title: Web-based interventions to decrease alcohol use in adolescents: a Delphi study about increasing effectiveness and reducing drop-out.
abstract: BACKGROUND
  Web-based computer-tailored (CT) interventions have a high potential to reach a large number of people and effectively change health risk behaviors and their determinants. However, effect studies show small and variable effect sizes, and these interventions also suffer from high drop-out. In this study we explored how Web-based CT interventions can be used effectively to reduce binge drinking in 16- to 18-year-old adolescents.
  
  
  METHODS
  A three-round Delphi study was conducted. We invited experts to identify strategies to be used in Web-based CT interventions that can effectively decrease binge drinking in adolescents and to rate these strategies by importance. We asked to discriminate between interventions targeted for adolescents and those targeted for parents. Furthermore, we asked experts to suggest strategies for reducing drop-out and to indicate their importance.
  
  
  RESULTS
  Important strategies mentioned by the experts were: encouraging parents to set appropriate rules, encouraging consistent communication, and training refusal skills among adolescents. Concerning the reduction of drop-out from Web-based CT interventions experts came up with suggestions involving the content of the intervention (e.g., relevant material, use of language, tailored messages) but also involving the use of reminders and incentives.
  
  
  CONCLUSIONS
  The results of this explorative study provide useful strategies to increase effectiveness and decrease drop-out in future interventions.
authors.affiliation: Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, 6200 MD, The Netherlands. astrid.jander@maastrichtuniversity.nl.
authors.forename: Astrid
authors.initials: A
authors.lastname: Jander
authors.affiliation: Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, 6200 MD, The Netherlands. rik.crutzen@maastrichtuniversity.nl.
authors.forename: Rik
authors.initials: R
authors.lastname: Crutzen
authors.affiliation: Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, 6200 MD, The Netherlands. liesbeth.mercken@maastrichtuniversity.nl.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Mercken
authors.affiliation: Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, 6200 MD, The Netherlands. hein.devries@maastrichtuniversity.nl.
authors.forename: Hein
authors.initials: H
authors.lastname: De Vries
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control*; D003697:Delphi Technique; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands; D010287:Parent-Child Relations; D012648:Self Care / Q000379:methods; D013813:Therapy, Computer-Assisted / Q000379:methods*