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Chen Z, Siegel LN, Prutzman YM, Wiseman KP. Characterizing perceived usability and its correlation with smoking cessation: An analysis of user assessments of the smoking cessation app quitSTART. Internet Interv 2024; 35:100714. [PMID: 38313141 PMCID: PMC10835281 DOI: 10.1016/j.invent.2024.100714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background As smartphone ownership has become common in all demographic groups in the United States, smartphone applications (apps) for smoking cessation have grown in popularity due to their potential for supporting the diverse populations in the United States who are attempting to quit smoking. Usability is commonly assessed in mobile health (mHealth) technology as an important aspect of the user experience that could influence users' adherence to a health app and health outcomes. However, the variation of perceived usability across demographic groups, and the implications of that variation for app success, have not been well studied. Objective The aims of this study were to characterize variation in the perceived usability of the National Cancer Institute Smokefree.gov Initiative smoking cessation app quitSTART across demographic groups, and to assess the correlation between perceived usability and short-term smoking cessation. Methods We conducted a secondary analysis of data from a randomized controlled trial conducted from 2020 to 2021, which used a 16-item modified version of the mHealth App Usability Questionnaire (MAUQ) to quantify perceived usability four weeks after app download among 131 smokers attempting to quit. Responses were coded on a 5-point Likert-type scale ranging from strongly disagree (1) to strongly agree (5) and total perceived usability was calculated as the sum of all 16 items (range: 16-80). Associations between participant demographic characteristics (gender, race, education level, age, etc.) and total usability were determined using an ANCOVA model. A multivariable logistic regression model was used to assess the association between usability and smoking cessation, also assessed 4 weeks after app download. Results The ANCOVA model demonstrated that race was associated with perceived usability, with participants from a racial minority group reporting higher total usability than White participants (p < 0.001). White participants had an adjusted mean total usability of 55.8 (95 % CI: 52.8, 58.8) while racial minority group participants had an adjusted mean total usability of 66.5 (95 % CI: 61.2, 71.6). Other participant demographic characteristics, such as gender and sexual minority status, were not associated with mean total usability. Total usability was positively associated with smoking cessation (OR: 1.04, 95 % CI: 1.00, 1.08, p = 0.031). Conclusions Total perceived usability of quitSTART was higher among adults from a racial minority group compared to White adults, and perceived usability was positively associated with cessation success. These findings emphasize the importance of ensuring high usability of mHealth smoking cessation apps for diverse populations.
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Affiliation(s)
- Ziyan Chen
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Leeann N Siegel
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yvonne M Prutzman
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kara P Wiseman
- University of Virginia School of Medicine, Charlottesville, VA, USA
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2
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Zhang M, Wolters M, O'Connor S, Wang Y, Doi L. Smokers' user experience of smoking cessation apps: A systematic review. Int J Med Inform 2023; 175:105069. [PMID: 37084673 DOI: 10.1016/j.ijmedinf.2023.105069] [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: 12/26/2022] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES To explore how smokers view common functions and characteristics of smoking cessation apps. DESIGN Systematic review. SEARCH SOURCES CINAHL PLUS, MEDLINE, PsycINFO, EMBASE, IEEE Xplore, ACM Digital Library, and Google Scholar. REVIEW METHODS Seven digital databases were searched separately using relevant search terms. Search results were uploaded to Covidence. Inclusion and exclusion criteria were identified with the expert team in advance. Titles, abstracts, and full texts were screened by two reviewers independently. Any disagreements were discussed in research meetings. Pertinent data were extracted and analysed using qualitative content analysis. Findings were presented in a narrative approach. RESULTS 28 studies were included in this review. The overarching themes were app functionality and app characteristics. Under app "functionality", six subthemes emerged: 1) education; 2) tracking; 3) social support; 4) compensation; 5) distraction, and 6) reminding. Under "app characteristics", five subthemes emerged: 1) simplification, 2) personalisation, 3) diverse content forms, 4) interactivity, and 5) privacy and security. CONCLUSION Understanding user needs and expectations is crucial for developing a programme theory for smoking cessation app interventions. Relevant needs identified in this review should be linked to broader theories of smoking cessation and app-based intervention.
