Virtual theory-based program failed to improve opium prevention behaviors in young Iranian men

A brief, fully virtual intervention built on Social Cognitive Theory did not produce a statistically significant improvement in opium-use preventive behaviors among young men in northeastern Iran, according to a non-randomized cluster-controlled study published in BMC Psychology.

Eight health service centers were non-randomly allocated to either an intervention or a control group before participant recruitment began, and participants were not individually randomized. The intervention consisted of four Social Cognitive Theory-based sessions delivered through WhatsApp over two weeks.

Researchers collected data at baseline and again three months after the intervention using a validated, researcher-developed questionnaire that assessed both opium-use preventive behaviors and the theoretical constructs underlying the program. Analyses were performed on complete cases using non-parametric tests and a linear mixed-effects model that accounted for clustering of participants within health centers, conducted in SPSS.

The primary outcome was negative. Preventive behavior scores were similar between the two groups after the intervention, and the adjusted mixed-effects model showed no statistically significant difference between the intervention and control groups, with an estimated effect of 0.67 (95% confidence interval −1.83 to 3.17; p = 0.537). The confidence interval spanned both directions, meaning the study could not rule out either a modest benefit or a modest harm, though the point estimate and p-value indicated no detectable between-group effect.

Post-intervention between-group differences were also not observed for the Social Cognitive Theory constructs the program was designed to target. In other words, when intervention participants were compared directly with controls, none of the theoretical measures separated the groups after the program ended.

Within the intervention group, however, several constructs did improve when participants were assessed against their own baseline. Knowledge, outcome expectations and experiences, situational perception, environment, self-control, and emotional coping all showed within-group gains.

The study’s authors concluded that although the brief, fully virtual, theory-informed program was associated with improvements in some Social Cognitive Theory constructs within the intervention group, it did not result in a statistically significant improvement in preventive behaviors. They recommended that future interventions prioritize feedback-rich skills rehearsal and incorporate mechanisms that address social and contextual influences in order to improve behavioral impact.

Several limitations shape how these results should be read. The design was quasi-experimental rather than randomized, with only eight centers allocated non-randomly before recruitment, so unmeasured differences between centers cannot be excluded. The sample of 94 young men drawn from health service centers in one region of Iran limits generalizability, and the intervention was deliberately brief, consisting of just four WhatsApp sessions over two weeks. The findings describe a single trial of a specific program in a specific population and should not be generalized to other digital prevention efforts or other substances.

Subject of Research: A quasi-experimental trial of a Social Cognitive Theory-based virtual intervention for opium use prevention among young men in Iran

Article Title: Evaluating a social cognitive theory–based empowerment program to promote opium use prevention in young men aged 18–29: a non-randomized cluster-controlled study

Article References: Joveini, H., Sharifi, N., babaei, Z., Rajabzadeh, R., Hakkak, H. M., Hosseini, Z. S., & Taherpour, M. (2026). Evaluating a social cognitive theory–based empowerment program to promote opium use prevention in young men aged 18–29: a non-randomized cluster-controlled study. BMC Psychology. https://doi.org/10.1186/s40359-026-05793-8

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05793-8

Keywords: opium use prevention, Social Cognitive Theory, young men, Iran, WhatsApp intervention, digital health, quasi-experimental study, preventive behavior, self-efficacy, public health, BMC Psychology, health behavior change