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Sadasivam RS, Nagawa CS, Wijesundara JG, Flahive J, Nguyen HL, Larkin C, Faro JM, Balakrishnan K, Ha DA, Nguyen CK, Vuong A, Phan PT, Pham QPL, Allison JJ, Houston TK. Peer Texting to Promote Quitline Use and Smoking Cessation Among Rural Participants in Vietnam: Randomized Clinical Trial. Int J Public Health 2024; 69:1606941. [PMID: 38651035 PMCID: PMC11033404 DOI: 10.3389/ijph.2024.1606941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/29/2024] [Indexed: 04/25/2024] Open
Abstract
Objectives: We tested an adapted version of an effective U.S.-based peer-texting intervention to promote Quitline use and smoking cessation among rural participants in Vietnam. Methods: We conducted a two-arm randomized trial with participants recruited at four rural community centers. The intervention included peer messages sent for six months that promoted Quitline use and smoking cessation. Additionally, biweekly two-way text messages assessed participants' interest in Quitline referral and current smoking status. Comparison participants received only the bi-weekly text message assessment of their current smoking status. At six months, we assessed Quitline use and smoking cessation. Smoking cessation was assessed using the 7-day point prevalence question and verified with a carbon monoxide breath monitor (<=6 ppm). Results: Among 750 participants, the intervention had higher Quitline verified use (18%, 95% CI 0.14, 0.22) than comparison (1%, 95% CI .2, 2, p < 0.0001). Carbon-monoxide-verified smoking cessation did not differ between the two groups. However, intervention (28.3%, 95% CI) and comparison (28.1%, 95% CI) participants had substantial rates of carbon monoxide cessation at 6 months (both 28%). Conclusion: Our study highlighted the promise of texting interventions to extend tobacco control efforts in Vietnam.
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Affiliation(s)
- Rajani S. Sadasivam
- University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Catherine S. Nagawa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Jessica G. Wijesundara
- University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Julie Flahive
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Hoa L. Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Celine Larkin
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jamie M. Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kavitha Balakrishnan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Duc Anh Ha
- Ministry of Health (Vietnam), Hanoi, Vietnam
| | - Cuong Kieu Nguyen
- Institute of Population, Health and Development (PHAD), Hanoi, Vietnam
| | - Anh Vuong
- Institute of Population, Health and Development (PHAD), Hanoi, Vietnam
| | - Phuong Thu Phan
- Institute of Population, Health and Development (PHAD), Hanoi, Vietnam
| | | | - Jeroan J. Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Thomas Karr Houston
- School of Medicine, Wake Forest University, Winston-Salem, NC, United States
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Nadkarni A, Gaikwad L, Sequeira M, Velleman R, D'souza J, Hoble A, Haldankar R, Murthy P, Naughton F. Evaluation of Feasibility and Acceptability of a Text-Messaging Intervention for Tobacco Cessation in India. Nicotine Tob Res 2024; 26:72-78. [PMID: 37638548 PMCID: PMC10734385 DOI: 10.1093/ntr/ntad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/26/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION The aim of our study was to assess the feasibility and acceptability of a brief behavioral intervention for tobacco cessation delivered via mobile phone text messaging in India. AIMS AND METHODS We conducted an uncontrolled intervention cohort study in adult current users of tobacco. The participants received intervention messages on their mobile phones for eight weeks. We collected qualitative data about participants' perceptions of intervention delivery and receipt, acceptability, and feasibility of the intervention. The outcomes measured at 3 months post-recruitment were self-reported 7- and 28-day point-prevalence abstinence, and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) risk categories for tobacco-low (0-3), moderate (4-26), and high (≥27). RESULTS We recruited 26 eligible participants, and 22 completed the outcome assessments. The participants generally perceived the intervention content to be simple to access and useful in facilitating a change in tobacco use. None of the participants indicated that they wanted to discontinue receiving the intervention messages. Some suggestions for enhancing acceptability included supplementing text messaging with more intensive counseling and the use of multimedia content. Eighteen percent of participants reported abstinence in the past 7 and 28 days. A greater proportion of those who used smokeless tobacco were abstinent at follow-up compared to those who smoked (42.9% vs. 6.7%; p = .04). CONCLUSIONS If effective, simple and low-cost mobile phone text messaging can be used to deliver interventions for tobacco use, and has the potential to be scaled up so it can be delivered to populations of smokers interested in receiving cessation support. IMPLICATIONS Our study is an important step towards the development of a contextually relevant intervention suited for low- and middle-income countries and which is responsive to the needs of both those who use smoked and smokeless tobacco. If found to be effective, our intervention would be a scalable solution to overcome the human resource related barrier to accessing tobacco cessation services in low resource settings.
