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Calle P, Shao R, Liu Y, Hébert ET, Kendzor D, Neil J, Businelle M, Pan C. Towards AI-Driven Healthcare: Systematic Optimization, Linguistic Analysis, and Clinicians' Evaluation of Large Language Models for Smoking Cessation Interventions. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2024; 2024:436. [PMID: 38912297 PMCID: PMC11192205 DOI: 10.1145/3613904.3641965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Creating intervention messages for smoking cessation is a labor-intensive process. Advances in Large Language Models (LLMs) offer a promising alternative for automated message generation. Two critical questions remain: 1) How to optimize LLMs to mimic human expert writing, and 2) Do LLM-generated messages meet clinical standards? We systematically examined the message generation and evaluation processes through three studies investigating prompt engineering (Study 1), decoding optimization (Study 2), and expert review (Study 3). We employed computational linguistic analysis in LLM assessment and established a comprehensive evaluation framework, incorporating automated metrics, linguistic attributes, and expert evaluations. Certified tobacco treatment specialists assessed the quality, accuracy, credibility, and persuasiveness of LLM-generated messages, using expert-written messages as the benchmark. Results indicate that larger LLMs, including ChatGPT, OPT-13B, and OPT-30B, can effectively emulate expert writing to generate well-written, accurate, and persuasive messages, thereby demonstrating the capability of LLMs in augmenting clinical practices of smoking cessation interventions.
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Affiliation(s)
- Paul Calle
- School of Computer Science, University of Oklahoma Norman, Oklahoma, USA
| | - Ruosi Shao
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA
| | - Yunlong Liu
- School of Computer Science, University of Oklahoma Norman, Oklahoma, USA
| | - Emily T Hébert
- School of Public Health, The University of Texas Health Science Center at Houston Austin, TX, USA
| | - Darla Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA
| | - Jordan Neil
- TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA
| | - Michael Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma, USA
| | - Chongle Pan
- School of Computer Science, University of Oklahoma Norman, Oklahoma, USA
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Puljević C, Meciar I, Holland A, Stjepanović D, Snoswell CL, Thomas EE, Morphett K, Kang H, Chan G, Grobler E, Gartner CE. Systematic review and meta-analysis of text messaging interventions to support tobacco cessation. Tob Control 2024:tc-2023-058323. [PMID: 38448226 DOI: 10.1136/tc-2023-058323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To review randomised controlled trials (RCTs) investigating the effectiveness of text message-based interventions for smoking cessation, including the effects of dose (number of text messages) and concomitant use of behavioural or pharmacological interventions. DATA SOURCES We searched seven databases (PubMed, CINAHL, PsycINFO, Scopus, EMBASE, Cochrane Library and Web of Science), Google Scholar and the reference lists of relevant publications for RCTs. Eligible studies included participants aged ≥15 years who smoked tobacco at enrolment. STUDY SELECTION One reviewer screened titles and abstracts and two reviewers independently screened full texts of articles. DATA EXTRACTION One of three reviewers independently extracted data on study and intervention characteristics and smoking abstinence rates using Qualtrics software. DATA SYNTHESIS 30 of the 40 included studies reported higher rates of smoking cessation among those receiving text messaging interventions compared with comparators, but only 10 were statistically significant. A meta-analysis of seven RCTs found that participants receiving text messages were significantly more likely to quit smoking compared with participants in no/minimal intervention or 'usual care' conditions (risk ratio 1.87, 95% CI 1.52 to 2.29, p <0.001). Three trials found no benefit from a higher dose of text messages on smoking cessation. Two trials that tested the added benefit of text messaging to pharmacotherapy reported outcomes in favour of adding text messaging. CONCLUSIONS Findings suggest that text messaging-based interventions are effective at promoting smoking cessation. Further research is required to establish if any additional benefit is gained from an increased number of text messages or concurrent pharmacotherapy or behavioural counselling.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Isabel Meciar
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Alice Holland
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Daniel Stjepanović
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Centaine L Snoswell
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Emma E Thomas
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Heewon Kang
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- Seoul National University Institute of Health and Environment, Seoul, South Korea
| | - Gary Chan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Etienne Grobler
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
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Sweileh WM. Technology-based interventions for tobacco smoking prevention and treatment: a 20-year bibliometric analysis (2003-2022). Subst Abuse Treat Prev Policy 2024; 19:13. [PMID: 38321493 PMCID: PMC10848402 DOI: 10.1186/s13011-024-00595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Substance abuse, particularly tobacco smoking, is a significant global public health concern. Efforts have been made to reduce smoking prevalence and promote cessation, but challenges, such as nicotine addiction, marketing tactics by tobacco industry, and cultural acceptability hinder progress. Technology has emerged as a potential tool to address these challenges by providing innovative scalable interventions. The objective of the study was to analyze and map scientific literature on technology-based intervention for tobacco prevention and treatment. METHODS A bibliometric methodology was conducted. Scopus database was used to retrieve relevant research articles published between 2003 and 2022. The analysis included publication trends, key contributors, research hotspots, research themes, the most impactful articles, and emerging research topics. RESULTS A total of 639 articles were found, with a slow and fluctuating growth pattern observed after 2011. The Journal of Medical Internet Research was the most prominent journal in the field. The United States was the leading country in the field, followed up by the United Kingdom, and the Netherlands. Research hotspots included smoking cessation, randomized controlled trials, and technology-based methods such as internet, mHealth, smartphone apps, text messages, and social media. Four primary research themes were identified: development of smartphone applications, efficacy of text messaging interventions, acceptance and effectiveness of smartphone applications, and interventions targeting young adults and students using mobile phone and social media platforms. The top 10 cited articles demonstrated effectiveness of digital interventions in promoting smoking cessation rates and reducing relapse rates. Emerging research topics included the use of virtual reality interventions, interventions for specific populations through personalized tools, and technology-based interventions in non-Western countries. CONCLUSIONS The findings of the current study highlight the potential of technology to address the challenges associated with tobacco smoking. Further future research in this area is warranted to continue advancing the field and developing effective and evidence-based interventions to combat tobacco smoking.
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Affiliation(s)
- Waleed M Sweileh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Rose JJ, Krishnan-Sarin S, Exil VJ, Hamburg NM, Fetterman JL, Ichinose F, Perez-Pinzon MA, Rezk-Hanna M, Williamson E. Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association. Circulation 2023; 148:703-728. [PMID: 37458106 DOI: 10.1161/cir.0000000000001160] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Vaping and electronic cigarette (e-cigarette) use have grown exponentially in the past decade, particularly among youth and young adults. Cigarette smoking is a risk factor for both cardiovascular and pulmonary disease. Because of their more limited ingredients and the absence of combustion, e-cigarettes and vaping products are often touted as safer alternative and potential tobacco-cessation products. The outbreak of e-cigarette or vaping product use-associated lung injury in the United States in 2019, which led to >2800 hospitalizations, highlighted the risks of e-cigarettes and vaping products. Currently, all e-cigarettes are regulated as tobacco products and thus do not undergo the premarket animal and human safety studies required of a drug product or medical device. Because youth prevalence of e-cigarette and vaping product use was as high as 27.5% in high school students in 2019 in the United States, it is critical to assess the short-term and long-term health effects of these products, as well as the development of interventional and public health efforts to reduce youth use. The objectives of this scientific statement are (1) to describe and discuss e-cigarettes and vaping products use patterns among youth and adults; (2) to identify harmful and potentially harmful constituents in vaping aerosols; (3) to critically assess the molecular, animal, and clinical evidence on the acute and chronic cardiovascular and pulmonary risks of e-cigarette and vaping products use; (4) to describe the current evidence of e-cigarettes and vaping products as potential tobacco-cessation products; and (5) to summarize current public health and regulatory efforts of e-cigarettes and vaping products. It is timely, therefore, to review the short-term and especially the long-term implications of e-cigarettes and vaping products on cardiopulmonary health. Early molecular and clinical evidence suggests various acute physiological effects from electronic nicotine delivery systems, particularly those containing nicotine. Additional clinical and animal-exposure model research is critically needed as the use of these products continues to grow.
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El-Toukhy S, Kamke K. Intervention targeting and retention, engagement and abstinence outcomes among Latino and White users of Smokefree.gov text messaging programmes: a cross-sectional study. BMJ PUBLIC HEALTH 2023; 1:e000222. [PMID: 38124887 PMCID: PMC10732326 DOI: 10.1136/bmjph-2023-000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Background We examined retention, engagement, and abstinence among Latino users of SmokefreeTXT en Español (SFTXTesp), a Latino-targeted text messaging smoking cessation intervention, and Latino and White users of SmokefreeTXT (SFTXT), a non-targeted intervention. Methods Data came from 12281 users (1562 Latino SFTXTesp users and 2301 Latino and 8418 White SFTXT users). We conducted time-to-dropout analyses by race/ethnicity. Using logistic regression, we examined associations between intervention targeting, race/ethnicity, and responses to smoking status prompts, an engagement metric, and self-reported abstinence on quit day, intervention end, and one-month follow-up. Age, gender, census region, smoking frequency, cigarettes smoked per day, prequit time, and number of quit attempts were covariates. Results Latinos in SFTXTesp (aOR 0.63) and SFTXT (0.88) were less likely to drop out of the intervention than Whites. SFTXTesp Latino users had higher response rates to smoking prompts than SFTXT Latinos users (aORs 1.35, quit day; 1.84, intervention end; 1.82, one-month follow-up). However, SFTXTesp and SFTXT Latino users had lower response rates than Whites (aORs 0.68, 0.45, quit day; 0.60, 0.30, intervention end; 0.64, 0.33, one-month follow-up). Abstinence was equivalent among Latinos in SFTXTesp and SFTXT interventions, but Latinos using SFTXTesp and SFTXT were less likely to be abstinent than Whites (aORs 0.42, 0.41, quit day; 0.45, 0.37, intervention end; and 0.53, 0.35, one-month follow-up). Conclusion Linguistic intervention targeting improved retention and engagement among Latinos, but not abstinence. Latinos had higher retention but lower engagement and abstinence rates than Whites. Cultural targeting may engage Latinos in smoking cessation interventions and improve abstinence.
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Affiliation(s)
- Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health
| | - Kristyn Kamke
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health
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Braciszewski JM, Sala-Hamrick KJ, Zelenak L, Gootee J, Elsiss F, Ottolini J, Lanier A, Colby SM, Ahmedani BK. Reducing Smoking Cessation Disparities: Capacity for a Primary Care- and Technology-Based Approach Among Medicaid Recipients. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09925-1. [PMID: 36400987 DOI: 10.1007/s10880-022-09925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/19/2022]
Abstract
While cigarette use among U.S adults has recently decreased, vulnerable subgroups continue to smoke at high rates, including individuals receiving Medicaid insurance. These individuals have also experienced treatment access disparities, highlighting the need for approaches that leverage their strong desire to quit. We conducted interviews with 100 adult primary care patients receiving Medicaid who were current tobacco users about their use, openness to technology-based interventions, and readiness to change. Most (92%) reported current cigarette use and readiness to change averaged 6.98 out of 10 (SD = 2.82). Nearly all were open to completing an iPad-based tobacco screening (95%) and brief intervention (90%) at their next appointment, while 91% and 88% were willing to talk with their provider or a cessation counselor, respectively, about the subsequent results. Results persisted across age, sex, and race/ethnicity. Openness to technology-based interventions in this population provides support for future work that may ultimately reduce disparities.
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Nagawa CS, Lane IA, McKay CE, Kamberi A, Shenette LL, Kelly MM, Davis M, Sadasivam RS. Use of a Rapid Qualitative Method to Inform the Development of a Text Messaging Intervention for People With Serious Mental Illness Who Smoke: Formative Research Study. JMIR Form Res 2022; 6:e40907. [DOI: 10.2196/40907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/11/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background
People with serious mental illness are disproportionately affected by smoking and face barriers to accessing smoking cessation treatments in mental health treatment settings. Text-based interventions are cost-effective and represent a widely accessible approach to providing smoking cessation support.
Objective
We aimed to identify key factors for adapting text-based cessation interventions for people with serious mental illness who smoke.
