apprentices shows addictive behaviours like cigarette smoking, alcohol, cannabis, or compulsive Internet use, others do not show such behaviours at all. ready4life is a smartphone application-based coaching program for apprentices, which takes into account the heterogeneity of adolescent addictive behaviour by promoting life skills and reducing risk behaviours. The main objective of the planned study is to test the efficacy of ready4life for addiction prevention among apprentices in Switzerland within a controlled trial. Methods/design The efficacy of the ready4life coaching program will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with one follow-up assessment after 6 months. At the beginning of the program, participants of the intervention group will receive an individual profile, showing areas in which they have sufficient resources and in which there is a need for coaching. Based on this feedback, they can select two out of the following six program modules: stress, social skills, Internet use, tobacco/e-cigarettes, cannabis, and alcohol. Participants of the intervention group will receive individualised coaching by a conversational agent (chatbot) for a period of four months. The coaching relies on motivational and social-cognitive principles of behaviour change. Within weekly dialogues, the coach provides individually tailored information in different formats, such as videoclips, texts, or pictures. Study participants will be 1318 apprentices with a minimum age of 15, recruited in approximately 100 vocational school classes in Switzerland. Primary outcome will be a composite measure for addictive behaviours including (1) at risk-drinking, (2) tobacco/e-cigarette smoking, (3) cannabis use, and (4) problematic Internet use. Discussion The study will reveal whether this universally implementable but individually tailored intervention approach is effective in preventing the onset and escalation of addictive behaviors among apprentices. Trial registration ISRCTN59908406 (registration date: 21/10/2020).

Background Reconsolidation-based interventions have been suggested to be a promising treatment strategy for substance use disorders. In this study, we aimed to investigate the effectiveness of a working memory intervention to interfere with the reconsolidation of alcohol-related memories in a sample of non-treatment seeking heavy drinkers. Methods Participants were randomized to one of the two conditions that underwent a 3-day intervention: in the experimental condition, a 30-min working memory training was performed immediately after a 15-min memory retrieval session (i.e., within the memory reconsolidation time-window), whereas in the control condition, the working memory training was performed prior to a memory retrieval session. Results In contrast to our original hypothesis, a high working memory load after memory retrieval did not interfere with the reconsolidation of those memories while a high working memory load prior to memory retrieval (the original control condition) strongly reduced retrieval-induced craving and craving for alcohol at follow-up. Conclusion Whereas the neurocognitive mechanism behind this effect needs to be further investigated, the current findings suggest that, if replicated, working memory training prior to addiction-related memory retrieval has the potential to become an effective (adjunctive) intervention in the treatment of substance use disorders.

This article examines the implementation, participation rates, and potential determinants of participation in the digital addiction prevention program “ready4life.” A two-arm cluster-randomized trial recruited German vocational students via class-based strategies. Intervention group received 16 weeks of in-app coaching; the control group received health behavior information, with coaching offered after 12 months. Potential determinants of participation were analyzed based on class and individual characteristics. Out of 525 contacted schools, 35 participated, enrolling 376 classes. Implementation during the pandemic required flexible adjustments, with 49.7% of introductions conducted in person, 43.1% digitally via online streaming, and 7.2% received a video link via email. Despite challenges, 72.3% of the vocational students downloaded the app, and 46.7% gave informed consent. Participation rates were highest among (associate) professionals, vocational grammar school classes, classes introduced by females, younger individuals, members of the project team, and classes introduced face-to-face. Female gender, lower social competencies, lifetime cannabis use, higher problematic internet use, and higher perceived stress were associated with higher individual participation. The study highlights the importance of proactive outreach and personalized interventions for addiction prevention programs in vocational schools. While reached students aligned with the aims of the app, tailored recruitment strategies could enhance engagement among under-represented groups. The trial was registered in the German Clinical Trials Register (DRKS): DRKS00022328; registration date 09.10.2020.