Systematic review of digital interventions to support refusal self-efficacy in child and adolescent health promotion.

Refusal self-efficacy determines children's and adolescents' health behavior, for example when they are being offered cigarettes or alcohol and they face the challenge of refusing it. Since digital interventions are potential tools to support refusal self-efficacy, this review examined digital interventions to support refusal self-efficacy in child and adolescent health promotion. Twenty-three studies that examined such interventions were found. Most of the interventions that improved child and adolescent refusal self-efficacy were used in home settings and addressed all sources of self-efficacy regardless of intervention duration. Although the results varied, the interventions in general seemed to improve refusal self-efficacy, especially among girls. However, this study suggests that more high-quality research with more study participants is still needed to make stronger conclusions. Also, the benefits and weaknesses of digital interventions to support refusal self-efficacy need to be considered comprehensively before using them in child and adolescent health promotion.