Reducing at-risk adolescents' display of risk behavior on a social networking web site a randomized controlled pilot intervention trial

Objective: To determine whether an online intervention reduces references to sex and substance abuse on social networking Web sites among at-risk adolescents. Design: Randomized controlled intervention trial. Setting: www.MySpace.com. Participants: Self-described 18- to 20-year-olds with public MySpace profiles who met our criteria for being at risk (N = 190). Intervention: Single physician e-mail. Main Outcome Measures: Web profiles were evaluated for references to sex and substance use and for security settings before and 3 months after the intervention. Results: Of 190 subjects, 58.4% were male. At baseline, 54.2% of subjects referenced sex and 85.3% referenced substance use on their social networking site profiles. The proportion of profiles in which references decreased to 0 was 13.7% in the intervention group vs 5.3% in the control group for sex (P = .05) and 26.0% vs 22% for substance use (P = .61). The proportion of profiles set to "private" at follow-up was 10.5% in the intervention group and 7.4% in the control group (P = .45). The proportion of profiles in which any of these 3 protective changes were made was 42.1% in the intervention group and 29.5% in the control group (P =.07). Conclusions: A brief e-mail intervention using social networking sites shows promise in reducing sexual references in the online profiles of at-risk adolescents. Further study should assess how adolescents view different risk behavior disclosures to promote safe use of the Internet.