Methods
We recruited 24 adults from mental health programs who had a serious mental illness and currently smoked cigarettes or had quit smoking within the past 5 years. We then conducted virtual qualitative interviews between November 2020 and August 2021. Data were analyzed using the rapid thematic analytic approach.
Results
We identified the following 3 major themes: (1) interplay between smoking and having a serious mental illness, (2) social contextual factors of smoking in adults with serious mental illness, and (3) smoking and quitting behaviors similar to the general population. Participants reported barriers and facilitators to quitting across the 3 themes. Within the “interplay between smoking and having a serious mental illness” theme, barriers included smoking to manage stress and mental health symptoms, and facilitators to quitting included the awareness of the harm of smoking on mental health and patient-provider discussions on smoking and mental health. In the “social contextual factors of smoking in adults with serious mental illness” theme, barriers included high social acceptability of smoking among peers. Positive support and the combined social stigma of smoking and having a mental health condition outside of peer groups motivated individuals to quit. Some participants indicated that low exposure to other smokers during the COVID-19 pandemic helped them to engage in cessation efforts. In the “smoking and quitting behaviors similar to the general population” theme, barriers included smoking after eating, having coffee, drinking alcohol, and experiencing negative social support, and facilitators included health concerns, improvement in the general quality of life, and use of evidence-based tobacco treatments when available.
Conclusions
People with serious mental illness often smoke to cope with intense emotional states, manage mental health symptoms, or maintain social bonds. Text message content emphasizing equally effective and less harmful ways for stress reduction and mental health symptom management may improve quit rates in individuals with serious mental illness.
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Nair US, Greene K, Marhefka S, Kosyluk K, Galea JT. Developing a Conversational agent (Chatbot) for Individuals Ambivalent about Quitting Smoking: A Study Protocol (Preprint). JMIR Res Protoc 2022; 12:e44041. [PMID: 37000505 PMCID: PMC10131877 DOI: 10.2196/44041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/06/2023] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Cigarette smoking is the leading preventable cause of disease and death in the United States. Despite the availability of a plethora of evidence-based smoking cessation resources, less than one-third of individuals who smoke seek cessation services, and individuals using these services are often those who are actively contemplating quitting smoking. There is a distinct dearth of low-cost, scalable interventions to support smokers not ready to quit (ambivalent smokers). Such interventions can assist in gradually promoting smoking behavior changes in this target population until motivation to quit arises, at which time they can be navigated to existing evidence-based smoking cessation interventions. Conversational agents or chatbots could provide cessation education and support to ambivalent smokers to build motivation and navigate them to evidence-based resources when ready to quit. OBJECTIVE The goal of our study is to test the proof-of-concept of the development and preliminary feasibility and acceptability of a smoking cessation support chatbot. METHODS We will accomplish our study aims in 2 phases. In phase 1, we will survey 300 ambivalent smokers to determine their preferences and priorities for a smoking cessation support chatbot. A "forced-choice experiment" will be administered to understand participants' preferred characteristics (attributes) of the proposed chatbot prototype. The data gathered will be used to program the prototype. In phase 2, we will invite 25 individuals who smoke to use the developed prototype. For this phase, participants will receive an overview of the chatbot and be encouraged to use the chatbot and engage and interact with the programmed attributes and components for a 2-week period. RESULTS At the end of phase 1, we anticipate identifying key attributes that ambivalent smokers prefer in a smoking cessation support chatbot. At the end of phase 2, chatbot acceptability and feasibility will be assessed. The study was funded in June 2022, and data collection for both phases of the study is currently ongoing. We expect study results to be published by December 2023. CONCLUSIONS Study results will yield a smoking behavior change chatbot prototype developed for ambivalent smokers that will be ready for efficacy testing in a larger study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44041.
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Affiliation(s)
- Uma S Nair
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Karah Greene
- School of Social Work, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
| | - Stephanie Marhefka
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Kristin Kosyluk
- Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
| | - Jerome T Galea
- School of Social Work, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
- Department of Global Health and Social Medicine, Harvard School of Medicine, Boston, MA, United States
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Gakkhar A, Mehendale A, Mehendale S. Tobacco Cessation Intervention for Young People. Cureus 2022; 14:e30308. [PMID: 36407239 PMCID: PMC9659423 DOI: 10.7759/cureus.30308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023] Open
Abstract
Most adolescent tobacco control programs focus on preventing consumption, but teen smoking persists. It is uncertain whether adult-specific therapies can assist adolescents in quitting smoking. The rising incidence of smoking in low and middle-socioeconomic countries and the challenges of conducting tobacco cessation programs in these settings (due to increasing population, poor lifestyle, lack of awareness and education, professional stress, and non-compliance) need an emphasis on the scope of trials to conduct tobacco cessation in these settings. In the 11th Five Year Plan, the Indian government introduced a new National Tobacco Control Program, which currently spans 108 districts in 31 states across the country. The objective is to review the randomized control trials of selected individuals held in India and assess and evaluate the effectiveness of the steps taken by the government to help people quit tobacco consumption. These programs are important because of the hazards and impact they have on the public health indices of the nation. The government has taken steps like prohibiting smoking in public areas and banning sources. Several programs, particularly those that employed group counselling, included a range of approaches that proved beneficial in helping young people quit smoking. The RCTs mentioned are psychosocially followed by behavioral and pharmacological therapies. The challenges faced are not having participatory health care, motivating tobacco users to quit even in the short-term, adequate coverage; barriers at a different level of implementation (at a regional, state, or national level); and interference by the tobacco industry should be eliminated. The currently functioning programs in India are the National Tobacco Control Program, the National and three Regional Quitlines and mCessation.
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Affiliation(s)
- Avni Gakkhar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashok Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shivansh Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Insititute of Medical Sciences, Wardha, IND
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Jiang N, Rogers ES, Cupertino P, Zhao X, Cartujano-Barrera F, Lyu JC, Hu L, Sherman SE. Development of a WeChat-based Mobile Messaging Smoking Cessation Intervention for Chinese Immigrant Smokers: Qualitative Interview Study. JMIR Form Res 2022; 6:e36091. [PMID: 35771603 PMCID: PMC9284363 DOI: 10.2196/36091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 12/01/2022] Open
Abstract
Background Smoking remains a major public health issue among Chinese immigrants. Smoking cessation programs that focus on this population are scarce and have a limited population-level impact due to their low reach. Mobile messaging interventions have the potential to reach large audiences and expand smokers’ access to smoking cessation treatment. Objective This study describes the development of a culturally and linguistically appropriate mobile messaging smoking cessation intervention for Chinese immigrant smokers delivered via WeChat, the most frequently used social media platform among Chinese people globally. Methods This study had 2 phases. In phase 1, we developed a mobile message library based on social cognitive theory and the US Clinical Practice Guidelines for Treating Tobacco Use and Dependence. We culturally adapted messages from 2 social cognitive theory-based text messaging smoking cessation programs (SmokefreeTXT and Decídetexto). We also developed new messages targeting smokers who were not ready to quit smoking and novel content addressing Chinese immigrant smokers’ barriers to quitting and common misconceptions related to willpower and nicotine replacement therapy. In phase 2, we conducted in-depth interviews with 20 Chinese immigrant smokers (including 7 women) in New York City between July and August 2021. The interviews explored the participants’ smoking and quitting experiences followed by assessment of the text messages. Participants reviewed 17 text messages (6 educational messages, 3 self-efficacy messages, and 8 skill messages) via WeChat and rated to what extent the messages enhanced their motivation to quit, promoted confidence in quitting, and increased awareness about quitting strategies. The interviews sought feedback on poorly rated messages, explored participant preferences for content, length, and format, discussed their concerns with WeChat cessation intervention, and solicited recommendations for frequency and timing of messages. Results Overall, participants reported that the messages enhanced their motivation to quit, offered encouragement, and made them more informed about how to quit. Participants particularly liked the messages about the harms of smoking and strategies for quitting. They reported barriers to applying some of the quitting strategies, including coping with stress and staying abstinent at work. Participants expressed strong interest in the WeChat mobile messaging cessation intervention and commented on its potential to expand their access to smoking cessation treatment. Conclusions Mobile messages are well accepted by Chinese immigrant smokers. Research is needed to assess the feasibility, acceptability, and efficacy of WeChat mobile messaging smoking cessation interventions for promoting abstinence among Chinese immigrant smokers.
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Affiliation(s)
- Nan Jiang
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Erin S Rogers
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Paula Cupertino
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Xiaoquan Zhao
- Department of Communication, College of Humanities and Social Sciences, George Mason University, Fairfax, VA, United States
| | | | - Joanne Chen Lyu
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, United States
| | - Lu Hu
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Scott E Sherman
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
- Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, NY, United States
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da Silva Teixeira R, Garcia de Siqueira Galil A, Cupertino AP, Cartujano-Barrera F, Basile Colugnati FA. Effectiveness of a smoking cessation decision-making electronic tool ( Pare de Fumar Conosco): A randomized clinical trial. Health Informatics J 2022; 28:14604582221105450. [DOI: 10.1177/14604582221105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an underutilization of smoking cessation treatment among patients with chronic conditions, which indicates a need for new strategies to engage them. Web-based smoking cessation decision-making tools can be beneficial. This study assessed the effectiveness of the Pare de Fumar Conosco software at increasing engagement to smoking cessation counseling groups among Brazilian smokers with chronic conditions. Clinical trial participants were randomized to Pare de Fumar Conosco or standard of care. Engagement in the smoking cessation counseling group was the primary outcome. Secondary outcomes included motivation level, cessation rate, completion, and treatment adherence. The t-tests and Chi-square analyzed baseline differences between groups and the Poisson models, the effects of the intervention. Engagement rates were higher in the Pare de Fumar Conosco (IR=2.22; 95% CI: 1.06 - 4.63) concerning the standard of care. Pare de Fumar Conosco group was more adherent to treatment over time (6.4% versus 4.2% in the final week). Cessation rate was 26.3% in standard care and 23.1% in Pare de Fumar Conosco. Both interventions maintained significant motivation levels to quit smoking. The Pare de Fumar Conosco intervention effectively increases the engagement in the smoking cessation counseling groups. There is a need to improve the smoking cessation rate.
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Affiliation(s)
| | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, USA
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Nahum-Shani I, Dziak JJ, Wetter DW. MCMTC: A Pragmatic Framework for Selecting an Experimental Design to Inform the Development of Digital Interventions. Front Digit Health 2022; 4:798025. [PMID: 35355685 PMCID: PMC8959436 DOI: 10.3389/fdgth.2022.798025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Advances in digital technologies have created unprecedented opportunities to deliver effective and scalable behavior change interventions. Many digital interventions include multiple components, namely several aspects of the intervention that can be differentiated for systematic investigation. Various types of experimental approaches have been developed in recent years to enable researchers to obtain the empirical evidence necessary for the development of effective multiple-component interventions. These include factorial designs, Sequential Multiple Assignment Randomized Trials (SMARTs), and Micro-Randomized Trials (MRTs). An important challenge facing researchers concerns selecting the right type of design to match their scientific questions. Here, we propose MCMTC – a pragmatic framework that can be used to guide investigators interested in developing digital interventions in deciding which experimental approach to select. This framework includes five questions that investigators are encouraged to answer in the process of selecting the most suitable design: (1) Multiple-component intervention: Is the goal to develop an intervention that includes multiple components; (2) Component selection: Are there open scientific questions about the selection of specific components for inclusion in the intervention; (3) More than a single component: Are there open scientific questions about the inclusion of more than a single component in the intervention; (4) Timing: Are there open scientific questions about the timing of component delivery, that is when to deliver specific components; and (5) Change: Are the components in question designed to address conditions that change relatively slowly (e.g., over months or weeks) or rapidly (e.g., every day, hours, minutes). Throughout we use examples of tobacco cessation digital interventions to illustrate the process of selecting a design by answering these questions. For simplicity we focus exclusively on four experimental approaches—standard two- or multi-arm randomized trials, classic factorial designs, SMARTs, and MRTs—acknowledging that the array of possible experimental approaches for developing digital interventions is not limited to these designs.
