ABSTRACT

Unhealthy lifestyle, such as alcohol use, and negative health outcomes have been associated with impairments in psychological well-being. The primary objective of the study was to test the efficacy of an intervention based on Well-Being Therapy to prevent or stem alcohol use, binge drinking and other unhealthy lifestyle among Italian adolescents in school settings. A three-arm cluster randomized controlled trial including three test periods (baseline, post-test, six-month follow-up) was implemented. Seven classes (144 students) were randomly assigned to receive well-being intervention (WBI), lifestyle intervention (LI), or no intervention (NI). Primary outcomes were alcohol use (AUDIT-C), binge drinking and other unhealthy lifestyle behaviors (i.e. unhealthy diet, physical inactivity, tobacco and cannabis smoking, poor sleep and Internet addiction). Linear mixed models and mixed-effects logistic regression were used to test the efficacy of WBI in comparison with LI and NI. At six-month follow-up, AUDIT-C total score increased more in NI in comparison with WBI (p = 0.044) and LI (p = 0.016), whereas the odds of being classified as at-risk drinker were lower in WBI (p = 0.038) and LI (p = 0.002), than NI. Only WBI showed a protective effect for cannabis use at post-test in comparison with NI (p = 0.003) and LI (p = 0.014). Sleep hours at night decreased more in NI than in LI (p = 0.027) at six months. Internet addiction decreased more in WBI (p = 0.002) and LI (p = 0.005) at post-test in comparison with NI. Although both interventions showed a positive impact on adolescent lifestyle, the positive effect of WBI on cannabis use underlines how this approach might be promising to stem adolescents’ substance use.

摘要

不健康的生活方式（例如饮酒）和负面健康结果与心理健康受损有关。该研究的主要目的是测试基于健康疗法的干预措施对预防或阻止学校环境中意大利青少年酗酒、酗酒和其他不健康生活方式的干预效果。实施了一项三臂整群随机对照试验，包括三个测试期（基线、测试后、六个月随访）。七个班级（144 名学生）被随机分配接受健康干预（WBI）、生活方式干预（LI）或不干预（NI）。主要结果是饮酒（AUDIT-C）、酗酒和其他不健康的生活方式行为（即不健康的饮食、缺乏身体活动、吸烟和吸食大麻、睡眠质量差和网络成瘾）。使用线性混合模型和混合效应逻辑回归来测试 WBI 与 LI 和 NI 相比的功效。在六个月的随访中，与 WBI ( p  = 0.044) 和 LI ( p  = 0.016) 相比，NI 中的 AUDIT-C 总分增加更多，而 WBI 中被归类为高危饮酒者的几率较低（p  = 0.038) 和 LI ( p  = 0.002) 高于 NI。与 NI ( p  = 0.003) 和 LI ( p = 0.014)相比，只有 WBI 在测试后显示出对大麻使用的保护作用。 六个月时，NI 组夜间睡眠时间比 LI 组减少更多 ( p = 0.027)。 与 NI 相比，测试后WBI ( p  = 0.002) 和 LI ( p = 0.005) 的网络成瘾下降更多。尽管这两种干预措施都对青少年生活方式产生了积极影响，但 WBI 对大麻使用的积极影响凸显了这种方法可能有望阻止青少年的药物使用。