Technology-based substance use interventions for emerging adults and college students: A systematic review and meta-analysis.

Objective: To synthesize randomized controlled trial evidence on technology-based interventions' (TBIs) effectiveness for substance use among emerging adults (EA)/college students (CS). Methods: Nine electronic databases were searched. Two reviewers independently screened studies, extracted data, and assessed evidence quality. We used robust variance estimation in meta-regression for effect size synthesis and moderator analysis. Results: Based on 130 studies, the overall between-group effect size was 0.23 (95% CI= 0.18, 0.28). The effect sizes for comparing TBIs with no treatment, standard care, and non-technology interventions were 0.25 (CI=0.19, 0.31), 0.23 (CI=0.15, 0.32), and 0.12 (CI= -0.02, 0.25), respectively. Older participants showed significantly larger effect sizes, and interventions using multiple technologies had larger effects than smartphone-based ones. Conclusion: TBIs are effective in reducing substance use in EA/CS, with outcomes comparable to non-technology interventions and advantages over no treatment and standard care. Future research should address drug-related outcomes, multi-technology approaches, age-appropriate designs, and cultural diversity.