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Affiliation(s)
- Inbal Nahum-Shani
- Insitute for Social Research, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Inbal Nahum-Shani
| | - John J. Dziak
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, State College, PA, United States
| | - David W. Wetter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
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García Y, Ferrás C. Blended Therapies and Mobile Phones for Improving the Health of Female Victims of Gender Violence. Healthcare (Basel) 2022; 10:445. [PMID: 35326924 PMCID: PMC8955346 DOI: 10.3390/healthcare10030445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
We carried out a case study with a group of female victims of gender violence (n = 39) with the objective of evaluating a blended psychotherapeutic intervention. The results show that blended therapies with mobile text messages combined with face-to-face group therapies significantly improved the health of these women. Mood states and the symptoms of depression were measured with a PHQ-9 personal health questionnaire and evolved positively. In the group of women (n = 39) the scores improved from an initial 13.5 (SD = 7.2, range 3-34) to 6.0 at the end of the period of messages (SD = 5.2, range 0-18), which was a significant difference (t (39) = 2.02; p = 0.000). Most of the women stated that the messages had helped them improve their mood (91.6%) and their general health (83.3%), which made them feel more connected to their social environment (80.6%). We observed that adherence to medication for each woman improved. With mixed therapies and mobile phones, social service professionals can incorporate technology into daily practices and offer personalized attention and daily counseling to victims of gender-based violence.
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Affiliation(s)
- Yolanda García
- Faculty of Education and Social Work, University of Vigo, 32004 Ourense, Spain;
| | - Carlos Ferrás
- Mujeres Vulnerables Lab, Institute of Studies and Development of Galicia (IDEGA), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Jiang N, Nguyen N, Siman N, Cleland CM, Nguyen T, Doan HT, Abroms LC, Shelley DR. Adaptation and Assessment of a Text Messaging Smoking Cessation Intervention in Vietnam: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e27478. [PMID: 34623318 PMCID: PMC8538032 DOI: 10.2196/27478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/03/2021] [Accepted: 09/03/2021] [Indexed: 01/20/2023] Open
Abstract
Background Text message (ie, short message service, SMS) smoking cessation interventions have demonstrated efficacy in high-income countries but are less well studied in low- and middle-income countries, including Vietnam. Objective The goal of the research is to assess the feasibility, acceptability, and preliminary efficacy of a fully automated bidirectional SMS cessation intervention adapted for Vietnamese smokers. Methods The study was conducted in 3 phases. In phase 1, we adapted the SMS library from US-based SMS cessation programs (ie, SmokefreeTXT and Text2Quit). The adaptation process consisted of 7 focus groups with 58 smokers to provide data on culturally relevant patterns of tobacco use and assess message preferences. In phase 2, we conducted a single-arm pilot test of the SMS intervention with 40 smokers followed by in-depth interviews with 10 participants to inform additional changes to the SMS library. In phase 3, we conducted a 2-arm pilot randomized controlled trial (RCT) with 100 smokers. Participants received either the SMS program (intervention; n=50) or weekly text assessment on smoking status (control; n=50). The 6-week SMS program consisted of a 2-week prequit period and a 4-week postquit period. Participants received 2 to 4 automated messages per day. The main outcomes were engagement and acceptability which were assessed at 6 weeks (end of intervention). We assessed biochemically confirmed smoking abstinence at 6 weeks and 12 weeks. Postintervention in-depth interviews explored user experiences among a random sample of 16 participants in the intervention arm. Results Participants in both arms reported high levels of engagement and acceptability. Participants reported using the program for an average of 36.4 (SD 3.4) days for the intervention arm and 36.0 (SD 3.9) days for the control arm. Four of the 50 participants in the intervention arm (8%) reset the quit date and 19 (38%) texted the keyword TIPS. The majority of participants in both arms reported that they always or usually read the text messages. Compared to the control arm, a higher proportion of participants in the intervention arm reported being satisfied with the program (98% [49/50] vs 82% [41/50]). Biochemically verified abstinence was higher in the intervention arm at 6 weeks (20% [10/50] vs 2% [1/50]; P=.01), but the effect was not significant at 12 weeks (12% [6/50] vs 6% [3/50]; P=.49). In-depth interviews conducted after the RCT suggested additional modifications to enhance the program including tailoring the timing of messages, adding more opportunities to interact with the program, and placing a greater emphasis on messages that described the harms of smoking. Conclusions The study supported the feasibility and acceptability of an SMS program adapted for Vietnamese smokers. Future studies need to assess whether, with additional modifications, the program is associated with prolonged abstinence. Trial Registration ClinicalTrials.gov NCT03219541; https://clinicaltrials.gov/ct2/show/NCT03219541
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Affiliation(s)
- Nan Jiang
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Nam Nguyen
- Institute of Social and Medical Studies, Hanoi, Vietnam
| | - Nina Siman
- Ronald O Perelman Department of Emergency Medicine, Grossman School of Medicine, New York University, New York, NY, United States
| | - Charles M Cleland
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Trang Nguyen
- Institute of Social and Medical Studies, Hanoi, Vietnam
| | - Hue Thi Doan
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Lorien C Abroms
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Donna R Shelley
- School of Global Public Health, New York University, New York, NY, United States
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Cartujano-Barrera F, Rodríguez-Bolaños R, Arana-Chicas E, Allaham F, Sandoval L, Rubado M, Gallegos-Carrillo K, Colugnati FAB, Galil AG, Mejia RM, Cupertino AP. Smoking Cessation Mobile Interventions in Latin America: A Systematic Review. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:122-132. [PMID: 34263686 DOI: 10.1177/15404153211020410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review published articles reporting the use of smoking cessation mobile health (mHealth) interventions in Latin America. METHODS Five different databases were searched from database inception to 2020. Criteria: (1) the research was a smoking cessation randomized controlled trial (RCT), quasi-experimental research, or single-arm study; (2) the intervention used at least one type of mHealth intervention; (3) the research was conducted in Latin American; and (4) the research reported the cessation rate. RESULTS Of the seven selected studies, four were conducted in Brazil, two in Mexico, and one in Peru. Only one study was an adequately powered RCT. Interventions relied on text messages (n = 3), web-based tools (n = 2), and telephone calls (n = 3). Some studies (n = 4) provided pharmacotherapy support. Smoking cessation outcomes included self-reported (n = 5) and biochemically verified (n = 2) abstinence. Follow-ups were conducted at Month 6 (n = 2), Week 12 (n = 4), and Day 30 (n = 1). Cessation rates varied from 9.4% at Week 12 to 55.5% at Day 30. CONCLUSION Despite the promising cessation rates of mHealth interventions in Brazil, Mexico, and Peru, there is a need to rigorously evaluate these interventions in different Latin American countries with RCTs that are long-term, adequately powered, and use biochemical verification of cessation.
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Affiliation(s)
| | - Rosibel Rodríguez-Bolaños
- Departamento de Investigación sobre Tabaco, 37764Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Fatema Allaham
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Lizbeth Sandoval
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Rubado
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud Delegación Morelos, 37767Instituto Mexicano del Seguro Social. Cuernavaca, Morelos, Mexico
| | | | - Arise G Galil
- Faculdade de Medicina, Universidade Federal de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
| | - Raul M Mejia
- Programa de Medicina Interna General, 28196Universidad de Buenos Aires. Buenos Aires, Argentina
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
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16
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Rodríguez-Bolaños R, Caballero M, Ponciano-Rodríguez G, González-Robledo LM, Cartujano-Barrera F, Reynales-Shigematsu LM, Cupertino AP. Gender-related beliefs and attitudes about tobacco use and smoking cessation in Mexico. Health Psychol Behav Med 2021; 9:547-566. [PMID: 34178431 PMCID: PMC8204955 DOI: 10.1080/21642850.2021.1935963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND While overall trends in tobacco use among men are declining, tobacco use continues to rise significantly among women in developing countries. This study aimed to explore the gender-related beliefs and attitudes about tobacco use and smoking cessation in Mexico, one of the top five Latin America countries with the highest prevalence of tobacco consumption. MATERIALS AND METHODS This study was conducted using an explanatory qualitative methods design. Semi-structured interviews were conducted with 14 adults smokers (8 women & 6 men) who visited primary healthcare clinics in Mexico City. Two researchers independently coded the interviews and applied the final codes upon consensus. Inter-rater reliability was assessed for four groups of codewords (92% agreement), based on an ecological model on socio-cultural factors. FINDINGS Initiation to smoking in women begins out of curiosity, and in men by imitation. Also, women start using tobacco at an older age compared to men. During maintenance of smoking, women report experiencing loneliness and anxiety about multiple responsibilities, e.g. women reveal that they feel guilty when they smoke due to their maternal role as caregivers. Additionally, some women report that smoking is a symbol of freedom, recalling the media messages associated with promoting tobacco products. Among men, the results show that they smoke for pleasure and to socialize, and consider that women smoke to imitate men and feel powerful. Regarding cessation, women are ambivalent about quitting smoking or not, and men mention not needing professional support. For organizational barriers, women mention the cost of treatment and men, the distance to clinics. CONCLUSION Smoking cessation interventions should be proposed from an approach that involves changes in social norms, seeking a more equitable relationship between men and women. Therefore, there must be broad engagement from different sectors and not just at the health sector level.
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Affiliation(s)
| | - Marta Caballero
- Faculty of Higher Studies of Cuautla, Universidad Autónoma del Estado de Morelos, Morelos, México
| | - Guadalupe Ponciano-Rodríguez
- Public Health Department, Faculty of Medicine, National Autonomous University of Mexico, Ciudad de México, Mexico
| | | | | | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
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Cartujano-Barrera F, Lee D’Abundo M, Arana-Chicas E, Chock S, Valera P, Kamen CS, Cupertino AP. Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073437. [PMID: 33810269 PMCID: PMC8036939 DOI: 10.3390/ijerph18073437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
- Correspondence: ; Tel.: +1-585-353-0035
| | - Michelle Lee D’Abundo
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ 07110, USA;
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Surina Chock
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Charles S. Kamen
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
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Cartujano-Barrera F, Peña-Vargas CI, Arana-Chicas E, Pérez-Ramos JG, Mattei J, Hurtado-de-Mendoza A, Costas-Muñiz R, Jiménez J, Cupertino AP, Castro EM. Decídetexto: Feasibility and Acceptability of a Mobile Smoking Cessation Intervention in Puerto Rico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041379. [PMID: 33546156 PMCID: PMC7913140 DOI: 10.3390/ijerph18041379] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 12/04/2022]
Abstract
The purpose of this pilot study was to assess the feasibility and acceptability of a mobile smoking cessation intervention in Puerto Rico. This was a single-arm pilot study with 26 smokers in Puerto Rico who were enrolled in Decídetexto, a mobile smoking cessation intervention. Decídetexto incorporates three integrated components: (1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, (2) a 24-week text messaging counseling program with interactive capabilities, and (3) pharmacotherapy support. Outcome measures included self-reported 7-day point prevalence abstinence at Months 3 and 6, pharmacotherapy adherence, satisfaction with the intervention, and changes in self-efficacy. The average age of the participants was 46.8 years (SD 12.7), half of them (53.8%) were female. Most participants (92.3%) smoked daily and half of them (53.8%) used menthol cigarettes. All participants requested nicotine patches at baseline. However, only 13.0% of participants used the patch >75% of days. At Month 3, 10 participants (38.4%) self-reported 7-day point prevalence abstinence (88.5% follow-up rate). At Month 6, 16 participants (61.5%) self-reported 7-day point prevalence abstinence (76.9% follow-up rate). Most participants (90%, 18/20) reported being satisfied/extremely satisfied with the intervention at Month 6. Self-efficacy mean scores significantly increased from 40.4 (SD 12.1) at baseline to 57.9 (SD 11.3) at Month 3 (p < 0.01). The study suggests that Decídetexto holds promise for further testing among Puerto Rican smokers.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (J.G.P.-R.); (A.P.C.)
- Correspondence: ; Tel.: +1-585-353-0035
| | - Cristina I. Peña-Vargas
- Department of Psychiatry and Human Behavior, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.I.P.-V.); (J.J.); (E.M.C.)
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (J.G.P.-R.); (A.P.C.)
| | - José G. Pérez-Ramos
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (J.G.P.-R.); (A.P.C.)
