Internet-based interventions for young people with problematic substance use: a systematic review

Objective: To conduct a systematic review of randomised trials of web-based interventions for problematic substance use by adolescents and young adults. Data sources: An extensive search conducted in February 2009 of computer databases (MEDLINE, PsycINFO, Current Contents) and manual searches of key references. Study selection: Randomised comparisons of fully automated web-based interventions specifically targeting adolescents and young adults (ie, typically school or tertiary students, <= 25 years old) versus other interventions. Data synthesis: 16 relevant studies were identified, and data were extracted from 13 of the 14 reporting on alcohol use by young adults. The alcohol interventions had a small effect overall (d = -0.22) and for specific outcomes (level of alcohol consumption, d = -0.12; binge or heavy drinking frequency, d = -0.35; alcohol-related social problems, d = -0.57). The interventions were not effective (d = -0.001) in preventing subsequent development of alcohol-related problems among people who were non-drinkers at baseline. Due to methodological differences, data from the two studies reporting on tobacco interventions among adolescents were not combined. Conclusions: Based on findings largely from tertiary students, web interventions targeting alcohol-related problems have an effect about equivalent to brief in-person interventions, but with the advantage that they can be delivered to a far larger proportion of the target population. Web-based interventions to prevent the development of alcohol-related problems in those who do not currently drink appear to have minimal impact. There are currently insufficient data to assess the effectiveness of web-based interventions for tobacco use by adolescents. MJA 2010; 192: S15-S21