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

Lisa A Marsch, Sarah K Moore, Michael Grabinski, Sarah Y Bessen, Jacob Borodovsky, Emily Scherer, Lisa A Marsch, Sarah K Moore, Michael Grabinski, Sarah Y Bessen, Jacob Borodovsky, Emily Scherer

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://ichgcp.net/clinical-trials-registry/NCT02737696.

Keywords: adolescent; internet; opioids; prevention and control; randomized controlled trial.

Conflict of interest statement

Conflicts of Interest: LM is affiliated with both HealthSim, LLC (the business that received the NIH STTR grant and developed the web-based intervention described in this manuscript) as well as Dartmouth College. This relationship is extensively managed by her academic institution, Dartmouth College. JB is a member of the board of directors and treasurer of MySafeRx Inc., a non-profit scientific research organization, and does not receive any form of compensation (financial or otherwise) from this organization. All other authors have no conflicts to declare.

©Lisa A Marsch, Sarah K Moore, Michael Grabinski, Sarah Y Bessen, Jacob Borodovsky, Emily Scherer. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 25.02.2021.

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) diagram.
Figure 2
Figure 2
Geographic locations of participants. Zip code data for 379 of 406 participants (missing zip code data: n=27). In total, 41 of 50 states had at least one participant. Numbers in red circles are those of participants in a geographic area and may represent more than one state’s data. Alaska (n=4) is not shown on the map.

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