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Affiliation(s)
- Mengying Zhang
- School of Health in Social Science, The University of Edinburgh, UK; Scottish Collaboration for Public Health Research & Policy, The University of Edinburgh, UK.
| | - Maria Wolters
- School of Informatics, The University of Edinburgh, UK
| | | | - Yajing Wang
- School of Health in Social Science, The University of Edinburgh, UK
| | - Lawrence Doi
- School of Health in Social Science, The University of Edinburgh, UK; Scottish Collaboration for Public Health Research & Policy, The University of Edinburgh, UK
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Krishna M, Sybil D, Shrivastava PK, Premchandani S, Kumar H, Kumar P. An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study. JMIR Perioper Med 2021; 4:e31852. [PMID: 34982720 PMCID: PMC8760618 DOI: 10.2196/31852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/07/2021] [Accepted: 12/15/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication. OBJECTIVE The aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction. METHODS A postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale. RESULTS The ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8). CONCLUSIONS The testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions.
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Affiliation(s)
| | - Deborah Sybil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
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4
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Chen J, Wang Y. Social Media Use for Health Purposes: Systematic Review. J Med Internet Res 2021; 23:e17917. [PMID: 33978589 PMCID: PMC8156131 DOI: 10.2196/17917] [Citation(s) in RCA: 195] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/29/2021] [Accepted: 04/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years. Objective This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies. Methods The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles. Results This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public. Conclusions Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.
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Affiliation(s)
- Junhan Chen
- Department of Communication, University of Maryland, College Park, MD, United States
| | - Yuan Wang
- Department of Communication, University of Maryland, College Park, MD, United States
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5
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Gordon JS, Bell ML, Armin JS, Giacobbi PR, Nair US. A telephone-based guided imagery tobacco cessation intervention: results of a randomized feasibility trial. Transl Behav Med 2021; 11:516-529. [PMID: 32542352 PMCID: PMC7963280 DOI: 10.1093/tbm/ibaa052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence supports the use of guided imagery for smoking cessation; however, scalable delivery methods are needed to make it a viable approach. Telephone-based tobacco quitlines are a standard of care, but reach is limited. Adding guided imagery to quitline services might increase reach by offering an alternative approach. PURPOSE To develop and test the feasibility and potential impact of a guided imagery-based tobacco cessation intervention delivered using a quitline model. METHODS Participants for this randomized feasibility trial were recruited statewide through a quitline or community-based methods. Participants were randomized to guided imagery Intervention Condition (IC) or active behavioral Control Condition (CC). After withdrawals, there were 105 participants (IC = 56; CC = 49). The IC consisted of six sessions in which participants created guided imagery audio files. The CC used a standard six-session behavioral protocol. Feasibility measures included recruitment rate, retention, and adherence to treatment. We also assessed 6-month quit rates and consumer satisfaction. RESULTS Both the IC and CC protocols were feasible to deliver. We finalized protocols and materials for participants, coaches and study staff, and delivered the protocols with fidelity. We developed successful recruitment methods, and experienced high retention (6 months = 81.9%) and adherence (all sessions = 66.7%). Long-term quit rates (IC = 27.9%; CC = 38.1%) compared favorably to those of quitlines, and program satisfaction was high, suggesting that the protocols are acceptable to smokers and may contribute to smoking abstinence. CONCLUSIONS The guided imagery intervention is feasible and promising, suggesting that a fully powered RCT to test the efficacy of the intervention is warranted. TRIAL REGISTRATION NUMBER NCT02968381.