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Affiliation(s)
- Abhijit Nadkarni
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions and Related Research Group (ARG), Sangath, India
| | - Leena Gaikwad
- Addictions and Related Research Group (ARG), Sangath, India
| | | | - Richard Velleman
- Addictions and Related Research Group (ARG), Sangath, India
- Department of Psychology, University of Bath, Bath, UK
| | | | - Ankita Hoble
- Addictions and Related Research Group (ARG), Sangath, India
| | | | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, UK
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Nian T, Guo K, Liu W, Deng X, Hu X, Xu M, E F, Wang Z, Song G, Yang K, Li X, Shang W. Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC Med 2023; 21:378. [PMID: 37775745 PMCID: PMC10542700 DOI: 10.1186/s12916-023-03087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Although non-pharmacological smoking cessation measures have been widely used among smokers, current research evidence on the effects of smoking cessation is inconsistent and of mixed quality. Moreover, there is a lack of comprehensive evidence synthesis. This study seeks to systematically identify, describe, and evaluate the available evidence for non-pharmacological interventions in smoking populations through evidence mapping (EM), and to search for best-practice smoking cessation programs. METHODS A comprehensive search for relevant studies published from the establishment of the library to January 8, 2023, was conducted in PubMed, Web of Science, Embase, the Cochrane Library, CNKI, CBM, Wan Fang, and VIP. Two authors independently assessed eligibility and extracted data. The PRISMA statement and AMSTAR 2 tool were used to evaluate the report quality and methodology quality of systematic reviews/meta-analyses (SRs/MAs), respectively. Bubble plots were utilized to display information, such as the study population, intervention type, evidence quality, and original study sample size. RESULTS A total of 145 SRs/MAs regarding non-pharmacological interventions for smoking cessation were investigated, with 20 types of interventions identified. The most commonly used interventions were cognitive behaviour education (n = 32, 22.07%), professional counselling (n = 20, 13.79%), and non-nicotine electronic cigarettes (e-cigarettes) (n = 13, 8.97%). Among them, counselling and behavioural support can improve smoking cessation rates, but the effect varies depending on the characteristics of the support provided. These findings are consistent with previous SRs/MAs. The general population (n = 108, 74.48%) was the main cohort included in the SRs/MAs. The total score of PRISMA for the quality of the reports ranged from 8 to 27, and 13 studies (8.97%) were rated as high confidence, and nine studies (6.21%) as moderate confidence, in the AMSTAR 2 confidence rating. CONCLUSIONS The abstinence effect of cognitive behaviour education and money incentive intervention has advantages, and non-nicotine e-cigarettes appear to help some smokers transition to less harmful replacement tools. However, the methodological shortcomings of SRs/MAs should be considered. Therefore, to better guide future practice in the field of non-pharmacological smoking cessation, it is essential to improve the methodological quality of SRs and carry out high-quality randomized controlled trials (RCTs).
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Affiliation(s)
- Tao Nian
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Kangle Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wendi Liu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xinxin Deng
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xiaoye Hu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
| | - Meng Xu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Fenfen E
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Ziyi Wang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Guihang Song
- Gansu Provincial Medical Security Bureau, Lanzhou, 730000, People's Republic of China
| | - Kehu Yang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Xiuxia Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wenru Shang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China.
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Collaborative Innovation Center of First Hospital, Lanzhou University, Lanzhou, 730000, People's Republic of China.
