Open Access Open Badges Study protocol

Evaluation of computer-tailored health education (‘E-health4Uth’) combined with personal counselling (‘E-health4Uth + counselling’) on adolescents’ behaviours and mental health status: design of a three-armed cluster randomised controlled trial

Rienke Bannink1*, Evelien Joosten - van Zwanenburg2, Petra van de Looij - Jansen3, Els van As4 and Hein Raat1

Author Affiliations

1 Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands

2 Municipal Public Health Service South-Holland South, Karel Lotsyweg 40, 3318 AL, Dordrecht, the Netherlands

3 Municipal Public Health Service Rotterdam area, Schiedamsedijk 95, 3011 EN, Rotterdam, the Netherlands

4 Department of Youth Health Care, Rivas zorggroep, P.O. Box 90, 4200 AB, Gorichem, the Netherlands

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BMC Public Health 2012, 12:1083  doi:10.1186/1471-2458-12-1083

Published: 17 December 2012



About 15% of adolescents in the Netherlands have mental health problems and many also have health risk behaviours such as excessive alcohol consumption, cigarette smoking, use of drugs, and having unsafe sex. Mental health problems and health risk behaviours may have adverse effects on the short and longer term. Therefore, in the Netherlands there is a considerable support for an additional public health examination at age 15–16 years. The study evaluates the effect of two options for such an additional examination. Adolescents in the ‘E-health4Uth’ group receive internet-based tailored health messages on their health behaviour and well-being. Adolescents in the ‘E-health4Uth + counselling’ group receive the computer-tailored messages combined with personal counselling for adolescents at risk of mental health problems.

Methods and design

A three-arm cluster randomised controlled trial will be conducted in the Netherlands among fourth-grade secondary school students. School classes are the unit of randomisation. Both intervention groups complete the computer-tailored program during one class session; the program focuses on nine topics related on health behaviour and well-being. For each topic a score is computed that can be compared with the Dutch health norms for adolescents. Based on the score, a message is presented that reflects the person’s current behaviour or well-being, the Dutch health norm, and offers advise to change unhealthy behaviour or to talk to a person they trust. Adolescents in the ‘E-health4Uth + counselling’ group are also invited for an appointment to see the nurse when they are at risk of mental health problems. The control group receives ‘care as usual’.

The primary outcome measures are health behaviour (alcohol, drugs, smoking, safe sex) and mental health status. The secondary outcome measure is health-related quality of life. Data will be collected with a questionnaire at baseline and at 4-months follow-up. A process evaluation will also be conducted.


It is hypothesized that at follow-up adolescents in the ‘E-health4Uth’ group and adolescents in the ‘E-health4Uth + counselling’ group will show fewer mental health problems and less risky behaviour compared to the control group.

Trial registration

Current Controlled Trials NTR3596

Adolescents; Youth; Health behaviour (alcohol, drugs, smoking, safe sex); Psychosocial problems; Mental health; Well-being; E-health4Uth; Tailored health education; Counselling; Tailored counselling