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | | | - Rosario Costas-Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA;
| | - Julio Jiménez
- Department of Psychiatry and Human Behavior, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.I.P.-V.); (J.J.); (E.M.C.)
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (J.G.P.-R.); (A.P.C.)
| | - Eida M. Castro
- Department of Psychiatry and Human Behavior, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.I.P.-V.); (J.J.); (E.M.C.)
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19
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Krishnan N, Gu J, Abroms LC. Mobile phone-based messaging for tobacco cessation in low and middle-income countries: A systematic review. Addict Behav 2021; 113:106676. [PMID: 33038676 DOI: 10.1016/j.addbeh.2020.106676] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/21/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Mobile phone-based tobacco cessation (mCessation) interventions are effective in high-income countries but their effectiveness in low and middle-income countries (LMICs) is unclear. We aimed to assess the evidence-base for mCessation interventions in LMICs by synthesizing study characteristics and to describe intervention characteristics and content. METHODS Studies were included in this review if they evaluated an intervention that targeted tobacco users, were conducted in an LMIC, measured tobacco cessation as a primary or secondary outcome, and were primarily delivered using mobile phone (text or app-based) messaging. Data were extracted on fields pertaining to study and intervention characteristics and study quality was assessed using the Effective Public Health Practice Project tool. Screening, extraction and quality assessment were conducted by two independent reviewers. RESULTS Of 606 unique records, 12 articles were included. The majority of studies were methodologically weak. Methodological limitations included small sample sizes, short follow-up durations and use of self-reported outcomes. Most evaluations were conducted in upper middle-income countries with urban, adult smokers intending to quit smoking. Approximately half the interventions were bidirectional (enabled two-way messaging) and fully automated. Almost all interventions were delivered via SMS. Treatment offerings of the intervention and control groups varied widely. CONCLUSIONS More rigorous large-scale randomized controlled trials are needed to conclusively establish the efficacy of mCessation interventions in LMICs. Interventions also need to be tested across more diverse populations and settings. Future studies should test the relative effectiveness of different intervention characteristics.
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Affiliation(s)
- Nandita Krishnan
- The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, D.C., USA.
| | - Jiayan Gu
- The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, D.C., USA
| | - Lorien C Abroms
- The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, D.C., USA
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20
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Cartujano-Barrera F, Arana-Chicas E, Catley D, Cox LS, Diaz FJ, Ellerbeck EF, Graves KD, Ogedegbe C, Cupertino AP. Decídetexto: Mobile cessation support for Latino smokers. Study protocol for a randomized clinical trial. Contemp Clin Trials 2020; 99:106188. [PMID: 33080379 PMCID: PMC8315307 DOI: 10.1016/j.cct.2020.106188] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Latinos, the largest minority group in the U.S., experience tobacco-related disparities, including limited access to cessation resources. Evidence supports the efficacy of mobile interventions for smoking cessation, which may be greater among Latinos, the highest users of text messaging. OBJECTIVES To describe the methodology of a randomized clinical trial to evaluate the impact of Decídetexto, a culturally appropriate mobile smoking cessation intervention versus standard care on smoking abstinence (cotinine-verified 7-day point prevalence abstinence) at Month 6 among Latino smokers. METHODS Latino smokers (N = 618) will be randomized to one of two conditions: 1) Decídetexto or 2) standard of care. Decídetexto is a mobile smoking cessation intervention (available in English and Spanish) that incorporates three integrated components: 1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, 2) a 24-week text messaging counseling program with interactive capabilities, and 3) pharmacotherapy support. Decídetexto follows the Social Cognitive Theory as theoretical framework. Standard of care consists of printed smoking cessation materials along with referral to telephone quitline. Participants in both groups are given access to free pharmacotherapy (nicotine patches or gum) by calling study phone number. Promotores de Salud will rely on community-based approaches and clinical settings to recruit smokers into the study. All participants will complete follow-up assessments at Week 12 and Month 6. DISCUSSION If successful, Decídetexto will be ready to be implemented in different community- and clinic-based settings to reduce tobacco-related disparities.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America.
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, United States of America
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Francisco J Diaz
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Kristi D Graves
- Department of Oncology, Georgetown University, Washington, D.C., United States of America
| | - Chinwe Ogedegbe
- Emergency and Trauma Center, Hackensack University Medical Center, Hackensack, NJ, United States of America
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America
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21
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Jiang N, Zhang Y, Qian X, Thorpe L, Trinh-Shevrin C, Shelley D. Chinese immigrant smokers' access barriers to tobacco cessation services and experience using social media and text messaging. Tob Prev Cessat 2020; 6:52. [PMID: 33083680 PMCID: PMC7552855 DOI: 10.18332/tpc/125942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/18/2020] [Accepted: 08/02/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Smoking rates remain disproportionately high among Chinese immigrants in the US, particularly in males. Community-based smoking cessation services and quitlines have low engagement rates. Social media and text messaging programs can be effective in promoting quit rates and improving treatment engagement. This study examined Chinese immigrant smokers' barriers to accessing available smoking cessation services and patterns of using social media platforms and mobile phone text messaging. METHODS We conducted in-depth interviews (n=30) and a brief survey (n=49) with adult Chinese immigrant smokers leaving in New York City in 2018. Qualitative interviews explored smokers' challenges with smoking cessation, barriers to accessing and using smoking cessation services, and experience using social media and text messaging. The quantitative survey assessed smoking and quitting behaviors, and social media and text messaging use patterns. RESULTS Qualitative data revealed that participants faced various barriers to accessing cessation services, including the lack of awareness about services, skepticism about treatment effects, reliance on willpower for cessation, and time constraints. WeChat was mainly used to maintain social networking and acquire information. Participants rarely used text messaging or other social media platforms. Quantitative data showed that 55% of participants had no plan to quit smoking. Among those who reported past-year quit attempts (45%), 55% used cessation assistance. WeChat was the most frequently used platform with 94% users. CONCLUSIONS WeChat has potential to serve as an easily accessible platform for delivering smoking cessation treatment among Chinese immigrant populations. Research is warranted to explore the feasibility and efficacy of employing WeChat in smoking cessation treatment.
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Affiliation(s)
- Nan Jiang
- Department of Population Health, Grossman School of Medicine, New York University, New York, United States
| | - Yidan Zhang
- School of Global Public Health, New York University, New York, United States
| | - Xiaokun Qian
- Department of Population Health, Grossman School of Medicine, New York University, New York, United States
| | - Lorna Thorpe
- Department of Population Health, Grossman School of Medicine, New York University, New York, United States
| | - Chau Trinh-Shevrin
- Department of Population Health, Grossman School of Medicine, New York University, New York, United States
| | - Donna Shelley
- School of Global Public Health, New York University, New York, United States
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22
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The role of physiotherapists in smoking cessation. J Physiother 2020; 66:207-210. [PMID: 33036933 DOI: 10.1016/j.jphys.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
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Garrison KA, Pal P, O'Malley SS, Pittman BP, Gueorguieva R, Rojiani R, Scheinost D, Dallery J, Brewer JA. Craving to Quit: A Randomized Controlled Trial of Smartphone App-Based Mindfulness Training for Smoking Cessation. Nicotine Tob Res 2020; 22:324-331. [PMID: 29917096 DOI: 10.1093/ntr/nty126] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/15/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Mindfulness training may reduce smoking rates and lessen the association between craving and smoking. This trial tested the efficacy of mindfulness training via smartphone app to reduce smoking. Experience sampling (ES) was used to measure real-time craving, smoking, and mindfulness. METHODS A researcher-blind, parallel randomized controlled trial compared the efficacy of mobile mindfulness training with experience sampling (MMT-ES; Craving to Quit) versus experience sampling only (ES) to (1) increase 1-week point-prevalence abstinence rates at 6 months, and (2) lessen the association between craving and smoking. A modified intent-to-treat approach was used for treatment starters (MMT-ES n = 143; ES n = 182; 72% female, 81% white, age 41 ± 12 year). RESULTS No group difference was found in smoking abstinence at 6 months (overall, 11.1%; MMT-ES, 9.8%; ES, 12.1%; χ2(1) = 0.43, p = .51). From baseline to 6 months, both groups showed a reduction in cigarettes per day (p < .0001), craving strength (p < .0001) and frequency (p < .0001), and an increase in mindfulness (p < .05). Using ES data, a craving by group interaction was observed (F(1,3785) = 3.71, p = .05) driven by a stronger positive association between craving and cigarettes per day for ES (t = 4.96, p < .0001) versus MMT-ES (t = 2.03, p = .04). Within MMT-ES, the relationship between craving and cigarettes per day decreased as treatment completion increased (F(1,104) = 4.44, p = .04). CONCLUSIONS Although mindfulness training via smartphone app did not lead to reduced smoking rates compared with control, our findings provide preliminary evidence that mindfulness training via smartphone app may help lessen the association between craving and smoking, an effect that may be meaningful to support quitting in the longer term. IMPLICATIONS This is the first reported full-scale randomized controlled trial of any smartphone app for smoking cessation. Findings provide preliminary evidence that smartphone app-based MMT-ES may lessen the association between craving and smoking. TRIAL REGISTRATION Clinicaltrials.gov NCT02134509.
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Affiliation(s)
| | - Prasanta Pal
- Department of Medicine and Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | | | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.,Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Rahil Rojiani
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Jesse Dallery
- Department of Psychology, University of Florida, Gainesville, FL
| | - Judson A Brewer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.,Department of Medicine and Psychiatry, University of Massachusetts Medical School, Worcester, MA.,Center for Mindfulness, University of Massachusetts Medical School, Worcester, MA
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Kruse GR, Park ER, Chang Y, Haberer JE, Abroms LC, Shahid NN, Howard S, Haas JS, Rigotti NA. Proactively Offered Text Messages and Mailed Nicotine Replacement Therapy for Smokers in Primary Care Practices: A Pilot Randomized Trial. Nicotine Tob Res 2020; 22:1509-1514. [PMID: 32198520 PMCID: PMC7443591 DOI: 10.1093/ntr/ntaa050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/17/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Proactive, population health cessation programs can guide efforts to reach smokers outside of the clinic to encourage quit attempts and treatment use. AIMS AND METHODS This study aimed to measure trial feasibility and preliminary effects of a proactive intervention offering text messages (TM) and/or mailed nicotine replacement therapy (NRT) to smokers in primary care clinics. From 2017 to 2019 we performed a pilot randomized trial comparing brief telephone advice (control: BA), TM, 2 weeks of mailed NRT, or both interventions (TM + NRT). Patients were identified using electronic health records and contacted proactively by telephone to assess interest in the study. We compared quit attempts, treatment use, and cessation in the intervention arms with BA. RESULTS Of 986 patients contacted, 153 (16%) enrolled (mean age 53 years, 57% female, 76% white, 11% black, 8% Hispanic, 52% insured by Medicaid) and 144 (94%) completed the 12-week assessment. On average, patients in the TM arms received 159 messages (99.4% sent, 0.6% failed), sent 19 messages, and stayed in the program for 61 days. In all groups, a majority of patients reported quit attempts (BA 67% vs. TM 86% [p = .07], NRT 81% [p = .18], TM + NRT 79% [p = .21]) and NRT use (BA 51% vs. NRT 83% [p = .007], TM 65% [p = .25], TM + NRT 76% [p = .03]). Effect estimates for reported 7-day abstinence were BA 10% versus TM 26% (p = .09), NRT 28% (p = .06), and TM + NRT 23% (p = .14). CONCLUSIONS Proactively offering TM or mailed nicotine medications was feasible among primary care smokers and a promising approach to promote quit attempts and short-term abstinence. IMPLICATIONS Proactive intervention programs to promote quit attempts outside of office visits among smokers enrolled in primary care practices are needed. TM have potential to engage smokers not planning to quit or to support smokers to make a planned quit attempt. This pilot study demonstrates the feasibility of testing a proactive treatment model including TM and/or mailed NRT to promote quit attempts, treatment use, and cessation among nontreatment-seeking smokers in primary care. CLINICALTRIALS.GOV IDENTIFIER NCT03174158.
