![]() The widespread use of electronic communication technologies by young people, particularly the use of mobile phones and other mobile devices, presents new opportunities to intervene on risk and preventive behavior. Several systematic reviews and meta-analyses have found positive effects of interventions to reduce risk behavior among adolescents and young adults, including tobacco use, alcohol misuse, drug use, risky driving, and unsafe sex as well as interventions to promote health behaviors, such as use of contraception to prevent pregnancy, human papilloma virus (HPV) vaccination, oral health and hygiene, and nutrition and exercise promotion. For adolescents, adherence to preventive measures represents a challenge in that the immediate and short-term benefits are often hard to comprehend and the long-term benefits may not be fully appreciated. Many problem behaviors in adolescents, such as tobacco, alcohol, and other drug use risky driving and unsafe sex are preventable to a large extent, and their associated negative outcomes could be mitigated with preventive interventions. The burden of morbidity and mortality in adolescents worldwide is increasing, and the prevention of communicable and noncommunicable diseases, particularly those related to modifiable behavior, has been emphasized as a key component of adolescent health. Studies varied in sample size and methods of preventive behavior adherence or outcome assessment, which prohibited performing a meta-analysis. As early efforts in this field to establish feasibility and initial efficacy, most studies were low to moderate in quality. About half of the included studies (42%, 8/19) demonstrated significant improvement in preventive behavior with moderate standardized mean differences. Most studies reported good feasibility with high acceptability and satisfaction. Only 6 of 19 studies (32%) incorporated a theoretical framework in their design. Although most studies were randomized controlled trials (RCTs 58%, 11/19), only 5 followed an intent-to-treat analysis. ![]() Most studies were performed in the United States (47%, 9/19), included younger adolescents (63%, 12/19), and had sample size <100 (63%, 12/19). ![]() Studies targeted clinic attendance, contraceptive use, oral health, physical activity and weight management, sun protection, human papillomavirus (HPV) vaccination, smoking cessation, and sexual health. Of 1454 records, 19 met inclusion criteria, including text messaging (n=15) and mobile phone apps (n=4). The preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting results, and findings were critically appraised against the Oxford Centre for Evidence-based Medicine criteria. Included studies reflect original research-experimental or preexperimental designs with text messaging or mobile phone app interventions-targeting adherence to preventive behavior among adolescents (12-24 years old). Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. The search strategy sought articles on text messaging and mobile phone apps combined with adherence or compliance, and adolescents and youth. Searches included PubMed, Embase, CENTRAL, PsycINFO, CINAHL, INSPEC, Web of Science, Google Scholar, and additional databases. This review covers literature published between 19. ![]()
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