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Affiliation(s)
| | - Melanie L Bell
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Julie S Armin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA
| | - Peter R Giacobbi
- College of Physical Activity and Sport Sciences and School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Uma S Nair
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Vilardaga R, Casellas-Pujol E, McClernon JF, Garrison KA. Mobile Applications for the Treatment of Tobacco Use and Dependence. CURRENT ADDICTION REPORTS 2019; 6:86-97. [PMID: 32010548 PMCID: PMC6994183 DOI: 10.1007/s40429-019-00248-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Smoking remains a leading preventable cause of premature death in the world; thus, developing effective and scalable smoking cessation interventions is crucial. This review uses the Obesity-Related Behavioral Intervention Trials (ORBIT) model for early phase development of behavioral interventions to conceptually organize the state of research of mobile applications (apps) for smoking cessation, briefly highlight their technical and theory-based components, and describe available data on efficacy and effectiveness. RECENT FINDINGS Our review suggests that there is a need for more programmatic efforts in the development of mobile applications for smoking cessation, though it is promising that more studies are reporting early phase research such as user-centered design. We identified and described the app features used to implement smoking cessation interventions, and found that the majority of the apps studied used a limited number of mechanisms of intervention delivery, though more effort is needed to link specific app features with clinical outcomes. Similar to earlier reviews, we found that few apps have yet been tested in large well-controlled clinical trials, although progress is being made in reporting transparency with protocol papers and clinical trial registration. SUMMARY ORBIT is an effective model to summarize and guide research on smartphone apps for smoking cessation. Continued improvements in early phase research and app design should accelerate the progress of research in mobile apps for smoking cessation.
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Affiliation(s)
- Roger Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Erwin Terrace Building II, 2812 Erwin Rd, Box 13, Durham, NC 27705, USA
| | - Elisabet Casellas-Pujol
- Department of Psychiatry, Hospital Santa Creu I Sant Pau, Carrer de Sant Quinti, 89, 08041 Barcelona, Spain
| | - Joseph F. McClernon
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, USA
| | - Kathleen A. Garrison
- Department of Psychiatry, Yale School of Medicine, 1 Church Street, Suite 730, New Haven, CT 06510, USA
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Edwards EA, Caton H, Lumsden J, Rivas C, Steed L, Pirunsarn Y, Jumbe S, Newby C, Shenvi A, Mazumdar S, Smith JQ, Greenhill D, Griffiths CJ, Walton RT. Creating a Theoretically Grounded, Gamified Health App: Lessons From Developing the Cigbreak Smoking Cessation Mobile Phone Game. JMIR Serious Games 2018; 6:e10252. [PMID: 30497994 PMCID: PMC6293248 DOI: 10.2196/10252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/25/2018] [Accepted: 07/28/2018] [Indexed: 12/11/2022] Open
Abstract
Background Gaming techniques are increasingly recognized as effective methods for changing behavior and increasing user engagement with mobile phone apps. The rapid uptake of mobile phone games provides an unprecedented opportunity to reach large numbers of people and to influence a wide range of health-related behaviors. However, digital interventions are still nascent in the field of health care, and optimum gamified methods of achieving health behavior change are still being investigated. There is currently a lack of worked methodologies that app developers and health care professionals can follow to facilitate theoretically informed design of gamified health apps. Objective This study aimed to present a series of steps undertaken during the development of Cigbreak, a gamified smoking cessation health app. Methods A systematic and iterative approach was adopted by (1) forming an expert multidisciplinary design team, (2) defining the problem and establishing user preferences, (3) incorporating the evidence base, (4) integrating gamification, (5) adding behavior change techniques, (6) forming a logic model, and (7) user testing. A total of 10 focus groups were conducted with 73 smokers. Results Users found the app an engaging and motivating way to gain smoking cessation advice and a helpful distraction from smoking; 84% (62/73) of smokers said they would play again and recommend it to a friend. Conclusions A dedicated gamified app to promote smoking cessation has the potential to modify smoking behavior and to deliver effective smoking cessation advice. Iterative, collaborative development using evidence-based behavior change techniques and gamification may help to make the game engaging and potentially effective. Gamified health apps developed in this way may have the potential to provide effective and low-cost health interventions in a wide range of clinical settings.