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Affiliation(s)
- Gina R Kruse
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Elyse R Park
- Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Yuchiao Chang
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Jessica E Haberer
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
- Center for Global Health, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Naysha N Shahid
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Sydney Howard
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Jennifer S Haas
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Nancy A Rigotti
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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Wibowo MF, Kumar AA, Sumarsono S, Rodrigues R. Perceived usefulness of receiving a potential smoking cessation intervention via mobile phones among smokers in Indonesia. Wellcome Open Res 2020; 4:94. [PMID: 33043144 PMCID: PMC7531048 DOI: 10.12688/wellcomeopenres.15135.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The use of technology to support healthcare in Indonesia holds new promise in light of decreasing costs of owning mobile devices and ease of access to internet. However, it is necessary to assess end-user perceptions regarding mobile health interventions prior to its implementation. This would throw light on the acceptability of mobile phone communication in bringing about behavioral changes among the target Indonesian population. The aim of this study was to explore the perceived usefulness of receiving a potential smoking cessation intervention via mobile phones. Methods: This is an exploratory cross-sectional study involving current and former adult tobacco smokers residing in Indonesia. Online advertisement and snowballing were used to recruit respondents. Data was collected using a web-based survey over a period of 4 weeks. Those willing to participate signed an online consent and were subsequently directed to the online questionnaire that obtained demographics, tobacco usage patterns, perceived usefulness of a mobile phone smoking cessation application and its design. Results: A total of 161 people who smoked tobacco responded to the online survey. The mean age of the participants was 29.4. Of the 123 respondents, 102 were men. Prior experience with using a mobile phone for health communication (OR 3.6, P=0.014) and those willing to quit smoking (OR 5.1, P=0.043) were likely to perceive a mobile phone smoking cessation intervention as useful. A smartphone application was preferred over text messages, media messages or interactive voice response technology. Content consisting of motivational messages highlighting the methods and benefits of quitting smoking were requested. Conclusion: People who smoke in Indonesia perceived receiving a potential smoking cessation intervention via mobile phones as useful. A multi-component, personalized smartphone application was the desired intervention technique. Such an intervention developed and implemented within a public health program could help address the tobacco epidemic in Indonesia.
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Affiliation(s)
- Mochammad Fadjar Wibowo
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anil A. Kumar
- St John’s National Academy of Health Sciences, Bangalore, India
| | - Surahyo Sumarsono
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rashmi Rodrigues
- St John’s National Academy of Health Sciences, Bangalore, India
- Karolinska Institutet, Stockholm, Sweden
- Wellcome Trust/DBT India Alliance, New Delhi, India
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Cartujano-Barrera F, Sanderson Cox L, Arana-Chicas E, Ramírez M, Perales-Puchalt J, Valera P, Díaz FJ, Catley D, Ellerbeck EF, Cupertino AP. Feasibility and Acceptability of a Culturally- and Linguistically-Adapted Smoking Cessation Text Messaging Intervention for Latino Smokers. Front Public Health 2020; 8:269. [PMID: 32714891 PMCID: PMC7344180 DOI: 10.3389/fpubh.2020.00269] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/26/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: Assess the feasibility and acceptability of a culturally- and linguistically-adapted smoking cessation text messaging intervention for Latino smokers. Methods: Using a community-based strategy, 50 Latino smokers were recruited to participate in a smoking cessation pilot study. Participants received a 12-week text messaging intervention and were offered Nicotine Replacement Therapy (NRT) at no cost. We assessed biochemically verified abstinence at 12 weeks, text messaging interactivity with the program, NRT utilization, self-efficacy, therapeutic alliance, and satisfaction. Results: Participants were 44.8 years old on average (SD 9.80), and they were primarily male (66%) and had no health insurance (78%). Most of the participants were born in Mexico (82%) and were light smokers (1–10 CPD) (68%). All participants requested the first order of NRT, and 66% requested a refill. Participants sent an average of 39.7 text messages during the 12-week intervention (SD 82.70). At 12 weeks, 30% of participants were biochemically verified abstinent (88% follow-up rate) and working alliance mean value was 79.2 (SD 9.04). Self-efficacy mean score increased from 33.98 (SD 10.36) at baseline to 40.05 (SD 17.65) at follow-up (p = 0.04). The majority of participants (90.9%, 40/44) reported being very or extremely satisfied with the program. Conclusion: A culturally- and linguistically-adapted smoking cessation text messaging intervention for Latinos offers a promising strategy to increase the use of NRT, generated high satisfaction and frequent interactivity, significantly increased self-efficacy, produced high therapeutic alliance, and resulted in noteworthy cessation rates at the end of treatment. Additional testing as a formal randomized clinical trial is warranted.
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Evelyn Arana-Chicas
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Mariana Ramírez
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jaime Perales-Puchalt
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ, United States
| | - Francisco J Díaz
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, United States
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
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Effectiveness of a Psychosocial Therapy with SMS in Immigrant Women with Different Degrees of Depression. SOCIAL SCIENCES-BASEL 2020. [DOI: 10.3390/socsci9050063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Immigrant women who are forced to adapt to a new cultural context often live in low income situations, have informal jobs, and experience social inclusion difficulties; these women frequently have mental health and social relationship problems. We conducted an experimental investigation with a group of vulnerable immigrant women who were receiving support from public social services. Our goal was to analyze the effectiveness of a bio-psychosocial therapy system with text messages to personal mobile phones. We grouped women by different degrees of depression. We studied psychosocial characteristics from personalized interviews and developed message banks to advise healthy habits and accompany moods. We programmed a remote delivery system, and for 26 days, each woman (n = 44) received four of our messages. We analyzed changes in mood and depression at the beginning and at the end of therapy and observed positive changes. The analysis of the initial and final (Personal Health Questionnaire) PHQ−9 quartile intervals shows that text messages significantly improve the mood and depression symptoms of immigrant women when the initial PHQ−9 value is greater than 5 (moderate depression).
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Robinson CD, Seaman EL, Grenen E, Montgomery L, Yockey RA, Coa K, Prutzman Y, Augustson E. A content analysis of smartphone apps for adolescent smoking cessation. Transl Behav Med 2020; 10:302-309. [PMID: 30476293 PMCID: PMC7295698 DOI: 10.1093/tbm/iby113] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Adolescent cigarette smokers have an increased risk of sustained smoking into adulthood. Smartphone applications (apps) for smoking cessation are a promising treatment resource. However, research on apps for adolescent smoking cessation is limited. This study compared smoking cessation mobile apps targeting an adolescent audience with popular cessation apps for a general audience. Adolescent and general-audience apps were identified by searching the Google Play and Apple App Stores (November 2016). Two coders assessed each app for adherence to clinical practice guidelines for tobacco and adolescent-specific content (2016-2017) and developed a summary score that summed all adherence and adolescent content criteria. Eight adolescent apps were identified and compared with the top 38 general apps (as ranked by Apple and Google). Both general and adolescent apps commonly had adherence content related to developing a quit plan (general: 73.68 per cent; adolescent: 87.50 per cent) and enhancing motivation by describing the rewards of not smoking (general: 76.32 per cent; adolescent: 62.50 per cent). Adolescent-specific content such as peer influence on smoking was common in adolescent apps but not in general apps (general: 5.26 per cent; adolescent: 62.50 per cent). Adolescent apps had a higher general adherence content summary score [t (44) = 2.55, p = .01] and a higher adolescent content summary score [t (7.81) = 2.47, p = .04] than the general apps. On average, adolescent cessation apps included more adherence content and adolescent-specific content than general apps. Future research is needed to determine the extent to which adolescents engage with the adherence content available in these apps.
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Affiliation(s)
- Cendrine D Robinson
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Elizabeth L Seaman
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | | | - LaTrice Montgomery
- Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - R Andrew Yockey
- Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kisha Coa
- ICF International, Rockville, MD, USA
| | - Yvonne Prutzman
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Erik Augustson
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Pechmann CA, Calder D, Phillips C, Delucchi K, Prochaska JJ. The Use of Web-Based Support Groups Versus Usual Quit-Smoking Care for Men and Women Aged 21-59 Years: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e16417. [PMID: 31934869 PMCID: PMC6996731 DOI: 10.2196/16417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/26/2019] [Accepted: 10/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background Existing smoking cessation treatments are challenged by low engagement and high relapse rates, suggesting the need for more innovative, accessible, and interactive treatment strategies. Twitter is a Web-based platform that allows people to communicate with each other throughout the day using their phone. Objective This study aims to leverage the social media platform of Twitter for fostering peer-to-peer support to decrease relapse with quitting smoking. Furthermore, the study will compare the effects of coed versus women-only groups on women’s success with quitting smoking. Methods The study design is a Web-based, three-arm randomized controlled trial with two treatment arms (a coed or women-only Twitter support group) and a control arm. Participants are recruited online and are randomized to one of the conditions. All participants will receive 8 weeks of combination nicotine replacement therapy (patches plus their choice of gum or lozenges), serial emails with links to Smokefree.gov quit guides, and instructions to record their quit date online (and to quit smoking on that date) on a date falling within a week of initiation of the study. Participants randomized to a treatment arm are placed in a fully automated Twitter support group (coed or women-only), paired with a buddy (matched on age, gender, location, and education), and encouraged to communicate with the group and buddy via daily tweeted discussion topics and daily automated feedback texts (a positive tweet if they tweet and an encouraging tweet if they miss tweeting). Recruited online from across the continental United States, the sample consists of 215 male and 745 female current cigarette smokers wanting to quit, aged between 21 and 59 years. Self-assessed follow-up surveys are completed online at 1, 3, and 6 months after the date they selected to quit smoking, with salivary cotinine validation at 3 and 6 months. The primary outcome is sustained biochemically confirmed abstinence at the 6-month follow-up. Results From November 2016 to September 2018, 960 participants in 36 groups were recruited for the randomized controlled trial, in addition to 20 participants in an initial pilot group. Data analysis will commence soon for the randomized controlled trial based on data from 896 of the 960 participants (93.3%), with 56 participants lost to follow-up and 8 dropouts. Conclusions This study combines the mobile platform of Twitter with a support group for quitting smoking. Findings will inform the efficacy of virtual peer-to-peer support groups for quitting smoking and potentially elucidate gender differences in quit rates found in prior research. Trial Registration ClinicalTrials.gov NCT02823028; https://clinicaltrials.gov/ct2/show/NCT02823028 International Registered Report Identifier (IRRID) DERR1-10.2196/16417
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Affiliation(s)
- Cornelia Ann Pechmann
- The Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Douglas Calder
- The Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Connor Phillips
- The Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Kevin Delucchi
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Stanford University, Stanford, CA, United States
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Cupertino AP, Cartujano-Barrera F, Basile Colugnati FA, Batista Formagini TD, Garcia de Siqueira Galil A, Ferreira Carvalho Banhato E, Ferreira MA, Richter KP. Web-based decision-making tool for smoking cessation (Pare de fumar conosco) among patients with chronic conditions in Brazil : one-arm feasibility study. BMJ Health Care Inform 2020; 27:e100063. [PMID: 31915181 PMCID: PMC7062353 DOI: 10.1136/bmjhci-2019-100063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/07/2019] [Accepted: 12/18/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To assess the feasibility of Pare de fumar conosco, a web-based smoking cessation decision-making tool, among patients with chronic conditions in Brazil. METHODS We recruited 85 Brazilian smokers in two clinical centres for chronic conditions to complete Pare de fumar conosco. Outcome measures included interest in using smoking cessation resources and self-reported 7-day point prevalence abstinence 12 weeks following the intervention. RESULTS The average age of participants was 54.2 years old (SD=10.5) and 77.9% had not completed high school. All participants were daily smokers and the majority smoked ≥11 cigarettes per day (63.5%). Pre-post intervention interest in using pharmacotherapy and group counselling significantly increased (82.4% vs 22.4%, p≤0.0001; and 85.9% vs 21.2%, p≤0.0001, respectively). At 12 weeks, eight participants (9.4%) reported 7-day point prevalence abstinence using intention-to-treat analysis (35.2% follow-up rate). CONCLUSION The Pare de fumar conosco smoking cessation web-based tool significantly increased interest in pharmacotherapy and behavioural counselling. Additional testing as a formal randomised clinical trial appears warranted.
