{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:55:18Z","timestamp":1782845718351,"version":"3.54.5"},"reference-count":55,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Digital interventions have been successfully used to address addictive behaviors in adolescents and young adults. However, maintaining consistent usage remains a challenge. There is limited evidence on the determinants of usage with multiple behavioral interventions among vocational students.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This paper aims to describe how vocational school students used the app-based addiction prevention program \u201cready4life\u201d and to analyze student characteristics as potential determinants of intervention usage.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 2-arm cluster randomized trial evaluated \u201cready4life\u201d among German vocational students aged \u226516 years. After downloading the app during class, students completed an anonymous screening and received individual risks and competencies feedback. Intervention participants (n=1286) received 4 months of individual app-based coaching, with weekly chat contacts with a conversational agent. They were asked to choose 2 of 6 modules: alcohol, tobacco, cannabis, social media and gaming, stress, and social competencies that were delivered sequentially in a random order. In addition to the weekly chats, users could self-initiate chat dialogues at any time. Chats included media (videos, images, or links), quizzes, and contests. Control participants (n=1282) received a link to health behavior information and could access coaching after 12 months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Usage was low among intervention participants who received their assigned intervention (n=1266; females n=569, 44.9%; mean age 19.53, SD 3.57 years). On average, participants started 4.8 (SD 5.1) and completed 4.3 (SD 5.2) of 16 weekly in-app chats. Most students (n=903, 71.3%) completed no self-initiated chats, and 50.2% (n=636) stopped using the app before week 3. Unadjusted negative binomial multilevel regression models showed that females completed significantly more weekly dialogues (\n P<\/jats:italic>\n <.001; incidence rate ratio [IRR] 1.55, 95% CI 1.33\u20101.80), while fewer were completed by individuals with higher self-efficacy (\n P<\/jats:italic>\n =.04; IRR 0.96, 95% CI 0.93\u20100.998), higher social competencies (\n P<\/jats:italic>\n <.001; IRR 0.97, 95% CI 0.95\u20100.98), and individuals engaging in more addictive behaviors (\n P<\/jats:italic>\n <.001; IRR 0.87, 95% CI 0.82\u20100.93). Concerning specific educational tracks, professionals, technicians, associate professionals, and vocational grammar school students had the highest number of completed weekly dialogues. Determinants of completed self-initiated chats and usage time largely aligned with the findings for weekly dialogues. Additionally, those with higher perceived stress completed significantly more self-initiated chats (\n P<\/jats:italic>\n <.001; IRR 1.19, 95% CI 1.08\u20101.31). Age and year of education were not significantly associated with any of the usage parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our study supports the existing evidence that maintaining consistent usage among adolescents and young adults is a major challenge for digital interventions. An important finding was that students with higher needs for support in terms of self-efficacy, social competence, and perceived stress showed higher intervention usage. In terms of health equity, additional efforts should be made to increase intervention usage among males, those with lower levels of education, and those with higher levels of addictive behaviors.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/68754","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T12:00:07Z","timestamp":1746619207000},"page":"e68754-e68754","source":"Crossref","is-referenced-by-count":0,"title":["Usage of an App-Based Addiction Prevention Program for German Vocational Students: Secondary Analysis of Data From a Cluster Randomized Controlled Trial"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-5347","authenticated-orcid":false,"given":"Diana","family":"Guertler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-0479","authenticated-orcid":false,"given":"Anne","family":"M\u00f6hring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-8574","authenticated-orcid":false,"given":"Dominic","family":"Bl\u00e4sing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4722-7109","authenticated-orcid":false,"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-5862","authenticated-orcid":false,"given":"Hannah","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2330-0937","authenticated-orcid":false,"given":"Florian","family":"Rehbein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2761-4152","authenticated-orcid":false,"given":"Merten","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4393-0171","authenticated-orcid":false,"given":"Arne","family":"Drei\u00dfigacker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-3329","authenticated-orcid":false,"given":"Anja","family":"Bischof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0432-5497","authenticated-orcid":false,"given":"Gallus","family":"Bischof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7006-5502","authenticated-orcid":false,"given":"Svenja","family":"S\u00fcrig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6091-2374","authenticated-orcid":false,"given":"Lisa","family":"Hohls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-8299","authenticated-orcid":false,"given":"Susanne","family":"Wurm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-3987","authenticated-orcid":false,"given":"Stefan","family":"Borgwardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6539-5045","authenticated-orcid":false,"given":"Severin","family":"Haug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6848-920X","authenticated-orcid":false,"given":"Hans-J\u00fcrgen","family":"Rumpf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.17623\/BZGA:Q3-ALKSY21-DE-1.0","article-title":"Der