[Impact of an indicated prevention program on risk behaviors among adolescents at psychosocial risk].

[Adolescent prevention as a tool for reducing healthcare system burden].

INTRODUCTION Adolescence is of particular importance in the prevention of non-communicable chronic diseases, as health behavior patterns established during this life stage may influence adult morbidity in the long term. The healthcare system and societal burden of chronic diseases justify the development of prevention programs initiated early in life and adapted to the needs of the target population. OBJECTIVE The aim of our study was to assess program awareness, health behavior characteristics and perceptions of prevention programs among the target population of the "Youth for a Healthy Future" (YHF) program. METHOD A cross-sectional quantitative questionnaire-based study was conducted in 2025 using convenience sampling. The 26-item online questionnaire was completed by 427 examined individuals; data processing was performed using IBM SPSS Statistics 30.0 software. In addition to descriptive statistics, cross-tabulation, Pearson's χ² test and Cramér's association coefficient were applied. RESULTS The sample comprised 46% boys and 52.0% girls; the mean age was 18.0 years (SD = 1.73). The YHF program was known by 16% of respondents, and 29 examined individuals reported direct participation. Regular smoking was reported by 16% and occasional smoking by 17% of respondents. A significant association was found between school type and smoking status (χ² = 36.798; p<0.001; Cramér's V = 0.29): a lower smoking rate was observed among grammar school students, whereas regular smoking was more frequent among vocational secondary school and technical school students. Awareness of the YHF program was also associated with school type (χ² = 12.070; p = 0.002; Cramér's V = 0.17), with higher awareness among grammar school students. Among barriers to participation, insufficient information was reported by 61% of respondents, lack of free or discounted participation by 58%, and the insufficiently practical nature of programs by 38%. Among future program topics, stress management, mental health and sports events attracted the greatest interest. CONCLUSION Based on our findings, improving the reach of the YHF program and similar prevention initiatives requires more targeted communication, program structures better adapted to differences by school type and sex, and a stronger emphasis on practical and interactive program elements. Due to the cross-sectional design, causal conclusions cannot be drawn; however, the results may provide a basis for future longitudinal and controlled studies. Orv Hetil. 2026; 167(30): 1207-1212.

Understanding Risk Acceptance in Performance Enhancing Substance Use: A Cluster Randomized Prevention Study Among Recreational Fitness Athletes.

BACKGROUND The use of performance-enhancing substances such as pre-workout supplements has become increasingly common in recreational fitness environments. Although behavioral interventions aim to reduce enhancement-related substance use, little is known about whether such interventions operate similarly across different psychosocial athlete profiles and which psychological mechanisms may underlie behavioral change. METHODS Data were analyzed from a cluster-randomized prevention trial conducted in ten fitness studios in Germany, including 602 recreational fitness athletes. Cluster-adjusted logistic regression models examined intervention effects on booster use at follow-up (T3). Moderation analyses tested differential responsiveness across psychosocial athlete profiles, while mediation analyses examined changes in risk acceptance as a potential psychological pathway. RESULTS Participants in the intervention group showed lower odds of booster use compared with the control group (OR = 0.58, 95% CI [0.33, 1.00], p = .052), corresponding to an absolute risk reduction of 6.65 percentage points. Risk acceptance decreased more strongly among motivationally ambivalent athlete profiles, whereas comparable moderation effects were not observed for booster use. These reductions were consistent with a partial mediation pathway linking the intervention to reduced booster use. CONCLUSIONS The findings suggest that behavioral interventions in recreational fitness settings may operate differently across psychosocial athlete profiles rather than producing uniform effects. Changes in risk acceptance appear to represent a key psychological mechanism associated with intervention-related reductions in booster use, highlighting the importance of psychologically informed prevention strategies tailored to psychosocial athlete profiles in recreational fitness populations.

Advancing in Personalization of Psychological, Indicated Preventive Interventions: A Randomized Controlled Trial in Adolescents at High-Risk of Developing Emotional Disorders.

This randomized controlled trial evaluated the effectiveness of a personalized, transdiagnostic, indicated preventive intervention (PROCARE-I+) compared to its standard format (PROCARE-I) in high-risk adolescents. One hundred and thirty-nine participants were randomized to either a standard transdiagnostic, indicated preventive intervention (PROCARE-I; n = 70) or the personalized intervention with add-on modules (PROCARE-I+; n = 69). Participants were assessed at post-intervention at 6 and 7-month follow-ups (the latter, one month after receiving a booster session). Results showed significant reductions not only in anxiety and depressive symptoms, but also in emotional risk. Improvements in emotion regulation, psychological flexibility, resilience, and quality of life were also found. While both interventions were effective, the personalized PROCARE-I+ intervention revealed greater improvements over time in key outcomes. These findings suggest the potential added value of personalization in transdiagnostic, indicated prevention and its potential to enhance long-term outcomes in adolescents at high risk of developing emotional disorders.

Behavioral Effects of a Telehealth Family Prevention Program for Black Adolescents: 2 Year Results of a Randomized Trial.

Effectiveness of Sport-Based Interventions in Substance Use Prevention: A Multi-Criteria and Causal Analysis

There was a strong negative relationship between mental health and substance use and a positive relationship between peer influence and increased risk, whereas sport participation appeared to have a moderate protective relationship, but with a range of variation in participants.

Effectiveness of universal secondary school-based interventions addressing the psychological risk factors of eating disorders in adolescents: a systematic review

To evaluate the effectiveness of universal secondary-school interventions targeting core eating disorder (ED) psychopathology and at least one additional psychological risk factor. A systematic search of databases was conducted, including Scopus, CINAHL, Embase, PsycINFO, MEDLINE and Google Scholar in March 2025. Eligible randomised controlled trials (RCTs) reported quantitative outcomes (e.g., ED psychopathology, body dissatisfaction, dieting behaviors) following universal secondary-school interventions addressing weight, shape, or eating concerns and another psychological risk factor in non-clinical adolescents aged 11–18. Results were synthesized narratively, and study quality was evaluated using the Cochrane Risk of Bias (RoB-2). Seventeen RCTs were included. Eleven studies were conducted in Europe, most participants were female and in middle adolescence. Overall, most universal school-based ED interventions produced some immediate improvement in ED symptoms or well-being but effects were generally small or rarely sustained at follow-up. There were no significant changes in BMI. However, the high risk of bias limits the confidence of findings. These improvements were short term, and their effects were mostly small. Future research would benefit from adopting active comparison groups and longer follow-ups. Whilst core ED psychopathology in addition to the risk factors of body image dissatisfaction, dieting, self-esteem, and social media appear consistent factors to include in universal interventions, further understanding of the most effective risk factors to target in this population is needed.