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Affiliation(s)
- Ana Paula Cupertino
- Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | | | | | | | | | | | | | - Kimber P Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Abstract
Rates of certain tobacco products have decreased over the past decade, but nicotine use disorder is still prevalent among adolescents. New trends in tobacco use, such as in the use of electronic cigarettes, are creating alarm. This article reviews nicotine addiction and measurement in adolescents, along with potential health risks and comorbidities. Various psychosocial and pharmacologic interventions are reviewed along with novel interventions that show promise for reducing tobacco use in this vulnerable population.
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A randomized controlled trial to test the effectiveness of a peer-based social mobile game intervention to reduce smoking in youth. Dev Psychopathol 2019; 31:1923-1943. [PMID: 31607279 DOI: 10.1017/s0954579419001378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Smoking is a major cause of worldwide morbidity and mortality. Almost no evidence-based intervention programs are available to help youth quit smoking. We argue that ineffective targeting of peer influence and engagement difficulties are significant barriers to successful youth smoking cessation. To address these barriers, we developed the mobile game intervention HitnRun. A two-armed randomized controlled trial (RCT; n = 144) was conducted and young smokers (Mage = 19.39; SDage = 2.52) were randomly assigned to either play HitnRun or read a psychoeducational brochure. Prior to, directly following the intervention period, and after three-month follow-up, weekly smoking behavior, abstinence rates, intervention dose, and peer- and engagement-related factors were assessed. Results indicated similar reductions in weekly smoking levels and similar abstinence rates for both groups. Yet, we found a dose effect with HitnRun only: The longer participants played HitnRun, the lower their weekly smoking levels were. In the brochure group, a higher dose was related to higher weekly smoking levels at all measurement moments. Exploratory analyses showed the most powerful effects of HitnRun for participants who connected with and were engaged by the intervention. Future work should build on the promising potential of HitnRun by increasing personalization efforts and strengthening peer influence components.
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Nolan MB, Warner MA, Jacobs MA, Amato MS, Graham AL, Warner DO. Feasibility of a Perioperative Text Messaging Smoking Cessation Program for Surgical Patients. Anesth Analg 2019; 129:e73-e76. [PMID: 31425205 DOI: 10.1213/ane.0000000000003715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although surgical patients who smoke could benefit from perioperative abstinence, few currently receive support. This pilot study determined the feasibility and acceptability of a perioperative text messaging smoking cessation program. One hundred patients (73% of eligible patients approached) enrolled in a surgery-specific messaging service, receiving 1-3 daily messages about smoking and surgical recovery for 30 days. Only 17 patients unenrolled, the majority responded to prompting messages, and satisfaction with the program was high. Surgical patients are amenable to text message-based interventions; a future efficacy trial of text messaging smoking cessation support in surgical patients is warranted.
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Affiliation(s)
- Margaret B Nolan
- From the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Matthew A Warner
- From the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Megan A Jacobs
- Department of Innovations, Truth Initiative, Washington, DC
| | | | - Amanda L Graham
- Department of Innovations, Truth Initiative, Washington, DC
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC
| | - David O Warner
- From the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
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García Y, Ferrás C, Rocha Á, Aguilera A. Exploratory Study of Psychosocial Therapies with Text Messages to Mobile Phones in Groups of Vulnerable Immigrant Women. J Med Syst 2019; 43:277. [PMID: 31280404 DOI: 10.1007/s10916-019-1393-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022]
Abstract
Various experimental studies on psychosocial therapy have been carried out through text messages with groups of people suffering from depression, anxiety, alcoholism, addictions, etc., but without distinguishing between men and women or highly vulnerable groups such as immigrants. We present an exploratory study of a mobile communication system which intends to improve the mental, physical and social health of a group of vulnerable immigrant women in Spain (n = 71), distinguishing between an intervention group and a non-equivalent control group. We sent automatic text messages (SMS) to the mobile phones of an intervention group formed by immigrant women who used the social services (n = 44). During a 26-day intervention period, the women received 4 daily automatic text messages on their phones, at a predetermined time. We measured mood and depression symptoms at the beginning and end of the intervention, and analysed the qualitative data to determine the acceptance level of a remote message program. The mood and depression symptoms were measured with the personal health questionnaire-9 (PHQ-9) and were significantly better in the intervention group; they evolved from an initial 9.4 (DS = 6.4, range 1-25) to a 5.0 score at the end of the message period (DS = 4.8); with a significant difference (t (44) = 2.01, p = 7.80). Most women stated that the messages had improved their mood (86.3%), which made them feel more connected to their social environment (65.9%) and that they would like to continue receiving more messages (86.6%).
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Affiliation(s)
- Yolanda García
- Department of Communications Sciences, University of Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain.
| | - Carlos Ferrás
- Department of Geography, University of Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain
| | - Álvaro Rocha
- Department of Informatics Engineering, University of Coimbra, Coimbra, Portugal
| | - Adrián Aguilera
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA
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Wibowo MF, Kumar AA, Sumarsono S, Rodrigues R. Perceived usefulness of receiving a potential smoking cessation intervention via mobile phones among smokers in Indonesia. Wellcome Open Res 2019; 4:94. [PMID: 33043144 PMCID: PMC7531048 DOI: 10.12688/wellcomeopenres.15135.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2019] [Indexed: 09/27/2023] Open
Abstract
Background: The use of technology to support healthcare in Indonesia holds new promise in light of decreasing costs of owning mobile devices and ease of access to internet. However, it is necessary to assess end-user perceptions regarding mobile health interventions prior to its implementation. This would throw light on the acceptability of mobile phone communication in bringing about behavioural changes among the target Indonesian population. The aim of this study was to explore the perceived usefulness of receiving a potential smoking cessation intervention via mobile phones. Methods: This is an exploratory cross-sectional study involving current and former adult tobacco smokers residing in Indonesia. Online advertisement and snowballing were used to recruit respondents. Data was collected using a web-based survey over a period of 4 weeks. Those willing to participate signed an online consent and were subsequently directed to the online questionnaire that obtained demographics, tobacco usage patterns, perceived usefulness of a mobile phone smoking cessation application and its design. Results: A total of 161 people who smoked tobacco responded to the online survey. The mean age of the participants was 29.4. Of the 123 respondents, 102 were men. Prior experience with using a mobile phone for health communication (OR 3.6, P=0.014) and those willing to quit smoking (OR 5.1, P=0.043) were likely to perceive a mobile phone smoking cessation intervention as useful. A smartphone application was preferred over text messages, media messages or interactive voice response technology. Content comprising of motivational messages highlighting the methods and benefits of quitting smoking were requested. Conclusion: People who smoke in Indonesia perceived receiving a potential smoking cessation intervention via mobile phones as useful. A multi-component, personalized smartphone application was the desired intervention technique. Such an intervention developed and implemented within a public health program could help address the tobacco epidemic in Indonesia.
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Affiliation(s)
- Mochammad Fadjar Wibowo
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anil A. Kumar
- St John’s National Academy of Health Sciences, Bangalore, India
| | - Surahyo Sumarsono
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rashmi Rodrigues
- St John’s National Academy of Health Sciences, Bangalore, India
- Karolinska Institutet, Stockholm, Sweden
- Wellcome Trust/DBT India Alliance, New Delhi, India
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Ngan TT, Do VV, Huang J, Redmon PB, Minh HV. Willingness to use and pay for smoking cessation service via text-messaging among Vietnamese adult smokers, 2017. J Subst Abuse Treat 2019; 104:1-6. [PMID: 31370973 DOI: 10.1016/j.jsat.2019.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To examine willingness to use (WTU) and willingness to pay (WTP) for smoking cessation service via text-messaging among adult smokers in Vietnam in 2017; and to identify demographic and socioeconomic factors associated with the WTU and WTP. METHODS A cross-sectional study of 602 adult smokers who had intention to quit in the next 12 months was conducted in Vietnam in 2017. Participants were provided with the information about a mobile health (mHealth) smoking cessation service via text-messaging and asked about their willingness to use and pay for it. The contigent valuation method was used to estimate the WTP for the service, using single bound question format. Discrete choice model was applied to estimate the average WTP and its associated factors. RESULTS Seventy-two percent of smokers expressed willingness to use smoking cessation service via text-messaging if it were available. The average willingness to pay among those interested in using the mHealth cessation service was 82,000 VND (US$3.5). Smoking status and quit attempts in the last twelve months were associated with WTU, whereas age of the smokers and monthly income were significant predictors of WTP. CONCLUSION A high proportion of Vietnamese smokers with intention to quit were interested in using smoking cessation services via text-messaging. The high level of smokers' willingness to use and pay for the text messaging cessation program indicates the mHealth methods could be a potential option for developing and delivering smoking cessation services in Vietnam.
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Affiliation(s)
- Tran Thu Ngan
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Vuong Van Do
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA, USA.
| | | | - Hoang Van Minh
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
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Cupertino AP, Cartujano-Barrera F, Ramírez M, Rodríguez-Bolaños R, Thrasher JF, Pérez-Rubio G, Falfán-Valencia R, Ellerbeck EF, Reynales-Shigematsu LM. A Mobile Smoking Cessation Intervention for Mexico (Vive sin Tabaco... ¡Decídete!): Single-Arm Pilot Study. JMIR Mhealth Uhealth 2019; 7:e12482. [PMID: 31021326 PMCID: PMC6658244 DOI: 10.2196/12482] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 01/26/2023] Open
Abstract
Background Of the 14.3 million Mexicans who smoke, only a minority take advantage of evidence-based approaches to smoking cessation. Mobile health interventions have the potential to increase the reach of effective cessation interventions in Mexico. Objective This study aimed to assess the feasibility and acceptability of an innovative, personalized, and interactive smoking cessation mobile intervention developed for Mexican smokers. Methods We recruited 40 Mexican smokers to participate in Vive sin Tabaco... ¡Decídete!, a smoking cessation program that uses a tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. Outcome measures included participant text messaging interactivity with the program, participant satisfaction, and 12-week verified abstinence using urinary cotinine testing or exhaled carbon monoxide. Results Average age of the participants was 36 years (SD 10.7), and they were primarily male (65%, 26/40) with at least an undergraduate degree (62%, 25/40). Most participants (95%, 38/40) smoked daily and were interested in quitting in the next 7 days. As an indicator of participant interactivity, participants sent an average of 21 text messages during the 12-week intervention (SD 17.62). Of the 843 messages that participants sent to the program, only 96 messages (11.3%, 96/843) used keywords. At 12 weeks, 40% (16/40) of participants were biochemically verified (87%, 35/40, follow-up rate). The majority of participants (85%, 30/35) reported being very satisfied or extremely satisfied with the program. Conclusions The Vive sin Tabaco... ¡Decídete! smoking cessation mobile intervention was accepted by participants, generated high satisfaction and high text messaging interactivity, and resulted in a noteworthy cessation rate at the end of treatment. This intervention is a promising strategy for smoking cessation in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
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Affiliation(s)
- Ana Paula Cupertino
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Mariana Ramírez
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States
| | - Gloria Pérez-Rubio
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Laboratorio HLA, Mexico City, Mexico
| | - Ramcés Falfán-Valencia
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Laboratorio HLA, Mexico City, Mexico
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
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Kruse GR, Park E, Haberer JE, Abroms L, Shahid NN, Howard SE, Chang Y, Haas JS, Rigotti NA. Proactive text messaging (GetReady2Quit) and nicotine replacement therapy to promote smoking cessation among smokers in primary care: A pilot randomized trial protocol. Contemp Clin Trials 2019; 80:48-54. [PMID: 30923022 DOI: 10.1016/j.cct.2019.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Most smokers see a physician each year, but few use any assistance when they try to quit. Text messaging programs improve smoking cessation in community and school settings; however, their efficacy in a primary care setting is unclear. The current trial assesses the feasibility and preliminary clinical outcomes of text messaging and mailed nicotine replacement therapy (NRT) among smokers in primary care. METHODS In this single-center pilot randomized trial, eligible smokers in primary care are offered brief advice by phone and randomly assigned to one of four interventions: (1) Brief advice only, (2) text messages targeted to primary care patients and tailored to quit readiness, (3) a 2-week supply of nicotine patches and/or lozenges (NRT), and (4) both text messaging and NRT. Randomization is stratified by practice and intention to quit. The text messages (up to 5/day) encourage those not ready to quit to practice a quit attempt, assist those with a quit date through a quit attempt, and promote NRT use. The 2-week supply of NRT is mailed to patients' homes. RESULTS Feasibility outcomes include recruitment rates, study retention, and treatment adherence. Clinical outcomes are assessed at 1, 2, 6, and 12-weeks post-enrollment. The primary outcome is ≥1self-reported quit attempt(s). Secondary clinical outcomes include self-reported past 7- and 30-day abstinence, days not smoked, NRT adherence, and exhaled carbon monoxide. CONCLUSIONS This pilot assesses text messaging plus NRT, as a proactively offered intervention for smoking cessation support in smokers receiving primary care and will inform full-scale randomized trial planning. TRIAL REGISTRATION ClinicalTrials.govNCT03174158.