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Zhou X, Wei X, Cheng A, Liu Z, Su Z, Li J, Qin R, Zhao L, Xie Y, Huang Z, Xia X, Liu Y, Song Q, Xiao D, Wang C. Mobile Phone-Based Interventions for Smoking Cessation Among Young People: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2023; 11:e48253. [PMID: 37706482 PMCID: PMC10510452 DOI: 10.2196/48253] [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: 04/17/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 09/15/2023] Open
Abstract
Background Mobile phone-based cessation interventions have emerged as a promising alternative for smoking cessation, while evidence of the efficacy of mobile phone-based smoking cessation programs among young people is mixed. Objective This study aimed to determine the efficacy of mobile phone-based interventions compared to usual practice or assessment-only controls on smoking cessation in young people. Methods In this systematic review and meta-analysis, we searched Cochrane Library, Embase, PubMed, and Web of Science on March 8, 2023. We included randomized controlled trials that examined the efficacy of mobile phone-based interventions on smoking cessation in young people (age ≤30 years). The risk of bias was assessed with Cochrane Risk of Bias 2. Results A total of 13 eligible studies, comprising 27,240 participants, were included in this analysis. The age range of the participants was between 16 and 30 years. Nine studies were SMS text messaging interventions, and 4 studies were app-based interventions. The duration of the smoking cessation intervention varied from 5 days to 6 months. The included studies were conducted in the following countries: the United States, China, Sweden, Canada, Switzerland, and Thailand. The meta-analysis revealed that SMS text messaging interventions significantly improved continuous abstinence rates compared to inactive control conditions (risk ratio [RR] 1.51, 95% CI 1.24-1.84). The subgroup analysis showed pooled RRs of 1.90 (95% CI 1.29-2.81), 1.64 (95% CI 1.23-2.18), and 1.35 (95% CI 1.04-1.76) for continuous abstinence at the 1-, 3-, and 6- month follow-up, respectively. Pooling across 7 studies, SMS text messaging interventions showed efficacy in promoting 7-day point prevalence abstinence (PPA), with an RR of 1.83 (95% CI 1.34-2.48). The subgroup analysis demonstrated a significant impact at the 1- and 3-month follow-ups, with pooled RRs of 1.72 (95% CI 1.13-2.63) and 2.54 (95% CI 2.05-3.14), respectively, compared to inactive control conditions. However, at the 6-month follow-up, the efficacy of SMS text messaging interventions in promoting 7-day PPA was not statistically significant (RR 1.45, 95% CI 0.92-2.28). In contrast, app-based interventions did not show significant efficacy in promoting continuous abstinence or 7-day PPA. However, it is important to note that the evidence for app-based interventions was limited. Conclusions SMS text messaging-based smoking cessation interventions compared to inactive controls were associated with abstinence among young people and could be considered a viable option for smoking cessation in this population. More research is needed on smoking cessation apps, especially apps that target young people. Future research should focus on identifying the most effective mobile phone-based cessation approaches and on developing strategies to increase their uptake and intention.
