Effectiveness of WeChat Public Account Intervention Based on the Information-Motivation-Behavioral Skills Model Among College Students With Internet Addiction: Randomized Controlled Trial

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BACKGROUND Internet addiction (IA) among college students causes multiple harms and increases suicide risk. Effective interventions can reduce these and have public health value. OBJECTIVE This study evaluates a WeChat public-account intervention based on the information, motivation, behavioral skills (IMB) model to reduce IA in college students and to examine mechanisms driving behavior change. METHODS A total of 226 college students aged 18 to 24 years with IA were recruited from a university in Anhui Province, China, and randomized (stratified by gender) to intervention (n=113) or control (n=113) groups. The intervention comprised a 6-week structured online program delivered via a WeChat public account, organized into 3 modules: information, motivation, and behavioral skills. Controls received no intervention. Preintervention data were subjected to statistical comparison using an independent sample t test, Mann-Whitney U test, and chi-square test. Primary and secondary indicators were measured using the Internet Addiction Test (IAT), Chinese Treatment Self-Regulation Questionnaire, and Internet Control Self-Efficacy Questionnaire. To evaluate the intervention’s effects and identify pre- to postintervention changes, we used generalized linear mixed models and generalized estimating equations for analysis with SPSS software (version 23.0), considering statistical significance at α=.05. Participants were further stratified into mild and moderate to severe IA subgroups based on their baseline scores, and subgroup analyses were conducted to examine both the intervention effects within each stratum and the between-group differences across different addiction severity levels. RESULTS The intervention group showed a significant reduction in IA (χ21=14.154; P<.001). This paper confirmed a substantial reduction in addiction levels after the intervention compared to the control group (adjusted mean change –4.531, 95% CI –7.281 to –1.781; P=.001), with no significant differences in internet use duration. Consistent findings were obtained in the subgroup analyses. A time-group interaction was identified for sleep duration (P<.001), with a notable increase observed in the intervention group (odds ratio 2.186, 95% CI 1.142-4.183; P=.02). No significant differences were observed between the groups in sleep quality and somatic-psychological symptoms. Consistent findings were observed in the subgroup analyses of the above studies. The intervention group showed increased motivation (adjusted mean change 4.283, 95% CI 0.804-7.763; P=.02) and behavioral skills (adjusted mean change 3.407, 95% CI 1.771-5.043; P<.001) after the intervention. Only behavioral skills were improved in the mild IA subgroup, whereas only motivation showed improvement in the moderate to severe subgroup. CONCLUSIONS The WeChat public-account intervention based on the IMB model significantly reduced the level of IA in college students and simultaneously had a positive effect on increasing sleep duration. The decline in IAT scores observed in the moderate to severe subgroup was twice as large as that in the mild subgroup. CLINICALTRIAL ClinicalTrials.gov NCT06704984; https://clinicaltrials.gov/study/NCT06704984

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