A cluster randomised controlled trial of a school-based digital health intervention to prevent e-cigarette use: The OurFutures Vaping Program

Abstract

Background/Aims: E-cigarette use ('vaping') is prevalent among adolescents, with emerging evidence of adverse physical and mental health effects. Effective behaviour change interventions are urgently needed, and school is an ideal setting for delivery. This study evaluated the efficacy of the OurFutures Vaping Program; a universal school-based preventive intervention targeting e-cigarette use.   Methods: A cluster randomised controlled trial (RCT) was conducted in 40 secondary schools across New South Wales, Queensland and Western Australia. Schools were randomised to either receive the OurFutures Vaping Program (intervention) or Year 7/8 health education as usual (active control). The intervention comprised four web-based cartoon lessons and accompanying activities. Students completed self-report assessments at baseline, post-test, 6-, and 12-months. The primary outcome was e-cigarette use at 12-months. Secondary outcomes were tobacco cigarette use, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation.   Results: A total of 5,157 Year 7/8 students (Mage=13.3yrs, SD=0.6; 46% female) took part. At baseline, the prevalence of lifetime e-cigarette use was 8.3%, and past 30-day use was 1.97%. The 12-month survey is currently underway and data will be analysed and presented.   Conclusions: This is the first rigorous evaluation of a school-based eHealth program targeting e-cigarette use among Australian adolescents. If effective, the OurFutures Vaping Program could be immediately disseminated via the existing OurFutures platform, which has reached >1,400 schools/organisations (>38,000 students), and incorporated into health education classes nationwide.