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      Technologiebasierte Interventionen zur Alkoholprävention bei Kindern und Jugendlichen Translated title: Technology-based interventions for alcohol prevention among children and adolescents

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          Abstract

          Hintergrund

          Ein früher Einstieg und der exzessive Alkoholkonsum im Kindes- und Jugendalter erhöhen das Risiko für Krankheit, Abhängigkeit und andere kurz-, mittel- und langfristige Beeinträchtigungen durch z. B. Unfälle, Gewalthandlungen und Konflikte. Face-to-Face-Präventionsansätze zeigen signifikante Effekte auf die Reduktion des Alkoholkonsums. Die Inanspruchnahme durch Kinder und Jugendliche mit riskantem Alkoholkonsum ist jedoch oft gering. Technologiebasierte Alkoholprävention hat das Potenzial, mit kosteneffektiven, standardisierten und niedrigschwelligen Maßnahmen die Zielgruppe zu erreichen.

          Fragestellung und Methode

          Das vorliegende narrative Review bietet einen Überblick über verschiedene Ansätze technologiebasierter Maßnahmen zur Prävention und Frühintervention riskanten Alkoholkonsums bei Kindern und Jugendlichen sowie deren Wirksamkeit und Einsatzbereiche.

          Ergebnisse

          Technologiebasierte Alkoholprävention kann in einer Vielfalt von Settings eingesetzt werden, z. B. Schule, Gemeinde, hausärztliche Versorgung oder Klinik. Programme werden häufig via interaktive Website mit oder ohne Einbettung in Face-to-Face-Module, via App oder SMS-Nachrichten umgesetzt. Während die kumulierte Evidenz bei Erwachsenen und jungen Erwachsenen für die Wirksamkeit technologiebasierter Alkoholprävention spricht, ist die Studienlage für Kinder und Jugendliche heterogen.

          Diskussion

          Der Einsatz von technologiebasierter Alkoholprävention bei Kindern und Jugendlichen bietet theoretisch großes Potenzial im Hinblick auf Zielgruppenerreichung, Kosteneffektivität und Nutzereinbindung. Im Fokus zukünftiger Forschung sollten Studienreplikationen und die Evaluation der Wirksamkeit einzelner Elemente stehen, wie etwa der Individualisierung von Inhalten, der Nutzereinbindung durch multiple Kontaktaufnahmen und des Einsatzes von multimedialen Elementen und Funktionen.

          Translated abstract

          Background

          Early onset and excessive alcohol use in childhood and adolescence is associated with an elevated risk of experiencing short-, mid-, and long-term negative consequences caused by, e.g., accidents, violent acts, and conflicts. Face-to-face prevention approaches show significant effects on the reduction of alcohol use. However, service utilization is often low among children and adolescents. Technology-based alcohol prevention has the potential to reach this target group with potentially cost-effective, standardized, and low-threshold measures.

          Aim and method

          This narrative review provides an overview of different approaches of technology-based interventions for the prevention and early intervention of risky alcohol use among children and adolescents, their effectiveness, and settings for implementation.

          Results

          Technology-based alcohol prevention can be implemented in a variety of settings, e.g., school, community, primary care, or hospital. Implementation is often realized via websites with or without embedding face-to-face modules, apps, or SMS messages. While the cumulative evidence of the effectiveness of technology-based alcohol prevention is strong for adults and young adults, evidence for the effectiveness among children and adolescents is heterogeneous.

          Discussion

          Technology-based alcohol prevention has great theoretical potential with regards to reach, cost-effectiveness, and user engagement. Study replications are needed and evaluations of the effects of single elements, such as the individualization of content, user engagement through multiple contacts, and the use of multimedia elements and functions, should be addressed by future research.

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          Most cited references42

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis, Use of Behavior Change Techniques, and Mode of Delivery on Efficacy

            Background The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. Objectives The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. Methods We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. Results We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. Conclusions The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery.
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              Age at drinking onset and alcohol dependence: age at onset, duration, and severity.

              To examine whether starting to drink at an early age is associated with developing alcohol dependence at a younger age and chronic relapsing dependence, controlling for respondent demographics, smoking and illicit drug use, childhood antisocial behavior and depression, and family alcoholism history. Cross-sectional survey. Nationwide face-to-face survey with a multistage probability sample. A total of 43,093 adults were surveyed in 2001-2002. Based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, lifetime alcohol dependence, dependence within 10 years of starting drinking, multiple episodes, an alcohol dependence episode in the past year, episodes exceeding 1 year, and meeting 6 or 7 dependence criteria. Relative to respondents who began drinking at 21 years or older, those who began drinking before age 14 years were more likely to experience alcohol dependence ever and within 10 years of first drinking (adjusted hazard ratios and 95% confidence intervals [CIs], 1.78 [1.51-2.11] and 1.69 [1.38-2.07], respectively). They also more often experienced past-year dependence and multiple dependence episodes (adjusted odds ratios, 1.93 [95% CI, 1.40-2.64] and 3.09 [95% CI, 2.19-4.35], respectively). Among alcohol-dependent persons, the odds were 2.62 (95% CI, 1.79-3.84) for having at least 1 episode exceeding 1 year and 2.89 (95% CI, 1.97-4.23) for meeting 6 or 7 dependence diagnostic criteria. There is a need to screen and counsel adolescents about alcohol use and to implement policies and programs that delay alcohol consumption.
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                Author and article information

                Contributors
                s.diestelkamp@uke.de
                Journal
                Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
                Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
                Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1436-9990
                1437-1588
                5 May 2021
                5 May 2021
                2021
                : 64
                : 6
                : 714-721
                Affiliations
                GRID grid.13648.38, ISNI 0000 0001 2180 3484, DZSKJ – Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, , Universitätsklinikum Hamburg-Eppendorf, ; Martinistr. 52, 20246 Hamburg, Deutschland
                Article
                3338
                10.1007/s00103-021-03338-5
                8187222
                33950365
                515a727c-c791-40f8-bec0-d196a02bd7b7
                © The Author(s) 2021, korrigierte Publikation 2021

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                History
                : 2 December 2020
                : 26 April 2021
                Funding
                Funded by: Universitätsklinikum Hamburg-Eppendorf (UKE) (5411)
                Categories
                Leitthema
                Custom metadata
                © Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2021

                e‑intervention,alkohol,prävention,kinder,jugendliche,alcohol,prevention,children,adolescents

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