Moderators of outcome in a technology-based intervention to prevent and reduce problem drinking among adolescents

Introduction: Moderators of outcome are investigated in a technology-based intervention that has been shown to effectively reduce binge drinking among adolescents. Methods: Secondary data analyses were performed on socio-demographic, health-related, and socio-cognitive moderators of intervention efficacy. Students attending 80 vocational and upper secondary school classes with different levels of alcohol use were randomized to either a web- and text messaging-based intervention (n =547) or an assessment-only control group (n =494). Moderators of outcome were analysed across the entire sample, and separately for lower-risk and higher-risk drinkers. Results: Based on an intention-to-treat analysis, we identified smoking status and educational level to moderate the intervention effectiveness across the total sample and in the lower-risk subsample, with a greater reduction in binge-drinking prevalence in smokers versus non-smokers, and in more highly-educated versus less-educated adolescents. Conclusions: Technology-based interventions targeting heavy drinking might be especially effective in smokers and highly-educated adolescents. Interventions can prevent low-risk drinkers that smoke from developing a problematic alcohol use.

"The three main findings were: (1) the intervention was more effective at reducing binge-drinking prevalence in smokers than in non-smokers; (2) the intervention also was more effective in highly- versus less-educated subjects; and (3) whereas smoking status and educational level were moderators of the intervention’s effectiveness in subjects considered to be at lower risk for problem drinking, based upon their baseline level of alcohol use, no baseline characteristics moderated the intervention’s effectiveness in higher-risk drinkers." (Paz Casto et al. 2017, p. 68)