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Patten CA, Koller KR, Sinicrope PS, Prochaska JJ, Young C, Resnicow K, Decker PA, Hughes CA, Merritt ZT, McConnell CR, Huang M, Thomas TK. Facebook Intervention to Connect Alaska Native People With Resources and Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial. Nicotine Tob Res 2023; 25:803-813. [PMID: 36130170 PMCID: PMC10032195 DOI: 10.1093/ntr/ntac221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION There is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults. AIMS AND METHODS Recruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence. RESULTS Of intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97). CONCLUSIONS While additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence. IMPLICATIONS This study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, 1265 Welch Road, Stanford, CA, 94305-5411, USA
| | - Colleen Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, 200 First St SW, Rochester, MN, 55905, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI, 48109, USA
| | - Paul A Decker
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Christine A Hughes
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Zoe T Merritt
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Timothy K Thomas
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
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Shuter J, Chander G, Graham AL, Kim RS, Stanton CA. Randomized Trial of a Web-Based Tobacco Treatment and Online Community Support for People With HIV Attempting to Quit Smoking Cigarettes. J Acquir Immune Defic Syndr 2022; 90:223-231. [PMID: 35175971 PMCID: PMC9203899 DOI: 10.1097/qai.0000000000002936] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Persons with HIV (PWH) in the United States (US) smoke cigarettes at approximately triple the rate of the general adult population and are less successful in their quit attempts than other smokers. This randomized trial tested whether a novel web-based cessation program for PWH yielded higher cigarette quit rates compared with a control program. SETTING Two urban HIV care sites in NYC and Baltimore. METHODS Between 2016 and 2020, 506 PWH were randomized to either Positively Smoke Free on the Web (PSFW+; N = 255), a multimodal platform, interactive web intervention hosted within an online social network to support quitting among PWH who smoke, and an attention-matched web-based control intervention (American Heart Association Getting Healthy; N = 251). All participants were offered 12 weeks of nicotine patch. Our primary outcome was biochemically confirmed exhaled carbon monoxide < 10 parts per million (ppm) 7-day point prevalence abstinence at 6 months. RESULTS Participants were middle-aged (mean 50.2 years; range 23-73 years), 57% male, 19% Latinx, 83% Black, and 13% White. At 6 months, a significantly greater percentage of PSFW+ participants (14.9%) achieved biochemically confirmed 7-day point prevalence abstinence in intent-to-treat analysis compared with 8.8% of American Heart Association Getting Healthy participants [odds ratio =1.82 (95% confidence interval =1.04 to 3.18), P = 0.03]. CONCLUSIONS PSFW+ is a promising cessation intervention composed of empirically tested content and real-time social support through an online social network that was found to promote abstinence. This digital approach has broad reach and scalability, can be easily integrated into comprehensive HIV care, and represents an advance in the fight against tobacco use among PWH.
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Affiliation(s)
- Jonathan Shuter
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, NY
| | | | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC
- Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Ryung S Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Rockville, MD; and
- Department of Oncology, Georgetown University Medical Center, Washington, DC
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Bardier C, Yang JS, Li J, Mackey TK. Characterizing alternative and emerging tobacco product transition of use behavior on Twitter. BMC Res Notes 2021; 14:303. [PMID: 34372926 PMCID: PMC8351350 DOI: 10.1186/s13104-021-05719-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The objective of this study was to develop an inductive coding approach specific to characterizing user-generated social media conversations about transition of use of different tobacco and alternative and emerging tobacco products (ATPs). RESULTS A total of 40,206 tweets were collected from the Twitter public API stream that were geocoded from 2018 to 2019. Using data mining approaches, these tweets were then filtered for keywords associated with tobacco and ATP use behavior. This resulted in a subset of 5718 tweets, with 657 manually annotated and identified as associated with user-generated conversations about tobacco and ATP use behavior. The 657 tweets were coded into 9 parent codes: inquiry, interaction, observation, opinion, promote, reply, share knowledge, use characteristics, and transition of use behavior. The highest number of observations occurred under transition of use (43.38%, n = 285), followed by current use (39.27%, n = 258), opinions about use (0.07%, n = 46), and product promotion (0.06%, n = 37). Other codes had less than ten tweets that discussed these themes. Results provide early insights into how social media users discuss topics related to transition of use and their experiences with different and emerging tobacco product use behavior.
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Affiliation(s)
- Cortni Bardier
- Global Health Policy and Data Institute, San Diego, CA, USA
- Department of Anthropology, Global Health Program, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Joshua S Yang
- Department of Public Health, California State University, Fullerton, Fullerton, CA, USA
| | - Jiawei Li
- Global Health Policy and Data Institute, San Diego, CA, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Tim K Mackey
- Global Health Policy and Data Institute, San Diego, CA, USA.
