Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial
Abstract BackgroundDigital 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 inter...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-07-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e68754 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849336347006861312 |
|---|---|
| author | Diana Guertler Anne Möhring Dominic Bläsing Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf |
| author_facet | Diana Guertler Anne Möhring Dominic Bläsing Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf |
| author_sort | Diana Guertler |
| collection | DOAJ |
| description |
Abstract
BackgroundDigital 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.
ObjectiveThis 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.
MethodsA 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.
ResultsUsage 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 (PPPPP
ConclusionsOur 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. |
| format | Article |
| id | doaj-art-a24e25f00f854aa7bf34e84b20ac7cf4 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-a24e25f00f854aa7bf34e84b20ac7cf42025-08-20T03:44:58ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-07-0127e68754e6875410.2196/68754Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled TrialDiana Guertlerhttp://orcid.org/0000-0002-2533-5347Anne Möhringhttp://orcid.org/0000-0002-5063-0479Dominic Bläsinghttp://orcid.org/0000-0003-0326-8574Christian Meyerhttp://orcid.org/0000-0003-4722-7109Hannah Schmidthttp://orcid.org/0000-0002-9393-5862Florian Rehbeinhttp://orcid.org/0009-0007-2330-0937Merten Neumannhttp://orcid.org/0000-0003-2761-4152Arne Dreißigackerhttp://orcid.org/0000-0003-4393-0171Anja Bischofhttp://orcid.org/0000-0003-3176-3329Gallus Bischofhttp://orcid.org/0000-0003-0432-5497Svenja Sürighttp://orcid.org/0000-0001-7006-5502Lisa Hohlshttp://orcid.org/0009-0008-6091-2374Susanne Wurmhttp://orcid.org/0000-0001-6924-8299Stefan Borgwardthttp://orcid.org/0000-0002-5792-3987Severin Haughttp://orcid.org/0000-0002-6539-5045Hans-Jürgen Rumpfhttp://orcid.org/0000-0001-6848-920X Abstract BackgroundDigital 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. ObjectiveThis 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. MethodsA 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. ResultsUsage 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 (PPPPP ConclusionsOur 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.https://www.jmir.org/2025/1/e68754 |
| spellingShingle | Diana Guertler Anne Möhring Dominic Bläsing Christian Meyer Hannah Schmidt Florian Rehbein Merten Neumann Arne Dreißigacker Anja Bischof Gallus Bischof Svenja Sürig Lisa Hohls Susanne Wurm Stefan Borgwardt Severin Haug Hans-Jürgen Rumpf Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial Journal of Medical Internet Research |
| title | Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial |
| title_full | Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial |
| title_fullStr | Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial |
| title_full_unstemmed | Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial |
| title_short | Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial |
| title_sort | usage of an app based addiction prevention program for german vocational students secondary analysis of data from a cluster randomized controlled trial |
| url | https://www.jmir.org/2025/1/e68754 |
| work_keys_str_mv | AT dianaguertler usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT annemohring usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT dominicblasing usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT christianmeyer usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT hannahschmidt usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT florianrehbein usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT mertenneumann usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT arnedreißigacker usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT anjabischof usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT gallusbischof usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT svenjasurig usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT lisahohls usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT susannewurm usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT stefanborgwardt usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT severinhaug usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial AT hansjurgenrumpf usageofanappbasedaddictionpreventionprogramforgermanvocationalstudentssecondaryanalysisofdatafromaclusterrandomizedcontrolledtrial |