substanzkonsum jugendlicher und junger erwachsener in Deutschland, ergebnisse des alkoholsurveys 2021 zu alkohol, rauchen, cannabis und trends [Article in German]","author":"Orth","journal-title":"BZgA-Forschungsbericht"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2017.0419","article-title":"The prevalence and psychosocial correlates of internet gaming disorder: analysis in a nationally representative sample of 12-to 25-year-olds","volume":"114","author":"Wartberg","journal-title":"Dtsch \u00c4rzteblatt Int"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.11.002","article-title":"School-based programmes to reduce and prevent substance use in different age groups: what works for whom? Systematic review and meta-regression analysis","volume":"44","author":"Onrust","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s00103-024-03854-0","article-title":"Substance use and the usage of social media, computer games, and gambling among apprentices at vocational schools","volume":"67","author":"Lochb\u00fchler","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Meyer C Jahnel T Freyer-Adam J Ulbricht S Hanke M John U . Konsum Von Gl\u00fccksspielen, Medien, Cannabis, Alkohol Und Tabak Bei Jugendlichen Und Jungen Erwachsenen in Beruflichen Schulen Und Produktionsschulen Mecklenburg-Vorpommerns: Eine Landesrepr\u00e4sentative Querschnittserhebung [Gambling, Media, Cannabis, Alcohol and Tobacco Consumption Among Adolescents and Young Adults in Vocational Schools and Production Schools in Mecklenburg-Vorpommern: A State-Representative Cross-Sectional Survey] [Book in German]. Institut f\u00fcr Sozialmedizin und Pr\u00e4vention, Universit\u00e4tsmedizin Greifswald; 2016.","DOI":"10.1055\/s-0037-1605617"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18020637","article-title":"Multiple health risk factors in vocational education students: a systematic review","volume":"18","author":"Atorkey","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"e206","DOI":"10.1016\/S2589-7500(19)30088-3","article-title":"Effectiveness of school-based eHealth interventions to prevent multiple lifestyle risk behaviours among adolescents: a systematic review and meta-analysis","volume":"1","author":"Champion","journal-title":"Lancet Digit Health"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-023-00518-1","article-title":"Digital interventions for substance use disorders in young people: rapid review","volume":"18","author":"Monarque","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1097\/JAN.0000000000000416","article-title":"Systematic review of smartphone apps as a mHealth intervention to address substance abuse in adolescents and adults","volume":"32","author":"Kazemi","journal-title":"J Addict Nurs"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20031970","article-title":"Effects of an app-based intervention program to reduce substance use, gambling, and digital media use in adolescents and young adults: a multicenter, cluster-randomized controlled trial in vocational schools in Germany","volume":"20","author":"Pietsch","journal-title":"Int J Environ Res Public Health"},{"issue":"23","key":"R11","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315730","article-title":"Efficacy of a mobile app-based coaching program for addiction prevention among apprentices: a cluster-randomized controlled trial","volume":"19","author":"Haug","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/35371","article-title":"Factors influencing adherence to mHealth apps for prevention or management of noncommunicable diseases: systematic review","volume":"24","author":"Jakob","journal-title":"J Med Internet Res"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231203876","article-title":"Adherence to e-Health interventions for substance use and the factors influencing it: systematic review, meta-analysis, and meta-regression","volume":"9","author":"Shams","journal-title":"Digit Health"},{"issue":"7","key":"R14","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17072180","article-title":"Engagement with a web-based health promotion intervention among vocational school students: a secondary user and usage analysis","volume":"17","author":"Stassen","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"R15","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1037\/a0038295","article-title":"When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change","volume":"141","author":"Wilson","journal-title":"Psychol Bull"},{"issue":"5","key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.3932","article-title":"Who follows eHealth interventions as recommended? A study of participants\u2019 personal characteristics from the experimental arm of a randomized controlled trial","volume":"17","author":"Reinwand","journal-title":"J Med Internet Res"},{"issue":"6","key":"R17","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1080\/10810730.2015.1012243","article-title":"Tailored eHealth lifestyle promotion: which behavioral modules do users prefer?","volume":"20","author":"Schulz","journal-title":"J Health Commun"},{"issue":"12","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/22390","article-title":"Use and appreciation of a web-based, computer-tailored diet and physical activity intervention based on the self-determination theory: