<b>Mobile health interventions for substance use reduction: a systematic review</b>
Creators: name: Guta, Mistire Teshome
name: Abamecha, Fira
name: Amdissa, Demuma
name: Abate, Kalkidan Hassen
Publisher: name: figshare
Year: 2025
Subjects: classificationCode: 420605
subject: Preventative health care
classificationCode: 420603
subject: Health promotion

description: This systematic review explores the potential of mobile health (mHealth) interventions in reducing substance use among young adults, specifically students aged 16-25 in low- and middle-income countries (LMICs). Substance use disorders often emerge in adolescence or early adulthood, posing significant risks to both physical and mental health. However, young adults in LMICs frequently face barriers to accessing treatment, including stigma, high costs, and a lack of services tailored to their needs. MHealth interventions, leveraging widely accessible digital platforms like mobile apps, SMS, and instant messaging, present an innovative and scalable solution to address substance use within this demographic. The review evaluates the effectiveness of these digital tools by analyzing studies published from 1991 onward, identifying five studies that met the inclusion criteria.The included studies focused on various mHealth interventions, such as instant messaging apps, mobile applications, Telegram, and SMS, to reduce alcohol consumption and smoking behaviors. These interventions were found to be feasible, highly engaging, and effective in reducing substance use. Behavioral models like the Health Belief Model (HBM) and Social Cognitive Theory (SCT) were utilized to deliver personalized and interactive content to users.MHealth interventions in the reviewed studies employed diverse delivery methods, including video conferencing, mobile chat-based messaging, and SMS. SMS messaging, in particular, emerged as a widely used and cost-effective tool, especially in resource-limited settings where smartphone penetration may be lower. Instant messaging apps, however, showed high acceptability among younger users due to their interactive nature. Notable interventions included the "Quit with US" app, which combined pharmacist counseling with app-based support to improve smoking cessation, and a Telegram-based educational program targeting smoking prevention. The studies also relied on psychometric tools such as the Alcohol Use Disorders Identification Test (AUDIT) and Heaviness of Smoking Index to assess outcomes, incorporating behavioral change techniques like HBM, SCT, and the Transtheoretical Model (TTM) to modify substance use behaviors.While the reviewed studies reported positive outcomes in reducing or preventing substance use, several challenges and limitations were noted. The sample sizes were generally small, and follow-up durations were short, preventing a comprehensive understanding of the long-term effects of the interventions. Additionally, the studies primarily focused on university students in upper-middle-income countries, with no interventions conducted in Africa or low-income countries. This gap highlights the need for further research to test mHealth interventions in regions with high substance use burdens and limited cessation infrastructure.The review also emphasizes the diversity in intervention characteristics, including the platforms used, the frequency of delivery, and the content provided. The duration of interventions typically spanned three months, with delivery frequencies ranging from daily to weekly. The use of interactive platforms, such as mobile apps and instant messaging, proved more effective than one-way messaging in fostering engagement and reducing dropout rates. mHealth interventions demonstrated potential for reducing substance use among vulnerable groups, such as university students, by providing real-time support and education.The review recognizes several limitations in the current body of research, including the reliance on self-reported data, which may introduce bias, and the absence of long-term follow-up data. These factors hinder the ability to draw definitive conclusions about the sustained effectiveness and scalability of mHealth interventions. To strengthen the evidence base, future research should focus on larger sample sizes, include more diverse populations, and incorporate objective measures to validate outcomes. Furthermore, the review emphasizes the need for further investigation of mHealth interventions in different regions, particularly in Africa, and for testing their applicability to various forms of substance use. Addressing these gaps will help inform the development of evidence-based guidelines for implementing mHealth interventions to combat substance use in low- and middle-income countries (LMICs). Despite the promising results, the review highlights the necessity of large-scale, rigorous trials to confirm the findings and assess the broader impact of these interventions.Overall, mHealth interventions show significant promise in reducing substance use among young adults, particularly in resource-limited settings. However, more large-scale, rigorous trials are necessary to validate their effectiveness and assess their scalability. Continued research and optimization of these interventions will be essential to maximize their impact and improve public health outcomes for young adults in LMICs.