Digital screening and brief intervention for illicit drug misuse in college students: A mixed methods, pilot, cluster, randomized trial from India

Background: Adolescence and early adulthood are vulnerable periods for substance use-related disorders later in life. The use of internet-enabled interventions can be useful, especially in low-resource settings.Aims: To examine the feasibility, acceptability, and preliminary effectiveness of single-session digital screening and brief intervention (d-SBI) for illicit drug misuse in college students and explore barriers and facilitators of d-SBI.Methods: Design: Mixed-methods, pilot cluster randomized trial. Setting: Four conveniently selected colleges were randomized into intervention and control groups. Participants: 219 students were screened, and 37 ful-filled eligibility. Twenty-four completed follow-ups. In-depth interviews were done with ten students. Inter-vention and Comparator: Following a digital screening, Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) based brief intervention was provided in the d-SBI group. The control group received brief education. Measurements: Acceptability was assessed by direct questions and usage statistics. ASSIST scores of groups were assessed at baseline and 3 months. Inductive coding of the interview transcript was done.Results: More than 50 % of participants found d-SBI user-friendly, appropriate, and useful. Eighty percent of users, who logged in, completed screening. Per-protocol analysis showed a reduction in cannabis-ASSIST score over 3 months. The mean ASSIST score for other drugs combined did not differ significantly between groups. The difference in risk transition (moderate to low) was not significant. Qualitative analysis revealed three over-arching themes-recruitment, engagement, and behavior change.Conclusions: Digital SBI for drug misuse is feasible among college students. d-SBI might be effective in reducing cannabis use.