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Affiliation(s)
- G R Kruse
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - E Park
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - J E Haberer
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - L Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - N N Shahid
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - S E Howard
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Y Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - J S Haas
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - N A Rigotti
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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Cartujano-Barrera F, Arana-Chicas E, Ramírez-Mantilla M, Perales J, Cox LS, Ellerbeck EF, Catley D, Cupertino AP. "Every day I think about your messages": assessing text messaging engagement among Latino smokers in a mobile cessation program. Patient Prefer Adherence 2019; 13:1213-1219. [PMID: 31413549 PMCID: PMC6659777 DOI: 10.2147/ppa.s209547] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/08/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers. METHODS We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction. RESULTS Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), did not have health insurance (75%), and reported low nicotine-dependence (60%). The majority of participants (75%) sent at least one text message to the program. On average, participants who interacted with the program sent 31.8 (SD=39.7) text messages. Eight themes were identified in participants' messages (eg, well-being, self-efficacy, strategies to quit, extra-treatment social support, etc). At 12 weeks, 30% of the participants were biochemically verified as abstinent. CONCLUSION A smoking cessation text message intervention generated high engagement among Latinos and resulted in noteworthy cessation rates. Future studies should assess the relationship of text messaging interactions with psychological effects (eg, intra-treatment social support, therapeutic alliance, and perceived autonomy support).
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, USA
- Correspondence: Francisco Cartujano-BarreraDepartment of Cancer Prevention and Control, Hackensack University Medical Center, 107 1st Street, Building B, Hackensack, NJ07601, USATel +1 551 996 4242Email
| | - Evelyn Arana-Chicas
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Mariana Ramírez-Mantilla
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jaime Perales
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Delwyn Catley
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
| | - Ana Paula Cupertino
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, USA
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Liao Y, Wu Q, Kelly BC, Zhang F, Tang YY, Wang Q, Ren H, Hao Y, Yang M, Cohen J, Tang J. Effectiveness of a text-messaging-based smoking cessation intervention ("Happy Quit") for smoking cessation in China: A randomized controlled trial. PLoS Med 2018; 15:e1002713. [PMID: 30562352 PMCID: PMC6298640 DOI: 10.1371/journal.pmed.1002713] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/06/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND China has the highest global prevalence of cigarette smokers, accounting for more than 40% of the total cigarette consumption in the world. Considering the shortage of smoking cessation services in China, and the acceptability, feasibility, and efficacy of mobile-phone-based text messaging interventions for quitting smoking in other countries, we conducted a mobile-phone-based smoking cessation study in China. METHODS AND FINDINGS We conducted a randomized controlled trial in China across 30 cities and provinces from August 17, 2016, to May 27, 2017. Adult smokers aged 18 years and older with the intention to quit smoking were recruited and randomized to a 12-week high-frequency messaging (HFM) or low-frequency messaging (LFM) intervention ("Happy Quit") or to a control group in a 5:2:3 ratio. The control group received only text messages unrelated to quitting. The primary outcome was biochemically verified continuous smoking abstinence at 24 weeks. Secondary outcomes included (1) self-reported 7-day point prevalence of abstinence (i.e., not even a puff of smoke, for the last 7 days) at 1, 4, 8, 12, 16, 20, and 24 weeks; (2) self-reported continuous abstinence at 4, 12, and 24 weeks; and (3) self-reported average number of cigarettes smoked per day. A total of 1,369 participants received 12 weeks of intervention or control text messages with continued follow-up for 12 weeks. The baseline characteristics of participants among the HFM (n = 674), LFM (n = 284), and control (n = 411) groups were similar. The study sample included 1,295 (94.6%) men; participants had a mean age of 38.1 (SD 9.79) years and smoked an average of 20.1 (SD 9.19) cigarettes per day. We included the participants in an intention-to-treat analysis. Biochemically verified continuous smoking abstinence at 24 weeks occurred in 44/674 participants in the HFM group (6.5%), 17/284 participants in the LFM group (6.0%), and 8/411 participants (1.9%) in the control group; participants in both the HFM (odds ratio [OR] = 3.51, 95% CI 1.64-7.55, p < 0.001) and the LFM (OR = 3.21, 95% CI 1.36-7.54], p = 0.002) intervention groups were more likely to quit smoking than those in the control group. However, there was no difference in quit rate between the HFM and LFM interventions. We also found that the 7-day point quit rate from week 1 to week 24 ranged from approximately 10% to more than 26% with the intervention and from less than 4% to nearly 12% without the intervention. Those who continued as smokers in the HFM group smoked 1 to 3 fewer cigarettes per day than those in the LFM group over the 24 weeks of trial. Among study limitations, the participants were able to use other smoking cessation services (although very few participants reported using them), cotinine tests can only detect smoking status for a few days, and the proportion of quitters was small. CONCLUSIONS Our findings demonstrate that a mobile-phone-based text messaging intervention (Happy Quit), with either high- or low-frequency messaging, led to smoking cessation in the present study, albeit in a low proportion of smokers, and can therefore be considered for use in large-scale intervention efforts in China. Mobile-phone-based interventions could be paired with other smoking cessation services for treatment-seeking smokers in China. TRIAL REGISTRATION ClinicalTrials.gov NCT02693626.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center on Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Brian C. Kelly
- Department of Sociology, Purdue University, West Lafayette, Indiana, United States of America
- Center for Research on Young People’s Health, Purdue University, West Lafayette, Indiana, United States of America
| | - Fengyu Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Global Clinical and Translational Research Institute, Bethesda, Maryland, United States of America
| | - Yi-Yuan Tang
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, United States of America
- Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Honghong Ren
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mei Yang
- Department of Drug Dependence, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Joanna Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Jinsong Tang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center on Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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Do HP, Tran BX, Le Pham Q, Nguyen LH, Tran TT, Latkin CA, Dunne MP, Baker PR. Which eHealth interventions are most effective for smoking cessation? A systematic review. Patient Prefer Adherence 2018; 12:2065-2084. [PMID: 30349201 PMCID: PMC6188156 DOI: 10.2147/ppa.s169397] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To synthesize evidence of the effects and potential effect modifiers of different electronic health (eHealth) interventions to help people quit smoking. METHODS Four databases (MEDLINE, PsycINFO, Embase, and The Cochrane Library) were searched in March 2017 using terms that included "smoking cessation", "eHealth/mHealth" and "electronic technology" to find relevant studies. Meta-analysis and meta-regression analyses were performed using Mantel-Haenszel test for fixed-effect risk ratio (RR) and restricted maximum-likelihood technique, respectively. Protocol Registration Number: CRD42017072560. RESULTS The review included 108 studies and 110,372 participants. Compared to nonactive control groups (eg, usual care), smoking cessation interventions using web-based and mobile health (mHealth) platform resulted in significantly greater smoking abstinence, RR 2.03 (95% CI 1.7-2.03), and RR 1.71 (95% CI 1.35-2.16), respectively. Similarly, smoking cessation trials using tailored text messages (RR 1.80, 95% CI 1.54-2.10) and web-based information and conjunctive nicotine replacement therapy (RR 1.29, 95% CI 1.17-1.43) may also increase cessation. In contrast, little or no benefit for smoking abstinence was found for computer-assisted interventions (RR 1.31, 95% CI 1.11-1.53). The magnitude of effect sizes from mHealth smoking cessation interventions was likely to be greater if the trial was conducted in the USA or Europe and when the intervention included individually tailored text messages. In contrast, high frequency of texts (daily) was less effective than weekly texts. CONCLUSIONS There was consistent evidence that web-based and mHealth smoking cessation interventions may increase abstinence moderately. Methodologic quality of trials and the intervention characteristics (tailored vs untailored) are critical effect modifiers among eHealth smoking cessation interventions, especially for web-based and text messaging trials. Future smoking cessation intervention should take advantages of web-based and mHealth engagement to improve prolonged abstinence.
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Affiliation(s)
- Huyen Phuc Do
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Bach Xuan Tran
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quyen Le Pham
- Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Carl A Latkin
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Philip Ra Baker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
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García Y, Ferrás C, Rocha Á, Aguilera A. Design and acceptability of a psychosocial text messaging intervention for victims of gender-based violence. Health Informatics J 2018; 25:1588-1594. [PMID: 30113247 DOI: 10.1177/1460458218792688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mobile phones can produce detailed and personalized data to help diagnose, treat, prevent or rehabilitate women who are victims of gender violence. We sent automatic text messages, based on cognitive-behavioural therapy, to female victims of gender violence to assess the feasibility of the medium for mental health intervention. During the 28-day intervention period, each woman received four automatic text messages every day on a pre-established schedule. We evaluated symptoms of depression using the Personal Health Questionnaire-9. The Personal Health Questionnaire-9 decreased from an average of 14.8 at the beginning of the intervention, to 6.1 at the end of the text messaging period. All of the women reported that they liked receiving the messages, they found them useful and they felt that the messages had improved their health. Text messages are acceptable to women users who are recipients of public health and social services. Future research should focus more on the evaluation of the results and on how the specific content and aspects of text messaging improve health outcomes.
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Gopinathan P, Kaur J, Joshi S, Prasad VM, Pujari S, Panda P, Murthy P. Self-reported quit rates and quit attempts among subscribers of a mobile text messaging-based tobacco cessation programme in India. ACTA ACUST UNITED AC 2018. [DOI: 10.1136/bmjinnov-2018-000285] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IntroductionIn 2015, as part of the WHO and International Telecommunication Union’s ‘Be Healthy Be Mobile’ initiative using mobile technology to combat non-communicable diseases, the Ministry of Health and Family Welfare and the Ministry of Communication and Information Technology in India developed a short text message-based mobile health programme (the ‘mCessation’ programme) to support tobacco users to quit tobacco use.ObjectivesTo evaluate the effectiveness of the mCessation programme by estimating quit rates and quit attempts among registered subscribers of the programme and to understand subscriber perceptions of the programme.MethodsSubscribers to the mCessation (QuitNow) programme were telephonically interviewed 4–6 months after registration. A total of 12 502 calls were made, and completed responses recorded from 3362 ever tobacco users. A total of 6978 respondents either gave very few responses or refused to participate in the telephonic survey. Never tobacco users (1935) and subscribers to the mDiabetes programme (227) were excluded from the sample.ResultsA large proportion of registrants (1935 out of 12 502 respondents) were found to be never users. The quit rate (estimated as those who stated they had not had any tobacco in the past 30 days at 4–6 months after registering with the programme from the total sample (excluding never smokers and mDiabetes registrants)) was 19%. Sixty-six per cent of registered subscribers who were current tobacco users had made quit attempts in the period between registration and survey. Seventy-seven per cent of respondents reported that the programme was helpful/very helpful to quit tobacco.ConclusionThe mCessation programme has successfully helped tobacco users in India to quit tobacco by motivating and supporting registered participants through mobile text messages.
