Web-based tailored intervention for reducing cannabis use

About the program

The web-based tailored intervention for reducing cannabis is grounded in Ajzen’s theory of planned behaviour whereby the immediate predictor of behaviour is the intention to engage in the behaviour. The program involves delivery of tailored educational and reinforcement messages online based on participants reported past cannabis use.

The overarching goals of the program are to develop:

• A positive attitude; and
• A sense of control regarding cannabis abstinence.

The program is delivered online in adult education centres across Quebec.

Who does it work for?

This web-based program is designed for 18-24 year old youth. This program has only been evaluated in Canada. A randomised control trial (Cote et al. 2018) was conducted with 588 people (295 in intervention group and 293 in control group). The majority of study participants were female (54%), an average age of 19 years and over half (58%) had used cannabis at least once in the past year.

This program has not been evaluated in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• Program participants’ intention to abstain from cannabis use increased

How effective is it?

Overall, the program had a positive effect on client outcomes.

How strong is the evidence?

Promising research evidence:

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• Fewer RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects.

How is it implemented?

The program is delivered over five, 10-minute visits to a web platform undertaken at 2-week intervals over a period of 13 weeks. The online intervention took place in adult education centres.

Seven user profiles were generated based on frequency of cannabis use in the past month/year and intention to abstain in the coming month. Each profile corresponded to an intervention sequence. During the first visit, participants had to log in with a username and complete a brief questionnaire to assess behaviour and cognitive dimensions. Answers were instantly analysed by a computer algorithm to establish the user profile.

At each visit, an educational message was delivered in short video clips. These educational messages targeted the determinants and were geared to bolstering a positive attitude and a sense of control regarding cannabis abstinence. There were 35 educational messages and up to 16 reinforcement messages, depending on reported past-month cannabis use.

On the third visit, behaviour and intention were measured. The algorithm then compared the measurement against the behaviour reported on the first visit and delivered a personalized reinforcement message followed by an educational message.

On the fifth and last visit, a final educational message was delivered and behaviour and cognitive dimensions were measured once again. At this point, a final personalized reinforcement message was received.

How much does it cost?

Program costs were not reported in the study.

What else should I consider?

Youth workers at the adult education centres reminded participants to log in to the web platform and provided individualised follow-up.

A member of the research team was available at each visit to assist as needed.

The program draws on Intervention Mapping (IM) which is a methodological approach involving 6 steps for developing health prevention and promotion programs. It integrates theory, empirical evidence and information collected from target populations to design an action plan for intervention.

Where does the evidence come from?

1 RCT conducted in Canada with a sample of 588 young people (Cote et al. 2018).

Further resources

Côté, J, Tessier, S, Gagnon, H, April, N, Rouleau, G, & Chagnon, M 2018, ‘Efficacy of a web-based tailored intervention to reduce cannabis use among young people attending adult education centers in Quebec’, Telemedicine and e-Health, vol. 24, pp. 853-860, DOI 10.1089/tmj.2017.014.