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Affiliation(s)
- Elizabeth A Edwards
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Hope Caton
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Jim Lumsden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Carol Rivas
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Social Science Research Unit, University College London, London, United Kingdom
| | - Liz Steed
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yutthana Pirunsarn
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Sandra Jumbe
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chris Newby
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Aditi Shenvi
- Centre for Complexity Science, University of Warwick, Coventry, United Kingdom
| | - Samaresh Mazumdar
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jim Q Smith
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Darrel Greenhill
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Chris J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Robert T Walton
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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8
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Chib A, Lin SH. Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps. JOURNAL OF HEALTH COMMUNICATION 2018; 23:909-955. [PMID: 30449261 DOI: 10.1080/10810730.2018.1544676] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There are now few hundred thousand healthcare apps, yet there is a gap in our understanding of the theoretical mechanisms for which, and how, technological features translate into improved healthcare outcomes. In particular, the technological convergence, within mobile health (mHealth) apps, of the processes of mass and interpersonal communication, and human-computer interaction requires greater parsing in the literature. This paper analyzed 85 empirical studies on mHealth apps using the Input-Mechanism-Output model. We found in the literature that, firstly, there is a greater emphasis on technological inputs (87%) of accessibility, usability, usage, and data quality, than health outputs (52%) such as system process efficiencies and individual level behavioral or health outcomes. Secondly, there is little evidence of explanatory mechanisms (19%) of how the effects of mHealth apps are achieved. While we believe that successful apps would require research that incorporates technological inputs, theoretical mechanisms and health outputs, such studies are a rarity (n = 3). There is a minor increase in rigor with randomized control trials (n = 5), and a preponderance of discussion around social influence (n = 8) and gamification (n = 7), albeit in a scattered manner. We discuss the implications of the trend towards socialization and gamification findings in terms of future research, particularly in terms of study design guided by theoretical mechanisms.
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Affiliation(s)
- Arul Chib
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Sapphire H Lin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
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Abbate KJ, Hingle MD, Armin J, Giacobbi P, Gordon JS. Recruiting Women to a Mobile Health Smoking Cessation Trial: Low- and No-Cost Strategies. JMIR Res Protoc 2017; 6:e219. [PMID: 29101091 PMCID: PMC5695655 DOI: 10.2196/resprot.7356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/26/2017] [Accepted: 09/04/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful recruitment of participants to mobile health (mHealth) studies presents unique challenges over in-person studies. It is important to identify recruitment strategies that maximize the limited recruitment resources available to researchers. OBJECTIVE The objective of this study was to describe a case study of a unique recruitment process used in a recent mHealth software app designed to increase smoking cessation among weight-concerned women smokers. The See Me Smoke-Free app was deployed to the Google Play Store (Alphabet, Inc., Google, LLC), where potential participants could download the app and enroll in the study. Users were invited in-app to participate in the study, with no in-person contact. The recruitment activities relied primarily on earned (free) and social media. METHODS To determine the relationship between recruitment activities and participant enrollment, the researchers explored trends in earned and social media activity in relation to app installations, examined social media messaging in relation to reach or impressions, and described app users' self-reported referral source. The researchers collected and descriptively analyzed data regarding recruitment activities, social media audience, and app use during the 18-week recruitment period (March 30, 2015-July 31, 2015). Data were collected and aggregated from internal staff activity tracking documents and from Web-based data analytics software such as SumAll, Facebook Insights (Facebook, Inc.), and Google Analytics (Alphabet, Inc., Google, LLC). RESULTS Media coverage was documented across 75 publications and radio or television broadcasts, 35 of which were local, 39 national, and 1 international. The research team made 30 Facebook posts and 49 tweets, yielding 1821 reaches and 6336 impressions, respectively. From March 30, 2015 to July 31, 2015, 289 unique users downloaded the app, and 151 participants enrolled in the study. CONCLUSIONS Research identifying effective online recruitment methods for mHealth studies remains minimal, and findings are inconsistent. We demonstrated how earned media can be leveraged to recruit women to an mHealth smoking cessation trial at low cost. Using earned media and leveraging social media allowed us to enroll 3 times the number of participants that we anticipated enrolling. The cost of earned media resides in the staff time required to manage it, particularly the regular interaction with social media. We recommend communication and cooperation with university public affairs and social media offices, as well as affiliate programs in journalism and communications, so that earned media can be used as a recruitment strategy for mHealth behavior change interventions. However, press releases are not always picked up by the media and should not be considered as a stand-alone method of recruitment. Careful consideration of an intervention's broad appeal and how that translates into potential media interest is needed when including earned media as part of a comprehensive recruitment plan for mHealth research.