- Department of Anthropology, Global Health Program, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
- S-3 Research LLC, San Diego, CA, USA.
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Graham AL, Papandonatos GD, Jacobs MA, Amato MS, Cha S, Cohn AM, Abroms LC, Whittaker R. Optimizing Text Messages to Promote Engagement With Internet Smoking Cessation Treatment: Results From a Factorial Screening Experiment. J Med Internet Res 2020; 22:e17734. [PMID: 32238338 PMCID: PMC7386536 DOI: 10.2196/17734] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/09/2020] [Accepted: 02/22/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Smoking remains a leading cause of preventable death and illness. Internet interventions for smoking cessation have the potential to significantly impact public health, given their broad reach and proven effectiveness. Given the dose-response association between engagement and behavior change, identifying strategies to promote engagement is a priority across digital health interventions. Text messaging is a proven smoking cessation treatment modality and a powerful strategy to increase intervention engagement in other areas of health, but it has not been tested as an engagement strategy for a digital cessation intervention. OBJECTIVE This study examined the impact of 4 experimental text message design factors on adult smokers' engagement with an internet smoking cessation program. METHODS We conducted a 2×2×2×2 full factorial screening experiment wherein 864 participants were randomized to 1 of 16 experimental conditions after registering with a free internet smoking cessation program and enrolling in its automated text message program. Experimental factors were personalization (on/off), integration between the web and text message platforms (on/off), dynamic tailoring of intervention content based on user engagement (on/off), and message intensity (tapered vs abrupt drop-off). Primary outcomes were 3-month measures of engagement (ie, page views, time on site, and return visits to the website) as well as use of 6 interactive features of the internet program. All metrics were automatically tracked; there were no missing data. RESULTS Main effects were detected for integration and dynamic tailoring. Integration significantly increased interactive feature use by participants, whereas dynamic tailoring increased the number of features used and page views. No main effects were found for message intensity or personalization alone, although several synergistic interactions with other experimental features were observed. Synergistic effects, when all experimental factors were active, resulted in the highest rates of interactive feature use and the greatest proportion of participants at high levels of engagement. Measured in terms of standardized mean differences (SMDs), effects on interactive feature use were highest for Build Support System (SMD 0.56; 95% CI 0.27 to 0.81), Choose Quit Smoking Aid (SMD 0.38; 95% CI 0.10 to 0.66), and Track Smoking Triggers (SMD 0.33; 95% CI 0.05 to 0.61). Among the engagement metrics, the largest effects were on overall feature utilization (SMD 0.33; 95% CI 0.06 to 0.59) and time on site (SMD 0.29; 95% CI 0.01 to 0.57). As no SMD >0.30 was observed for main effects on any outcome, results suggest that for some outcomes, the combined intervention was stronger than individual factors alone. CONCLUSIONS This factorial experiment demonstrates the effectiveness of text messaging as a strategy to increase engagement with an internet smoking cessation intervention, resulting in greater overall intervention dose and greater exposure to the core components of tobacco dependence treatment that can promote abstinence. TRIAL REGISTRATION ClinicalTrials.gov NCT02585206; https://clinicaltrials.gov/ct2/show/NCT02585206. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2015-010687.
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Affiliation(s)
- Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States.,Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | | | - Megan A Jacobs
- Innovations Center, Truth Initiative, Washington, DC, United States
| | - Michael S Amato
- Innovations Center, Truth Initiative, Washington, DC, United States.,Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Sarah Cha
- Innovations Center, Truth Initiative, Washington, DC, United States
| | - Amy M Cohn
- Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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Graham AL, Papandonatos GD, Zhao K. The failure to increase social support: it just might be time to stop intervening (and start rigorously observing). Transl Behav Med 2017; 7:816-820. [PMID: 28070778 PMCID: PMC5684060 DOI: 10.1007/s13142-016-0458-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In 1986, Lichtenstein et al. (Behav Ther. 17(5):607-19, 1986) presented the results of five studies focused on enhancing social support for smoking cessation in community-based clinic and worksite interventions. The manuscript was titled Social Support in Smoking Cessation: In Search of Effective Interventions and its main conclusion was that "attempts to both increase social support and to enhance treatment effectiveness have not been successful." Thirty years later, the paper by Cutrona et al. (Transl Behav Med. 6(4):546-57, 2016) draws a similar conclusion from a study focused on providing social support through an online social network for smoking cessation. In reviewing these findings - and based on our knowledge of the extensive literature on social support interventions that has been published over the past 30+ years - we believe there is a need for a fundamental shift in research on social support. Our focus here is largely on smoking cessation, but our comments are applicable to other areas of behavior change.
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Affiliation(s)
- Amanda L Graham
- Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC, 20001, USA.
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
| | | | - Kang Zhao
- Tippie College of Business, The University of Iowa, Iowa City, IA, USA
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