The Antecedents and Consequences of Interpersonal Communication during a School-based Health Intervention.

School-based health interventions often have limited and inconsistent effects. Although interpersonal communication likely is important, hardly any studies have investigated interpersonal communication of students with their friends, classmates, and parents about the health programs and health behaviors in school-based health interventions. In a two-wave prospective study of 389 adolescents focusing on three health behaviors (i.e., alcohol use, snack intake, and exercise), we addressed two aims. Our first aim was to investigate how student evaluations of a school-based health intervention influenced interpersonal communication about health behaviors (i.e., valence and frequency of conversations). Findings showed that positively evaluating a school-based health intervention increased how often students talked about the intervention with friends, classmates, and parents, as well as how they discussed the three health behaviors. Our second aim was to investigate the influence of interpersonal communication with friends, classmates, and parents on predictors of health behaviors. We found for conversational frequency that frequently discussing health behaviors resulted in healthier (more positive) predictors of exercise, but also in unhealthier (more positive) predictors of snacking and drinking. Furthermore, findings showed that positively discussing exercising, and negatively discussing snacking and drinking, resulted in healthier predictors of these behaviors. Our findings show that it is important to understand the impact of post-intervention communication and that post-intervention communication with peers and parents about health behaviors are predictors of health behavior.

The Intervening Role of Conversational Frequency and Valence in a School-Based Health Intervention.

School-based health interventions are potentially an effective method to communicate health messages to adolescents. Unfortunately, effectiveness of such interventions is limited. Research in other contexts has shown that interpersonal communication can influence the effectiveness of health programs, but this has not been thoroughly tested for school-based health interventions. Therefore, our study investigated interpersonal communication (i.e., conversational valence and frequency) in a school-based intervention context. We used a three-wave randomized-controlled trial with 1056 students to study three aims. The first aim was to investigate the influence of a health intervention on conversational frequency and valence about drinking, snacking, and exercising. Our second aim was to investigate the influence of conversational frequency and valence on (predictors of) drinking, snacking, and exercising. Our third aim was to investigate whether the health intervention indirectly influenced the program outcomes through conversational frequency and valence. Findings showed that conversational frequency and valence were related to (predictors of) the three behaviors. Additionally, findings showed that the intervention did not influence conversational frequency and valence. Accordingly, findings showed no indirect influence of the intervention on program outcomes through conversational frequency and valence. Our findings show the potential of interpersonal communication for health behaviors and predictors; however, they also stress the importance of a health intervention to properly influence interpersonal communication. If health interventions can successfully influence interpersonal communication, intervention effectiveness can be improved.

How Viewing Alcohol Posts of Friends on Social Networking Sites Influences Predictors of Alcohol Use.

Young adults are frequently exposed to alcohol posts from their friends on social networking sites, and little research has investigated the influences of these posts on alcohol use. Therefore, this study investigated how exposure to alcohol posts influenced determinants of alcohol use, and whether alcohol posts of close friends influenced these determinants more strongly compared to alcohol posts of distant friends. Students from Dutch universities (N = 210) participated in an experiment with a 2 (post condition: alcohol or neutral) x 2 (friend condition: close or distant) between-subjects design. Participants that were exposed to alcohol posts reported higher intention to use alcohol, F(1, 204) = 4.32, p =.039, willingness to use alcohol, F(1, 204) = 8.15, p =.005, and more positive affective attitudes about alcohol, F(1, 204) = 5.84, p =.017, than participants that were exposed to neutral posts. Additionally, participants who viewed alcohol posts of close friends reported more positive affective attitudes about alcohol compared to participants who viewed alcohol posts of distant friends, F(1, 204) = 5.15, p =.024. Developers of health interventions could use these findings to raise awareness about the unhealthy influences of alcohol posts on determinants of young adults' alcohol use.

Effectiveness of the InCharge Prevention Program to Promote Healthier Lifestyles: Protocol for a Randomized Controlled Trial.

BACKGROUND: InCharge is a newly developed school-based health intervention aimed at older adolescents. It aims to promote a healthier lifestyle by increasing self-regulation skills. After the InCharge program's effectiveness was previously investigated in a pilot study, the content of the program was adapted. OBJECTIVE: This study describes the protocol of a cluster randomized controlled trial that aims to investigate the effectiveness of the InCharge program. METHODS: A cluster randomized controlled trial including 70 classes with older adolescents (aged 16 years or older) in the Netherlands will be conducted to test the effectiveness of the InCharge program. After schools are recruited, randomization occurs at the class level. The trial consists of the following two conditions: an experimental condition and a control condition. Participants in the experimental condition will be given the InCharge intervention, consisting of four lessons of 50 minutes, with each lesson containing three assignments of approximately 15 minutes. While participants in the experimental condition will receive InCharge, participants in the control condition will receive regular academic school courses. Surveys are administered 1 week before the intervention (baseline), 1 week after the intervention (posttest), and 12 weeks after the intervention (follow-up). Variables of interest include, but are not limited to, self-regulation; predictors of snack intake, physical activity, and alcohol use; and interpersonal communication regarding these health behaviors. In addition to surveys, observations will be conducted during the first and fourth lessons, teachers will be interviewed, and focus groups will be held with a selection of students from the intervention condition. RESULTS: Enrollment started in September 2017. As of June 2019, a total of 1216 participants were enrolled for this trial. Findings will be published in peer-reviewed journals and presented at conferences. The trial has been approved by the Ethics Review Board of the Faculty of Social and Behavioral Sciences of the University of Amsterdam (reference no.: 2017-PC-8244). CONCLUSIONS: In this study protocol, the design of a cluster randomized controlled trial is described, which assesses how effectively the school-based intervention InCharge stimulates healthier lifestyles in late adolescents. We hypothesize that participants in the experimental condition will consume less alcohol, eat fewer unhealthy snacks, and be more physically active compared with participants in the control condition. TRIAL REGISTRATION: Netherlands Trial Register (NL6654); https://www.trialregister.nl/trial/6654. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/17702.