Youth Vaping Prevention through Immersive Technology

Project Summary / Abstract E-cigarette use among US adolescents is common and highly problematic. Current school-based prevention interventions have yet to address how mental health contributes to e-cigarette uptake, even though mental health concerns are prevalent among youth. Emotion regulation (i.e., the ability to effectively respond to the range of one’s emotions) is linked to maintaining good mental health and abstaining from substances during early adolescence, making it a prime target for e-cigarette prevention. Emerging research shows that poor emotion regulation is a risk factor for e-cigarette uptake. No school-based programs have focused on emotion regulation in the context of universal e-cigarette prevention. In response to this knowledge gap, we plan to prepare for and then conduct a multi-site cluster-randomized optimization-efficacy-implementation (OEI) trial of E-Invite Only VR: A Vaping Prevention and Virtual Reality (VR) Based Videogame. E-Invite Only VR is a unique school-based, universal e-cigarette prevention intervention that reinforces emotion regulation skills and constructs from the theory of planned behavior as well as social cognitive theory. Developed in partnership with schools, game designers, and an extensive multidisciplinary research team, this VR-based prevention approach has already been implemented in real-world middle school classrooms. Our initial pilot efficacy studies demonstrated promising results. E-Invite Only VR leverages the Accelerated Creation-to-Sustainment model, a design and implementation framework for behavioral health technologies. Our specific aims are to: 1) Optimize E-Invite Only VR by using iterative user-centered design approaches with community partners/end users; 2) Evaluate the efficacy of E-Invite Only VR, compared to wait-list control, on reducing the prevalence of any e-cigarette use (primary outcome) among 8th-grade students in real-world classrooms. We will also explore the degree to which intervention efficacy occurs through specific conceptual mediators (e.g., changes in emotion regulation; changes in intentions, knowledge, harm perceptions) and differs by moderators (e.g., baseline emotion regulation, sex, race/ethnicity, baseline self-assessment of overall mental health). Videogames and VR, with their immersive and interactive features, are compelling platforms for education and skill-based learning that adolescents are eager to engage with. Our innovative approach to e-cigarette prevention embeds emotion regulation skills within VR and leverages a rigorous methodology, based on solid preliminary data, to curb numerous adverse health outcomes associated with nicotine vaping, including cancer.