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Affiliation(s)
- Xinmei Zhou
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xiaowen Wei
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
| | - Anqi Cheng
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhao Liu
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zheng Su
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Jinxuan Li
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
| | - Rui Qin
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zhao
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ying Xie
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenxiao Huang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Xia
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi Liu
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qingqing Song
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship School of Clinical Medicine, Capital Medical University, Beijing, China
| | - Dan Xiao
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chen Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Panda R, Lahoti S, Mishra A, Prabhu RR, Das S, Satapathy DM, Nazareth I. Designing a mobile health smokeless tobacco cessation intervention in Odisha, India: User and provider perspectives. Digit Health 2023; 9:20552076221150581. [PMID: 36655182 PMCID: PMC9841872 DOI: 10.1177/20552076221150581] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/12/2022] [Indexed: 01/15/2023] Open
Abstract
Objective There is limited evidence on the development of mobile health (mHealth) interventions for smokeless tobacco (SLT) cessation, despite its widespread use in South Asia. This formative qualitative study explored the perceptions of tobacco users and healthcare providers (HCPs) regarding developing a mHealth intervention for SLT cessation. Methods This was a qualitative study using in-depth interviews (IDIs) with tobacco users (n = 26) and primary care physicians (PCPs) (n = 5) and focus group discussions (FGDs) with counsellors (n = 2) in four urban primary health centres (UPHCs) in Berhampur, Odisha from February to March 2020. The data were coded and analysed by two researchers using a framework analysis method. The discussion guides and initial codes were developed based on the Transtheoretical Model (TTM) of behaviour change. Results The results were elaborated under four themes: (1) Current scenario of SLT use; (2) Barriers and facilitators for quitting SLT; (3) Barriers and facilitators for mHealth counselling; and (4) Design and delivery of the proposed intervention. SLT use was prevalent in the community regardless of sociodemographic factors. Peer factors accounted for both tobacco consumption as well as considering cessation. Participants considered mobile message counselling helpful and acceptable. Not having a mobile phone and illiteracy were identified as barriers while ease of access and rising popularity of social media applications were considered facilitators to the use of mHealth for quitting tobacco. Participants preferred messages that were pictorial, short and simple, in the local language, and tailored to individual's needs. Conclusions This is the first study that provides evidence within the Indian context that the text messaging platform may be used for delivering an SLT cessation intervention. The integration of a theoretical basis and research findings from target users can guide future intervention development.
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Affiliation(s)
- Rajmohan Panda
- Research Division, Public Health Foundation of India, New Delhi, India
| | - Supriya Lahoti
- Research Division, Public Health Foundation of India, New Delhi, India
| | - Arti Mishra
- Project ECHO (Extension for Community Healthcare Outcomes), New Delhi, India
| | - Rajath R Prabhu
- Research Division, Public Health Foundation of India, New Delhi, India
| | - Sangeeta Das
- Research Division, Public Health Foundation of India, India
| | | | - Irwin Nazareth
- Department of Primary Care and Population Sciences, University College London, London, UK
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Evans WD, Abroms LC, Broniatowski D, Napolitano M, Arnold J, Ichimiya M, Agha S. Digital Media for Behavior Change: Review of an Emerging Field of Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159129. [PMID: 35897494 PMCID: PMC9331057 DOI: 10.3390/ijerph19159129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 01/25/2023]
Abstract
Digital media are omnipresent in modern life, but the science on the impact of digital media on behavior is still in its infancy. There is an emerging evidence base of how to use digital media for behavior change. Strategies to change behavior implemented using digital technology have included a variety of platforms and program strategies, all of which are potentially more effective with increased frequency, intensity, interactivity, and feedback. It is critical to accelerate the pace of research on digital platforms, including social media, to understand and address its effects on human behavior. The purpose of the current paper is to provide an overview and describe methods in this emerging field, present use cases, describe a future agenda, and raise central questions to be addressed in future digital health research for behavior change. Digital media for behavior change employs three main methods: (1) digital media interventions, (2) formative research using digital media, and (3) digital media used to conduct evaluations. We examine use cases across several content areas including healthy weight management, tobacco control, and vaccination uptake, to describe and illustrate the methods and potential impact of this emerging field of study. In the discussion, we note that digital media interventions need to explore the full range of functionality of digital devices and their near-constant role in personal self-management and day-to-day living to maximize opportunities for behavior change. Future experimental research should rigorously examine the effects of variable levels of engagement with, and frequency and intensity of exposure to, multiple forms of digital media for behavior change.
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Affiliation(s)
- William Douglas Evans
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
- The BRIGHT Institute, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA
- Correspondence:
| | - Lorien C. Abroms
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
- The BRIGHT Institute, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA
| | - David Broniatowski
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
- The BRIGHT Institute, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA
| | - Melissa Napolitano
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
- The BRIGHT Institute, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA
| | - Jeanie Arnold
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
| | - Megumi Ichimiya
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, USA; (L.C.A.); (D.B.); (M.N.); (J.A.); (M.I.)
