A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial
Open accessAbstract
BACKGROUND: Too few young people engage in behaviours that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. This study sought to assess the efficacy and cost-effectiveness of a theory-based online health behaviour intervention (based on self-affirmation theory, the Theory of Planned Behaviour and implementation intentions) targeting these behaviours in new university students, in comparison to a measurement-only control. METHODS: Two-weeks before starting university all incoming undergraduates at the University of Sheffield were invited to take part in a study of new students' health behaviour. A randomised controlled design, with a baseline questionnaire, and two follow-ups (1 and 6 months after starting university), was used to evaluate the intervention. Primary outcomes were measures of the four health behaviours targeted by the intervention at 6-month follow-up, i.e., portions of fruit and vegetables, metabolic equivalent of tasks (physical activity), units of alcohol, and smoking status. RESULTS: The study recruited 1,445 students (intervention n = 736, control n = 709, 58% female, Mean age = 18.9 years), of whom 1,107 completed at least one follow-up (23% attrition). The intervention had a statistically significant effect on one primary outcome, smoking status at 6-month follow-up, with fewer smokers in the intervention arm (8.7%) than in the control arm (13.0%; Odds ratio = 1.92, p = .010). There were no significant intervention effects on the other primary outcomes (physical activity, alcohol or fruit and vegetable consumption) at 6-month follow-up. CONCLUSIONS: The results of the RCT indicate that the online health behaviour intervention reduced smoking rates, but it had little effect on fruit and vegetable intake, physical activity or alcohol consumption, during the first six months at university. However, engagement with the intervention was low. Further research is needed before strong conclusions can be made regarding the likely effectiveness of the intervention to promote health lifestyle habits in new university students. TRIAL REGISTRATION: Current Controlled Trials, ISRCTN67684181.
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Two studies aimed at reducing alcohol consumption (N = 413 intervention; N = 433 control); one also reported post-intervention data on tobacco smoking (Epton et al., 2014; could not be pooled).
“Two studies aimed at reducing alcohol consumption (N = 413 in intervention group; N = 433 in control group), one of these also reported post-intervention data on tobacco smoking (Epton et al., 2014; could not be pooled).”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Epton et al., 2014
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredOnly one study in the meta-analysis used trial preregistration and publication of protocols (Epton et al., 2014; Epton et al., 2013).
“Only one study in our meta-analysis did so (Epton et al., 2014; Epton et al., 2013).”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Epton et al., 2014
The Abstract’s Trial registration section gives a registration number, and the References identify a published 2013 study protocol. Our copy does not give a registration date, so it does not establish that the trial was preregistered. The claim that this was the only such study in the meta-analysis is the citing authors’ own comparison, not something this trial report can establish. (LLM, conf=0.82)
Experimental — accuracy not yet measuredBoth substance misuse studies used a universal prevention approach for alcohol and alcohol/cigarette consumption.
“Both of these used a universal prevention approach for alcohol (Gilbertson et al., 2018) and alcohol and cigarette consumption (Epton et al., 2014).”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Epton et al., 2014
Only one study (Epton et al., 2014) evidently concealed group allocation and none clearly ensured blinding of participants.
“In particular, only one study (Epton et al., 2014) evidently concealed group allocation and, as is often the case in non-pharmacological trials (Boutron et al., 2007), none clearly ensured blinding of participants.”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Epton et al., 2014
Risk of bias of included studies was high; the study with lowest risk of bias (Epton et al., 2014) fulfilled just three out of five assessed Cochrane risk of bias criteria.
“Similarly, the risk of bias of the included studies was high, with the study with the lowest risk of bias (Epton et al., 2014) fulfilling just three out of the five assessed Cochrane risk of bias criteria.”
From The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials (2020) · cites this paper as Epton et al., 2014
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
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- Authors
- Epton, T., Norman, P., Dadzie, A.-S., Harris, P. R., Webb, T. L., Sheeran, P., Julious, S. A., Ciravegna, F., Brennan, A., Meier, P. S., Naughton, D., Petroczi, A., Kruger, J., & Shah, I.
- Affiliations
- University of Manchester (GB)
- University of Sheffield (GB)
- University of Sussex (GB)
- University of North Carolina at Chapel Hill (US)
- Kingston University London (GB)
- Corresponding author
- Epton, Tracy
- ORCID
- Venue
- BMC Public Health
- Published
- 2014-06-05
- Volume
- 14
- Issue
- 1
- Pages
- 563-563
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4067627
- OpenAlex
- W2141826154
- Cited by
- 82
- References
- 22
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 6 · 2023: 6 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 10 · 2018: 7 · 2017: 7 · 2016: 8 · 2015: 3 · 2014: 4
- FWCI
- 11.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Research Repository (Kingston University London) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, public-domain)
- Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Explorer (The University of Manchester) (submittedVersion)
- UNC Libraries
- Funders
- Wellcome Trust
- Alzheimer's Society
- Alzheimer's Research Trust
- Cancer Research UK
- National Institute for Health and Care Research
- British Heart Foundation
- Diabetes UK
- Stroke Association
- Public Health Agency
- Directorate for Biological Sciences
- Medical Research Council (MR/K023195/1, MR/J000450/1)
- Biotechnology and Biological Sciences Research Council
- Economic and Social Research Council
- World Cancer Research Fund
- Health and Social Care Research and Development Division
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Keywords
- university students, self-affirmation theory, theory of planned behavior, implementation intentions, smoking prevention, fruit and vegetable intake, physical activity, alcohol consumption, health behavior change, intervention engagement, cost-effectiveness
- MeSH terms
- Smoking Prevention, Adolescent, Cost-Benefit Analysis, Female, Health Promotion, Humans, Male, Models, Theoretical, Obesity, Students, Universities, Health Behavior, Treatment Outcome, Internet, Young Adult
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