evaluation study of process and predictors","volume":"5","author":"Coumans","journal-title":"JMIR Form Res"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1093\/her\/cyp063","article-title":"Characteristics of visitors and revisitors to an internet-delivered computer-tailored lifestyle intervention implemented for use by the general public","volume":"25","author":"Brouwer","journal-title":"Health Educ Res"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.764079","article-title":"Effect of engagement with digital interventions on mental health outcomes: a systematic review and meta-analysis","volume":"3","author":"Gan","journal-title":"Front Digit Health"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1093\/ntr\/ntq252","article-title":"A systematic review of randomized controlled trials: web-based interventions for smoking cessation among adolescents, college students, and adults","volume":"13","author":"Hutton","journal-title":"Nicotine Tob Res"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1177\/2055207617743354","article-title":"What makes online substance-use interventions engaging? A systematic review and narrative synthesis","volume":"4","author":"Milward","journal-title":"Digit Health"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1177\/1090198110372878","article-title":"Strategies to facilitate exposure to internet-delivered health behavior change interventions aimed at adolescents or young adults: a systematic review","volume":"38","author":"Crutzen","journal-title":"Health Educ Behav"},{"issue":"11","key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7928","article-title":"Engagement within a mobile phone-based smoking cessation intervention for adolescents and its association with participant characteristics and outcomes","volume":"19","author":"Paz Castro","journal-title":"J Med Internet Res"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/28638","article-title":"Engagement with a mobile phone-based life skills intervention for adolescents and its association with participant characteristics and outcomes: tree-based analysis","volume":"24","author":"Paz Castro","journal-title":"J Med Internet Res"},{"issue":"14","key":"R26","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20146379","article-title":"Predictors of youth accessibility for a mobile phone-based life skills training program for addiction prevention","volume":"20","author":"Haug","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09995-6","article-title":"Efficacy of a smartphone-based coaching program for addiction prevention among apprentices: study protocol of a cluster-randomised controlled trial","volume":"20","author":"Haug","journal-title":"BMC Public Health"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2016.02.027","article-title":"Polysubstance use patterns and trajectories in vocational students--a latent transition analysis","volume":"58","author":"Tomczyk","journal-title":"Addict Behav"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1080\/10826084.2022.2040029","article-title":"Latent classes of substance use in young adults \u2013 a systematic review","volume":"57","author":"de Jonge","journal-title":"Subst Use Misuse"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.2196\/59573","article-title":"Prevention needs and target behavior preferences in an app-based addiction prevention program for German vocational school students: cluster randomized controlled trial","volume":"13","author":"Guertler","journal-title":"JMIR mHealth uHealth"},{"key":"R31","unstructured":"Paz Castro R Wenger A Haug S . Ready4life coaching app der lungenliga - evaluation des mobiltelefonbasierten programms zur suchtpr\u00e4vention bei lernenden im schuljahr 2020\/21 [Ready4life coaching app of the lung league - evaluation of the mobile phone-based program for addiction prevention among students in the school year 2020\/21] [Article in German]. Schweizer Institut f\u00fcr Sucht- und Gesundheitsforschung, Z\u00fcrich; 2021."},{"issue":"3","key":"R32","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.jadohealth.2024.11.010","article-title":"App-based coaching to prevent addictive behaviors in vocational school students: a cluster randomized trial","volume":"76","author":"Guertler","journal-title":"J Adolesc Health"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1024\/0939-5911\/a000811","article-title":"App-based coaching to prevent addictive behaviors among young adults","volume":"69","author":"Schmidt","journal-title":"Sucht"},{"issue":"5","key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/36404","article-title":"Nonusage attrition of adolescents in an mHealth promotion intervention and the role of socioeconomic status: secondary analysis of a 2-arm cluster-controlled trial","volume":"10","author":"Maenhout","journal-title":"JMIR mHealth uHealth"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s40429-025-00632-z","article-title":"Self-efficacy as a mechanism of behavior change in addiction science and practice","volume":"12","author":"Magill","journal-title":"Curr Addict Rep"},{"issue":"5","key":"R36","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s11121-024-01702-w","article-title":"App-based addiction prevention at German vocational schools: implementation and reach for a cluster-randomized controlled trial","volume":"25","author":"Guertler","journal-title":"Prev Sci"},{"key":"R37","unstructured":"Ganzeboom HB . International standard classification of occupations ISCO-08 with ISEI-08 scores. Harry Ganzeboom. 