| | - Sohail Agha
- Stanford Behavior Design Lab, Seattle, WA 98109, USA;
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Pipe AL, Evans W, Papadakis S. Smoking cessation: health system challenges and opportunities. Tob Control 2022; 31:340-347. [PMID: 35241609 DOI: 10.1136/tobaccocontrol-2021-056575] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/24/2022] [Indexed: 11/03/2022]
Abstract
The systematic integration of evidence-based tobacco treatment has yet to be broadly viewed as a standard-of-care. The Framework Convention on Tobacco Control recommends the provision of support for tobacco cessation. We argue that the provision of smoking cessation services in clinical settings is a fundamental clinical responsibility and permits the opportunity to more effectively assist with cessation. The role of clinicians in prioritising smoking cessation is essential in all settings. Clinical benefits of implementing cessation services in hospital settings have been recognised for three decades-but have not been consistently provided. The Ottawa Model for Smoking Cessation has used an 'organisational change' approach to its introduction and has served as the basis for the introduction of cessation programmes in hospital and primary care settings in Canada and elsewhere. The significance of smoking cessation dwarfs that of many preventive interventions in primary care. Compelling evidence attests to the importance of providing cessation services as part of cancer treatment, but implementation of such programmes has been slow. We recognise that the provision of such services must reflect the realities and resources of a particular health system. In low-income and middle-income countries, access to treatment facilities pose unique challenges. The integration of cessation programmes with tuberculosis control services may offer opportunities; and standardisation of peri-operative care to include smoking cessation may not require additional resources. Mobile phones afford unique opportunities for interactive cessation programming. Health system change is fundamental to improving the provision of cessation services; clinicians can be powerful advocates for such change.
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Affiliation(s)
- Andrew L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - William Evans
- Department of Oncology, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Sophia Papadakis
- Clinic of Social and Family Medicine, University of Crete School of Medicine, Heraklion, Crete, Greece
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Streck S, McIntire R, Canale L, Michael Anderson J, Hartwell M, Torgerson T, Dunn K, Vassar M. An Evaluation of Evidence Underpinning Management Recommendations in Tobacco Use Disorder Clinical Practice Guidelines. Nicotine Tob Res 2022; 24:847-854. [PMID: 35023556 PMCID: PMC9048867 DOI: 10.1093/ntr/ntac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Clinical practice guidelines(CPGs) are important tools for medical decision-making. Given the high prevalence and financial burden associated with tobacco use disorder(TUD), it is critical that recommendations within CPGs are based on robust evidence. Systematic reviews(SRs) are considered the highest level of evidence, thus, we evaluated the quality of SRs underpinning CPG recommendations for TUD. METHODS We used PubMed to search for CPGs relating to TUD published between January 1, 2010 and May 21, 2021. SRs were extracted from CPG references and evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) and A MeaSurement Tool to Assess Systematic Reviews(AMSTAR-2) tools. We then compared SRs conducted by the Cochrane Collaboration with non-Cochrane SRs using a Mann-Whitney U test and determined associations between PRISMA and AMSTAR-2 extracted characteristics using multiple regression. RESULTS Our search generated 10 CPGs with 98 SRs extracted. Mean PRISMA completion was 74.7%(SD = 16.7) and mean AMSTAR-2 completion was 53.8%(SD = 22.0) across all guidelines. Cochrane SRs were more complete than non-Cochrane studies in the PRISMA and AMSTAR-2 assessments. The regression model showed a statistically significant association between PRISMA completion and AMSTAR-2 rating, with those classified as "low" or "moderate" quality having higher PRISMA completion than those with "critically low" ratings. CONCLUSION We found substandard adherence to PRISMA and AMSTAR-2 checklists across SRs cited in TUD CPGs. A lack of recent SRs in CPGs could lead to outdated recommendations. Therefore, frequent guideline updates with recently published evidence may ensure more accurate clinical recommendations and improve patient care. IMPLICATIONS Systematic reviews used to underpin clinical practice guideline recommendations influence treatment decisions and, ultimately, patient outcomes. We found that many systematic reviews underpinning tobacco use disorder guideline recommendations were out of date and unsatisfactory in reporting and quality. Thus, including newer systematic reviews containing more recently conducted trials and better reporting could alter recommendations and improve the rate of successful tobacco cessation attempts.
