Digital screening and brief intervention for illicit drug misuse in college students: A mixed methods, pilot, cluster, randomized trial from India.

BACKGROUND: Adolescence and early adulthood are vulnerable periods for substance use-related disorders later in life. The use of internet-enabled interventions can be useful, especially in low-resource settings. AIMS: To examine the feasibility, acceptability, and preliminary effectiveness of single-session digital screening and brief intervention (d-SBI) for illicit drug misuse in college students and explore barriers and facilitators of d-SBI. METHODS: Design: Mixed-methods, pilot cluster randomized trial. SETTING: Four conveniently selected colleges were randomized into intervention and control groups. PARTICIPANTS: 219 students were screened, and 37 fulfilled eligibility. Twenty-four completed follow-ups. In-depth interviews were done with ten students. Intervention and Comparator: Following a digital screening, Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) based brief intervention was provided in the d-SBI group. The control group received brief education. MEASUREMENTS: Acceptability was assessed by direct questions and usage statistics. ASSIST scores of groups were assessed at baseline and 3 months. Inductive coding of the interview transcript was done. RESULTS: More than 50 % of participants found d-SBI user-friendly, appropriate, and useful. Eighty percent of users, who logged in, completed screening. Per-protocol analysis showed a reduction in cannabis-ASSIST score over 3 months. The mean ASSIST score for other drugs combined did not differ significantly between groups. The difference in risk transition (moderate to low) was not significant. Qualitative analysis revealed three overarching themes- recruitment, engagement, and behavior change. CONCLUSIONS: Digital SBI for drug misuse is feasible among college students. d-SBI might be effective in reducing cannabis use.

Digital screening and brief intervention for alcohol misuse in college students: A pilot, mixed-methods, cluster randomized controlled trial from a low-resourced setting.

INTRODUCTION: We examined the feasibility and acceptability of digital screening and brief intervention (d-SBI) for alcohol misuse in college students; the effectiveness of d-SBI was our secondary outcome. We also explored the barriers and facilitators of d-SBI. METHODS: The study design is a mixed-methods, pilot, and cluster randomized trial. Five colleges from a northern city in India were randomly allocated to d-SBI and control groups. One hundred and ninety-one students were screened, and 25 (male = 23 and female = 2) participants (age 19.62 ± 2.58 years) fulfilled eligibility. All participants completed follow-up assessments at 3 months. In-depth interviews were done with 11 participants. Alcohol Use Disorder Identification Test (AUDIT) based screening brief intervention was provided on a web portal- or mobile application in the d-SBI group. The control group received digital screening and brief education. Direct questions and usage statistics assessed the measurement acceptability of the intervention. We compared the change in AUDIT scores in the intervention groups over 3 months post-intervention. Thematic analyses of transcripts of interviews were done by inductive coding. RESULTS: Most participants reported that d-SBI was user-friendly (80%), advice was appropriate (80%), and perceived it to be useful (72%). Ninety-six percent of users, who logged in, completed screening. There was a significant decrease in AUDIT scores both in d-SBI (p < .001) and control groups (p < .001). Time and group significantly affected the mean AUDIT score, but time × group interaction was non-significant. Thematic analysis revealed six overarching themes. CONCLUSIONS: Digital SBI for alcohol misuse is acceptable, feasible, and possibly effective among college students from low-resource settings.