Social marketing intervention for social media-related adolescent risk behaviours in North India: A multi-city cluster RCT protocol

Purpose: A majority of adolescents between the ages of 13 and 17 use at least one social media platform for interactive engagement. This age group marks a crucial period of social development, given the high susceptibility of young minds to influence. Excessive use of social media is associated with severe public health concerns, such as alcohol abuse, interpersonal dysfunction, and sexual behaviour-related concerns. This protocol details the development of a school-based social marketing intervention (SMI) and implementation of RCT to evaluate the effectiveness of SMI to reduce excessive social media use and associated adverse effects. Methods: The study will employ an open-label, cluster-randomized controlled trial (RCT) design. The study will be conducted in senior secondary schools located in three cities in Northern India (Chandigarh, Panchkula, and Mohali). A total of 12 schools will be selected, comprising four schools from each study area. Within each city, schools (clusters) will be randomized into intervention and control arms. Based on the available literature on sample size guidelines for Randomized Controlled Trials (RCTs), the total sample size is estimated to be 1260 students for all three cities. The SMI will be delivered in three phases: a pre-intervention assessment phase, a three-month intervention phase guided by the COM-B model of behavioural change, and a post-intervention evaluation phase to measure outcomes in both groups. Discussion: The adolescent relationship with social media is complex, providing both chances for learning and risks of misinformation and unhealthy behaviours. This study protocol aims to outline our plan to evaluate whether a structured SMI can enhance awareness and reduce adverse behaviours related to alcohol use, sexual health, and interpersonal relationships among adolescents. Trial Registration: Clinical Trial Registry-India, CTRI/2024/11/077115, originally registered on 11/11/2024.