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Affiliation(s)
- Sam Streck
- Corresponding Author: Sam Streck, BS, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, USA. Telephone: (918) 582-1972..
| | - Ryan McIntire
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Lawrence Canale
- Kansas City University College of Osteopathic Medicine, Joplin, MO, USA
| | - J Michael Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Trevor Torgerson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Kelly Dunn
- Oklahoma State University Center for Health Sciences, Department of Psychiatry and Behavioral Sciences, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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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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Yadav K, Ginsburg O, Basu P, Mehrotra R. Telemedicine and Cancer Care in Low- and Middle-Income Countries During the SARS-CoV-2 Pandemic. JCO Glob Oncol 2021; 7:1633-1638. [PMID: 34860567 PMCID: PMC8654432 DOI: 10.1200/go.21.00249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 12/29/2022] Open
Affiliation(s)
- Kavita Yadav
- Centre of Social Medicine & Community Health, Jawahar Lal Nehru University, New Delhi, India
| | - Ophira Ginsburg
- Department of Medicine at NYU Grossman School of Medicine, New York, NY
| | - Partha Basu
- Early Detection, Prevention & Infection Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ravi Mehrotra
- Chip Foundation, Noida, India
- Rollins School of Public Health, Emory University, Atlanta, GA
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Huang WC, Pham NY, Nguyen TA, Vu VG, Ngo QC, Nguyen VN, Freeman B, Jan S, Negin J, Marks GB, Fox GJ. Smoking behaviour among adult patients presenting to health facilities in four provinces of Vietnam. BMC Public Health 2021; 21:845. [PMID: 33933063 PMCID: PMC8088640 DOI: 10.1186/s12889-021-10880-z] [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: 09/18/2020] [Accepted: 04/20/2021] [Indexed: 11/20/2022] Open
Abstract
Background Attendance at healthcare facilities provides an opportunity for smoking cessation interventions. However, the smoking behaviours of patients seeking healthcare in Vietnam are not well-understood. We aimed to evaluate behaviours related to smoking among patients presenting to health facilities in Vietnam. Methods We conducted a cross-sectional study in 4 provinces of Vietnam. Consecutive patients aged ≥15 years presenting to 46 health facilities were assessed. Current smokers were randomly selected to complete a full survey about smoking behaviour, quit attempts, and preparedness to quit. Results Among 11,245 patients who sought healthcare, the prevalence of current smoking was 18.6% (95% CI: 17.8–19.4%) overall, 34.6% (95% CI: 33.2–36.0%) among men and 1.1% (95% CI: 0.8–1.3%) among women. Current smokers who were asked about smoking by healthcare providers in the last 12 months were more likely to make quit attempts than those not asked (40.6% vs 31.8%, p = 0.017). Current smokers who attempted to quit in the past 12 months made limited use of cessation aids: counselling (1.9%) and nicotine replacement therapy (10%). A higher proportion of patients wanted to quit in the next month at national/provincial hospitals (30.3%) than those visiting district hospitals (11.3%, p < 0.001) and commune health centres (11.1%, p = 0.004). Conclusions Smoking is common among male patients presenting to healthcare facilities in Vietnam. Formal smoking cessation supports are generally not used or offered. This population is likely to benefit from routine smoking cessation interventions that are integrated within the routine healthcare delivery system. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10880-z.
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Affiliation(s)
- Wan-Chun Huang
- Woolcock Institute of Medical Research, Hanoi, Vietnam. .,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia. .,Division of Thoracic Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Ngoc Yen Pham
- Woolcock Institute of Medical Research, Hanoi, Vietnam
| | | | - Van Giap Vu
- Respiratory Center, Bach Mai Hospital, Hanoi, Vietnam
| | - Quy Chau Ngo
- Respiratory Center, Bach Mai Hospital, Hanoi, Vietnam
| | | | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, Australia
| | - Stephen Jan
- Health Economics and Process Evaluation Program, George Institute for Global Health, Sydney, Australia
| | - Joel Negin
- School of Public Health, University of Sydney, Sydney, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, Hanoi, Vietnam.,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Gregory J Fox
- Woolcock Institute of Medical Research, Hanoi, Vietnam.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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