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Khalil GE, Calabro KS, Crook B, Machado TC, Perry CL, Prokhorov AV. Validation of mobile phone text messages for nicotine and tobacco risk communication among college students: A content analysis. Tob Prev Cessat 2018; 4. [PMID: 29888338 PMCID: PMC5989570 DOI: 10.18332/tpc/84866] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In the United States, young adults have the highest prevalence of tobacco use. The dissemination of mobile phone text messages is a growing strategy for tobacco risk communication among young adults. However, little has been done concerning the design and validation of such text messages. The Texas Tobacco Center of Regulatory Science (Texas-TCORS) has developed a library of messages based on framing (gain- or loss-framed), depth (simple or complex) and appeal (emotional or rational). This study validated the library based on depth and appeal, identified text messages that may need improvement, and explored new themes. METHODS The library formed the study sample (N=976 messages). The Linguistic Inquiry and Word Count (LIWC) software of 2015 was used to code for word count, word length and frequency of emotional and cognitive words. Analyses of variance, logistic regression and scatter plots were conducted for validation. RESULTS In all, 874 messages agreed with LIWC-coding. Several messages did not agree with LIWC. Ten messages designed to be complex indicated simplicity, while 51 messages designed to be rational exhibited no cognitive words. New relevant themes were identified, such as health (e.g. ‘diagnosis’, ‘cancer’), death (e.g. ‘dead’, ‘lethal’) and social connotations (e.g. ‘parents’, ‘friends’). CONCLUSIONS Nicotine and tobacco researchers can safely use, for young adults, messages from the Texas-TCORS library to convey information in the intended style. Future work may expand upon the new themes. Findings will be utilized to develop new campaigns, so that risks of nicotine and tobacco products can be widely disseminated.
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Affiliation(s)
- Georges E Khalil
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Karen S Calabro
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Brittani Crook
- The University of Texas Health Science Center, School of Public Health, Texas, United States
| | - Tamara C Machado
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Cheryl L Perry
- The University of Texas Health Science Center, School of Public Health, Texas, United States
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Wang X, Luo R, Liu C, Zhang L, Yue A, Medina A, Rozelle S. Using daily text messages to improve adherence to infant micronutrient powder (MNP) packets in rural western China: A cluster-randomized controlled trial. PLoS One 2018; 13:e0191549. [PMID: 29352304 PMCID: PMC5774801 DOI: 10.1371/journal.pone.0191549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 01/04/2018] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the effectiveness of daily text messages as a means to improve caregivers’ adherence to infant micronutrient powder (MNP) in rural Shaanxi Province of China. Methodology 638 infants aged 6–11 months in 234 villages were involved in a cluster-randomized controlled trial (RCT). All caregivers were given free infant MNP packets at baseline in April 2013 and the follow-up survey was in July 2013. We randomly assigned 318 infants in 117 villages to treatment group (receiving daily text message) and 320 infants in the other 117 villages as control group. Results On average, daily text messages increased the number of MNP packets fed (marginal effect = 4.63; 95% confidence interval (CI) = 0.16, 9.10). The text message is more likely to increase the consumption of MNP packets if the primary caregiver was the mother (marginal effect = 12.19; 95% CI = 0.69, 23.68). Receiving the text message appears to significantly increase the likelihood of full adherence when the primary caregiver can either check (odds ratio = 2.93; 95% CI = 1.34, 6.40) or knows how to send (odds ratio = 3.26; 95% CI = 1.53, 6.97) text messages. Conclusion Daily text messages improved the consumption of infant MNP packets. However, the impact was not large enough to increase the probability of caregivers being fully adherent to the feeding instruction, which is to feed 5–7 packets per week as recommended. In addition, when the mother is the caregiver and when the caregiver can check or knows how to send text messages there is greater adherence by the primary caregivers. Trial registration http://www.isrctn.com/ISRCTN44149146
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Affiliation(s)
- Xu Wang
- Education Global Practices (East and South Africa), the World Bank Group, NW, Washington DC, United States of America
| | - Renfu Luo
- China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Haidian District, Beijing, China
- * E-mail:
| | - Chengfang Liu
- China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Haidian District, Beijing, China
| | - Linxiu Zhang
- Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Chaoyang District, Beijing, China
| | - Ai Yue
- Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi’an, Shaanxi, China
| | - Alexis Medina
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, United States of America
| | - Scott Rozelle
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, United States of America
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MacLean RR, Martino S, Carroll KM, Smyth JM, Pincus AL, Wilson SJ. Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers. Nicotine Tob Res 2017; 19:716-722. [PMID: 28486711 DOI: 10.1093/ntr/ntw253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/28/2016] [Indexed: 12/20/2022]
Abstract
Introduction Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers' appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Methods Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. Results All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Conclusions Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. Implications This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used, but poorly studied, construct that has considerable utility in smoking cessation. Valuing personal health is frequently reported as a primary motivator for a quit attempt. Inasmuch as personal health is a distal nondrug reward used to motivate smoking abstinence, naturalistic evaluation of health importance, and motivators for continued smoking (ie, craving) could inform the timing and content of smoking treatment. This study is among the first to evaluate momentary assessment of personal values and craving within daily life.
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Affiliation(s)
- Robert Ross MacLean
- Department of Psychology, Pennsylvania State University, University Park, PA.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Steve Martino
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Kathleen M Carroll
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Joshua M Smyth
- Department of Biobehavioral Health and Medicine, Pennsylvania State University, University Park, PA
| | - Aaron L Pincus
- Department of Psychology, Pennsylvania State University, University Park, PA
| | - Stephen J Wilson
- Department of Psychology, Pennsylvania State University, University Park, PA
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An experimental comparison of mobile texting programs to help young adults quit smoking. Health Syst (Basingstoke) 2017. [DOI: 10.1057/s41306-016-0014-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Kong G, Goldberg A, Dallery J, Krishnan-Sarin S. An open-label pilot study of an intervention using mobile phones to deliver contingency management of tobacco abstinence to high school students. Exp Clin Psychopharmacol 2017; 25:333-337. [PMID: 29048181 PMCID: PMC5687821 DOI: 10.1037/pha0000151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This pilot study assessed the feasibility, acceptability, and preliminary efficacy of a smoking cessation intervention that used mobile phones to remotely deliver reinforcements contingent on tobacco abstinence (contingency management [CM]) and weekly in-person cognitive-behavioral therapy to adolescent smokers. Daily adolescent smokers (N = 15; 12 completed study procedures, 3 dropped out) were recruited to participate in a 4-week study. During the first 2 weeks, daily text messages sent at random times prompted participants to transmit a video of themselves providing a carbon monoxide (CO) sample. During the last 2 weeks, text messages sent on 3 randomly chosen days each week prompted participants to transmit a video of themselves providing a saliva sample. Negative samples (CO ≤8 ppm; cotinine ≤100 ng/ml) were reinforced with monetary incentives. Feasibility was assessed using the number of on-time, valid videos, and acceptability was determined using participant perceptions of the intervention. Seven-day point-prevalence (PP) abstinence (self-reported abstinence, cotinine <100 ng/ml) was assessed at end of treatment (EOT) and at a 1-month follow-up. The study findings indicate that remote delivery of CM using mobile phones was feasible (85.8% of the CO videos and 67% of the saliva cotinine videos were on time) and acceptable (positive perceptions of the CM procedures). Seven-day PP was 60% at EOT and 46.7% at the follow-up. Although larger randomized controlled trials are needed to evaluate efficacy, this pilot study suggests that the use of mobile phones to deliver CM for smoking cessation among adolescent smokers was acceptable and feasible. (PsycINFO Database Record
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Affiliation(s)
- Grace Kong
- Yale School of Medicine, Department of Psychiatry, New Haven CT 06519
| | - Alissa Goldberg
- Yale School of Medicine, Department of Psychiatry, New Haven CT 06519
| | - Jesse Dallery
- University of Florida, Department of Psychology, Gainsville, FL 32611
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Blitchtein-Winicki D, Zevallos K, Samolski MR, Requena D, Velarde C, Briceño P, Piazza M, Ybarra ML. Feasibility and Acceptability of a Text Message-Based Smoking Cessation Program for Young Adults in Lima, Peru: Pilot Study. JMIR Mhealth Uhealth 2017; 5:e116. [PMID: 28778850 PMCID: PMC5562935 DOI: 10.2196/mhealth.7532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 05/22/2017] [Accepted: 06/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background In Peru’s urban communities, tobacco smoking generally starts during adolescence and smoking prevalence is highest among young adults. Each year, many attempt to quit, but access to smoking cessation programs is limited. Evidence-based text messaging smoking cessation programs are an alternative that has been successfully implemented in high-income countries, but not yet in middle- and low-income countries with limited tobacco control policies. Objective The objective was to assess the feasibility and acceptability of an short message service (SMS) text message-based cognitive behavioral smoking cessation program for young adults in Lima, Peru. Methods Recruitment included using flyers and social media ads to direct young adults interested in quitting smoking to a website where interested participants completed a Google Drive survey. Inclusion criteria were being between ages 18 and 25 years, smoking at least four cigarettes per day at least 6 days per week, willing to quit in the next 30 days, owning a mobile phone, using SMS text messaging at least once in past year, and residing in Lima. Participants joined one of three phases: (1) focus groups and in-depth interviews whose feedback was used to develop the SMS text messages, (2) validating the SMS text messages, and (3) a pilot of the SMS text message-based smoking cessation program to test its feasibility and acceptability among young adults in Lima. The outcome measures included adherence to the SMS text message-based program, acceptability of content, and smoking abstinence self-report on days 2, 7, and 30 after quitting. Results Of 639 participants who completed initial online surveys, 42 met the inclusion criteria and 35 agreed to participate (focus groups and interviews: n=12; validate SMS text messages: n=8; program pilot: n=15). Common quit practices and beliefs emerged from participants in the focus groups and interviews informed the content, tone, and delivery schedule of the messages used in the SMS text message smoking cessation program. A small randomized controlled pilot trial was performed to test the program’s feasibility and acceptability; nine smokers were assigned to the SMS text message smoking cessation program and six to a SMS text message nutrition program. Participant retention was high: 93% (14/15) remained until day 30 after quit day. In all, 56% of participants (5/9) in the SMS text message smoking cessation program reported remaining smoke-free until day 30 after quit day and 17% of participants (1/6) in the SMS text message nutrition program reported remaining smoke-free during the entire program. The 14 participants who completed the pilot reported that they received valuable health information and approved the delivery schedule of the SMS text messages. Conclusions This study provides initial evidence that a SMS text message smoking cessation program is feasible and acceptable for young adults residing in Lima.
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Affiliation(s)
- Dora Blitchtein-Winicki
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru.,Executive Office of Research, Peruvian National Institute of Health, Lima, Peru
| | - Karine Zevallos
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru.,Centro de Investigación en Enfermedades Tropicales "Maxime Kuczynski", Peruvian National Institute of Health, Loreto, Peru
| | - M Reuven Samolski
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Requena
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Chaska Velarde
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia Briceño
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marina Piazza
- Mental Health, Alcohol and Drug Unit, Public Health Department, Universidad Peruana Cayetano Heredia, Lima, Peru.,Peruvian National Institute of Health, Lima, Peru
| | - Michele L Ybarra
- Center for Innovative Public Health Research, San Clemente, CA, United States
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Formagini TDB, Ervilha RR, Machado NM, Andrade BABBD, Gomide HP, Ronzani TM. A review of smartphone apps for smoking cessation available in Portuguese. CAD SAUDE PUBLICA 2017; 33:e00178215. [PMID: 28300972 DOI: 10.1590/0102-311x00178215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/13/2016] [Indexed: 06/23/2024] Open
Abstract
Smartphone apps are being developed as a complement to smoking cessation treatment. The current study aimed to analyze the content of available apps in Portuguese in two operational systems, Android and iOS. Fifty-one apps were found in iTunes and 600 in Google Play. Content evaluation included apps that focused on smoking cessation, with a total of 12 apps in iOS and 3 in Android. Each app was categorized according to its approach to smoking cessation and scored according to level of adherence to the Treating Tobacco Use and Dependence smoking cessation treatment guideline. Nine apps were classified as calendars, 8 as information tools, 6 as calculators, 3 as cigarette trackers, and 1 as hypnosis. The apps showed low level of adherence to the guideline, with a mean score of 12.8. We recommend that the available apps be revised and that future apps be developed using evidence-based practices for smoking cessation.
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