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It comprises six online video modules during health education class and a smartphone app.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol\u2010related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow\u2010up survey, 5698 (85.8%) two or more follow\u2010up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57\u20132.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64\u20131.47); increased light physical activity: OR, 1.00 (95% CI, 0.72\u20131.38); tobacco use frequency: relative difference, 0.03 (95% CI, \u20130.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, \u20130.34 (95% CI, \u20131.16 to 0.49) days per 30 days; device use time: relative difference, \u20130.07 (95% CI, \u20130.29 to 0.16) hours per day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e\u2010health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective).<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52279","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T06:13:54Z","timestamp":1712988834000},"page":"417-424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The <scp>Health4Life<\/scp> e\u2010health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled 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