2010. URL: http:\/\/www.harryganzeboom.nl\/ISCO08\/isco08_with_isei.pdf [Accessed 14-06-2025]"},{"issue":"11","key":"R38","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1089\/cyber.2017.0260","article-title":"Internet-related disorders: development of the short compulsive internet use scale","volume":"20","author":"Besser","journal-title":"Cyberpsychol Behav Soc Netw"},{"issue":"6","key":"R39","doi-asserted-by":"publisher","first-page":"444","DOI":"10.5271\/sjweh.752","article-title":"Validity of a single-item measure of stress symptoms","volume":"29","author":"Elo","journal-title":"Scand J Work Environ Health"},{"issue":"4","key":"R40","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/S0005-7894(75)80013-X","article-title":"An assertion inventory for use in assessment and research","volume":"6","author":"Gambrill","journal-title":"Behav Ther"},{"key":"R41","unstructured":"Beierlein C Kovaleva A Kemper CJ Rammstedt B . Ein messinstrument zur erfassung subjektiver kompetenzerwartungen: Allgemeine Selbstwirksamkeit Kurzskala (ASKU). Social Science Open Access Repository. 2012. URL: https:\/\/www.ssoar.info\/ssoar\/bitstream\/handle\/document\/29235\/ssoar-2012-beierlein_et_al-ein_messinstrument_zur_erfassung_subjektiver.pdf?sequence=1 [Accessed 25-06-2025]"},{"key":"R42","doi-asserted-by":"crossref","unstructured":"Twisk JW . Applied Multilevel Analysis: A Practical Guide for Medical Researchers. Cambridge University Press; 2006. ISBN: 9780511610806","DOI":"10.1017\/CBO9780511610806"},{"issue":"6","key":"R43","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1037\/met0000265","article-title":"Partitioning variation in multilevel models for count data","volume":"25","author":"Leckie","journal-title":"Psychol Methods"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.2196\/56897","article-title":"When and why adults abandon lifestyle behavior and mental health mobile apps: scoping review","volume":"26","author":"Kidman","journal-title":"J Med Internet Res"},{"key":"R45","unstructured":"Oliver S Kavanagh J Caird J Lorenc T Oliver K Harden A et al. Health promotion, inequalities and young people\u2019s health: a systematic review of research. EPPI Centre. 2008. URL: https:\/\/eppi.ioe.ac.uk\/cms\/Publications\/Systematicreviews\/Healthpromotion,inequalitiesandyoungpeople\/tabid\/2410\/Default.aspx [Accessed 25-06-2025]"},{"issue":"6","key":"R46","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4127","article-title":"Gender differences in searching for health information on the internet and the virtual patient-physician relationship in Germany: exploratory results on how men and women differ and why","volume":"17","author":"Bidmon","journal-title":"J Med Internet Res"},{"issue":"5","key":"R47","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/alcalc\/agl053","article-title":"Does socio-economic status influence the acceptability of, attendance for, and outcome of, screening and brief interventions for alcohol misuse: a review","volume":"41","author":"Littlejohn","journal-title":"Alcohol Alcohol"},{"issue":"6","key":"R48","doi-asserted-by":"publisher","first-page":"e267","DOI":"10.1016\/S2468-2667(17)30078-6","article-title":"Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data","volume":"2","author":"Katikireddi","journal-title":"Lancet Public Health"},{"issue":"12","key":"R49","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1016\/j.mayocp.2023.05.003","article-title":"Health disparities, clinical trials, and the digital divide","volume":"98","author":"Adedinsewo","journal-title":"Mayo Clin Proc"},{"issue":"3","key":"R50","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1159\/000499040","article-title":"Feasibility and acceptability of an intervention providing computer-generated tailored feedback to target alcohol consumption and depressive symptoms in proactively recruited health care patients and reactively recruited media volunteers: results of a pilot study","volume":"25","author":"Krause","journal-title":"Eur Addict Res"},{"issue":"5","key":"R51","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.amepre.2016.06.015","article-title":"Understanding and promoting effective engagement with digital behavior change interventions","volume":"51","author":"Yardley","journal-title":"Am J Prev Med"},{"key":"R52","unstructured":"Brandt D Schmidt H G\u00fcrtler D M\u00f6hring A Bl\u00e4sing D Meyer C et al. Pr\u00e4vention bei auszubildenden in bezug auf rauschmittelkonsum und internetbezogene st\u00f6rungen (PARI) - abschlussbericht [prevention of drug use and internet-related disorders in trainees (PARI) - final report] [Article in German]. ready4life. 2023. URL: http:\/\/www.ready4life.info\/files\/PARI-Abschlussbericht.pdf [Accessed 25-06-2025]"},{"issue":"3","key":"R53","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8.3.e20","article-title":"The law of attrition revisited","volume":"8","author":"Christensen","journal-title":"J Med Internet Res"},{"issue":"10","key":"R54","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2771","article-title":"Rethinking the dose-response relationship between usage and outcome in an online intervention for depression: randomized controlled trial","volume":"15","author":"Donkin","journal-title":"J Med Internet Res"},{"issue":"5","key":"R55","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1007\/s12529-016-9604-5","article-title":"Randomized controlled trial of a brief versus extended internet intervention for problem drinkers","volume":"24","author":"Cunningham","journal-title":"Int J Behav Med"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e68754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:55:45Z","timestamp":1782842145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e68754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":55,"URL":"https:\/\/doi.org\/10.2196\/68754","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]},"article-number":"v27i4e68754"}}