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Web Application Intervention for Multiple Risk Behavior Prevention in Thai
Female Adolescents: An Application of Theory of Planned Behavior

P. Thammaraksa, A. Powwattana, S. Boonlue, and Y. Meeklinhom 4
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Faculty of Nursing, Praboromarajchanok Institute, Thailand, Faculty of Public Health, Mahidol University,
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Thailand, Faculty of Education, King Mongkut’s University of Technology Thonburi, Thailand, and
Bangpleeratbamrung School, Bangpleeratbamrung School, Thailand
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Background: Multiple risk behaviors (MRB) among adolescents are associated with a multitude
of negative health and economic outcomes. Previous reviews have shown eHealth school-based
interventions for single health behaviors to be effective; however, less is known about interventions
targeting multiple risk behaviors. We developed an intervention delivered by a web application
(“STOPMRB”) to prevent multiple risk behaviors among Thai female adolescents. STOPMRB on a mobile
device allows more dynamic engagement and interaction between the user and the technology than
digital interventions previously tested.

Objective: To examine the effectiveness of web application (“STOPMRB”) on prevention multiple risk
behaviors among Thai female adolescents.

Methods: We conducted a quasi-experimental study among Thai female adolescents aged 13–15
(n=60). Participants allocated to the intervention arm (n=30) had access to web app plus text messages.
Participants allocated to the control arm (n=30) received usual care. The primary outcome was having
only one or no risk behavior at 2 months follow-up. Secondary outcomes were self-reported perceived
behavioral control and intention to avoid MRB. Outcomes were analyzed using repeated one-way ANOVA.
We conducted a post-hoc analysis of change in acceptability from baseline to follow-up.

Oral Presentation Abstracts
Results: After attending 2 months of intervention, no MRB was reported for the intervention group,
whereas 2 out of 30 participants (6.7%) among control group had MRB. After the program when
compared to before and those in the control group, the intervention group had higher secondary
outcomes (p<0.001). The secondary outcomes were maintained after first month until the end of the
intervention (p<0.001).

Conclusion: The intervention delivered by web app and text messages provided additional benefits
over usual care. The observed increases in perceived behavior control and intention to avoid MRB.
Future research is needed to establish the effect of the intervention on cognition among young males,
particularly with respect to substance abuse.

Keywords: web application, theory of planned behavior, multiple risk behaviors, female adolescents

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Correspondence: Arpaporn Powwattana, Faculty of Public Health, Mahidol University, Thailand
E-mail: arpaporn.pow@mahidol.ac.th

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