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This quasi-experimental study evaluated a Theory of Planned Behavior-based educational intervention among higher secondary students in Kathmandu, Nepal. The two-day intervention significantly reduced daily internet use and improved attitudes, subjective norms, perceived behavioral control, and behavioral intentions related to preventing internet addiction. No significant changes were observed in the control group, demonstrating that theory-driven, school-based educational programs can effectively promote healthier internet use behaviors among adolescents.
Internet addiction among adolescents is an emerging public health concern, associated with academic, emotional, and social difficulties, particularly in urban settings with high digital access. As internet use behavior is influenced by attitudes, subjective norms, and perceived behavioral control, this study applied the Theory of Planned Behavior (TPB) framework. The primary aim was to measure the effectiveness of educational intervention on behavioral intention based on the TPB framework towards the prevention of internet addiction among higher secondary level school students of Kathmandu Metropolitan City, Nepal.
A quasi-experimental study was conducted among 132 higher secondary students in Kathmandu. Participants were equally assigned to intervention and control groups using multistage random sampling. Baseline internet-use behavior and TPB constructs were assessed using validated se4lf- The intervention group received a two-day TPB-based educational program to improve attitudes, subjective norms, perceived behavioral control, and behavioral intentions toward preventing internet addiction, while the control group received no intervention. Post-intervention evaluation was conducted six weeks later, and changes in TPB construct scores were analyzed using paired t-tests.
At baseline, most TPB construct scores were similar between the intervention and control groups, although the intervention group reported higher daily internet use (5.71 ± 2.71 vs. 4.47 ± 1.05 hours) and subjective norms (14.15 ± 3.97 vs. 12.15 ± 4.39). Following the TPB-based educational intervention, the intervention group showed a significant reduction in daily internet use (3.14 ± 1.56) and improvements in attitudes 17.18 ± 2.14), subjective norms (16.20 ± 2.44), perceived behavioral control (18.33 ± 2.56), and behavioral intentions toward preventing internet addiction (20.64 ± 2.40). The control group showed no significant changes, indicating the effectiveness of the intervention in promoting healthier internet behaviors. The TPB-based educational intervention significantly reduced daily internet use and improved attitudes, subjective norms, perceived behavioral control, and behavioral intentions toward preventing internet addiction among higher secondary students. These findings highlight the effectiveness of theory-driven, school-based programs in promoting healthier internet behaviors in adolescents.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interventional Group- Educational Intervention | Experimental | Altogether 66 students were recruited in this group. This group received the educational intervention package over two days. The intervention consisted of three structured modules delivered to students, teachers, and parents using interactive and multimedia-based approaches: Module 1: Introduction to internet addiction and why adolescents are vulnerable (lectures, case stories, posters) Module 2: Types and signs/symptoms of internet addiction (PowerPoint presentations, Q&A sessions, posters) Module 3: Preventive strategies and available help-seeking sources (interactive sessions, Q&A, posters) |
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| Control Group - Standard School Curriculum | No Intervention | Participants continued their usual school activities without receiving any additional educational intervention. No educational materials, drugs, or devices were involved. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Educational Intervention Package based on the Theory of Planned Behavior | Other | The intervention package consisted of three structured modules delivered to students, teachers, and parents using interactive and multimedia-based approaches: Module 1: Introduction to internet addiction and adolescent vulnerability (lectures, case stories, posters). Module 2: Types and signs/symptoms of internet addiction (PowerPoint presentations, Q&A sessions, posters). Module 3: Preventive strategies and available help-seeking sources (interactive sessions, Q&A, posters). No drugs or devices were used in this intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Behavioral Intention Score | A structured questionnaire based on the Theory of Planned Behavior (TPB) will be used to evaluate the effectiveness of the intervention package in preventing internet addiction. The questionnaire comprises Likert-scale items assessing behavioral intention, attitudes, subjective norms, and perceived behavioral control. Each item will be scored from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating stronger behavioral intention toward preventing internet addiction (better outcome). The questionnaire will be adapted from existing validated TPB tools and further refined based on findings from the situational analysis and pre-testing. The instrument will be administered at baseline (pre-intervention) and 6 weeks post-intervention to assess changes in outcome measures. | Baseline (pre-intervention) and 6 weeks post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| TPB Constructs Score | A structured TPB-based questionnaire will be used to assess changes in all four TPB constructs: behavioral intention, attitudes, subjective norms, and perceived behavioral control. Each item will be scored on a Likert scale from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating more positive attitudes, stronger subjective norms, greater perceived behavioral control, and stronger behavioral intention toward preventing internet addiction. The questionnaire will be administered at baseline (pre-intervention) and at 6 weeks post-intervention to assess changes in these constructs. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Durga Prasad Pahari, PHD | Central Department of Public Health | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Manish Rajbanshi | Kathmandu | 44600 | Nepal |
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| Baseline (pre-intervention) and 6 weeks post-intervention |