1. A brief image-based prevention intervention for adolescents.
Werch C.E., Bian H., Moore M.J., et al. Psychology of Addictive Behaviors: 2010, 24(1), p. 170–175.

Across the sample, a brief face-to-face consultation highlighting how substance use might stop them becoming the sort of young adults they wanted to be generally did not prevent substance use among US high school pupils, but those already using substances were significantly more responsive, suggesting a selective if not a universal prevention role.

Summary:
The Behavior-Image Model approach to health promotion is based on the principle that portrayals of people attractive to the participant and their own improved possible future selves can integrate and motivate change in a range of activities which result in better health. Change is motivated by providing feedback on the participant's current health-related activities and their self-images, highlighting the discrepancy between them to foster commitment to setting goals to narrow this gap. Such interventions might prove more feasible for schools than single-target or lengthy programmes because in a short time they target multiple commonly used drugs and positive health promoting and personal development habits.

Two previous studies (1; 2) evaluating image-based prevention interventions among adolescents found improved substance use and other outcomes particularly among those already using substances at the start of the studies.

The featured article reports outcomes three months later in a third study. For the study 416 students (nearly two thirds girls) at a US school in grades intended for 15—17-year olds completed baseline questionnaires and were randomly assigned to the image-based intervention or to a control group who were simply given commercially available health promotion materials commonly used in schools. Of the 416, 87% completed the three-month follow-up.

The image-based intervention called Planned Success delivered scripted messages which illustrated how health-promoting behaviours support positive social and self-images of a successful young adult attractive to the student, while behaviours which risk health do the opposite. Content was tailored to the individual's current health behaviours and the images most attractive to them. At the end they were given a 'goal plan' against which to make progress after the session. Sessions were delivered to individual pupils face-to-face by specially trained nurses and health educators and lasted about 20 minutes. Starting a week later, parents and guardian were sent three weekly mailings of five parent–youth cards with messages parallel to those given the children.


2. Are effects from a brief multiple behavior intervention for college students sustained over time?
Werch C.E., Moore M.J., Bian H. et al. Preventive Medicine: 2010, 50, p. 30–34.

At a US university students at first cut back their drinking and cannabis use in response to a brief face-to-face fitness consultation, but the gains were no longer apparent a year after intervention. Yet still at that time they had at least experienced more positive trends in how they felt than students who had just read a fitness brochure.

Summary:
The Behavior-Image Model approach to health promotion is based on the principle that portrayals of people attractive to the participant and their own improved possible future selves can integrate and motivate change in a range of activities which result in better health. Change is motivated by providing feedback on the participant's current health-related activities and their self-images, highlighting the discrepancy between them to foster commitment to setting goals to narrow this gap.

An initial study evaluated three brief face-to-face, image-based interventions for college students conducted by fitness specialists. Over the following month several health-related activity domains and health-related quality of life significantly improved.

The featured article reports outcomes 12 months later from a second such study which at three months found that a brief image-based intervention had led to reductions in various measures of drinking and cannabis use, improved exercise and sleep patterns, and enhanced spiritual and social health-related quality of life.

For the study 18–21-year-old students at a public US university were recruited by adverts and announcements and paid for their participation. Of the 303 who volunteered, nearly all (299, of whom 60% were women) completed baseline questionnaires and were randomly assigned to then immediately participate in the image-based intervention or join a control group asked by a fitness specialist to read a standard brochure on fitness in a private office.