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Affiliation(s)
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
| | - Peter Giacobbi
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, WV, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
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10
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Schmidt CA, Romine JK, Bell ML, Armin J, Gordon JS. User Participation and Engagement With the See Me Smoke-Free mHealth App: Prospective Feasibility Trial. JMIR Mhealth Uhealth 2017; 5:e142. [PMID: 28993302 PMCID: PMC5653904 DOI: 10.2196/mhealth.7900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/08/2017] [Accepted: 08/14/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The See Me Smoke-Free (SMSF) mobile health (mHealth) app was developed to help women quit smoking by targeting concerns about body weight, body image, and self-efficacy through cognitive behavioral techniques and guided imagery audio files addressing smoking, diet, and physical activity. A feasibility trial found associations between SMSF usage and positive treatment outcomes. This paper reports a detailed exploration of program use among eligible individuals consenting to study participation and completing the baseline survey (participants) and ineligible or nonconsenting app installers (nonparticipants), as well as the relationship between program use and treatment outcomes. OBJECTIVE The aim of this study was to determine whether (1) participants were more likely to set quit dates, be current smokers, and report higher levels of smoking at baseline than nonparticipants; (2) participants opened the app and listened to audio files more frequently than nonparticipants; and (3) participants with more app usage had a higher likelihood of self-reported smoking abstinence at follow up. METHODS The SMSF feasibility trial was a single arm, within-subjects, prospective cohort study with assessments at baseline and 30 and 90 days post enrollment. The SMSF app was deployed on the Google Play Store for download, and basic profile characteristics were obtained for all app installers. Additional variables were assessed for study participants. Participants were prompted to use the app daily during study participation. Crude differences in baseline characteristics between trial participants and nonparticipants were evaluated using t tests (continuous variables) and Fisher exact tests (categorical variables). Exact Poisson tests were used to assess group-level differences in mean usage rates over the full study period using aggregate Google Analytics data on participation and usage. Negative binomial regression models were used to estimate associations of app usage with participant baseline characteristics after adjustment for putative confounders. Associations between app usage and self-reported smoking abstinence were assessed using separate logistic regression models for each outcome measure. RESULTS Participants (n=151) were more likely than nonparticipants (n=96) to report female gender (P<.02) and smoking in the 30 days before enrollment (P<.001). Participants and nonparticipants opened the app and updated quit dates at the same average rate (rate ratio [RR] 0.98; 95% CI 0.92-1.04; P=.43), but participants started audio files (RR 1.07; 95% CI 1.00-1.13; P<.04) and completed audio files (RR 1.11; 95% CI 1.03-1.18; P<.003) at significantly higher rates than nonparticipants. Higher app usage among participants was positively associated with some smoking cessation outcomes. CONCLUSIONS This study suggests potential efficacy of the SMSF app, as increased usage was generally associated with higher self-reported smoking abstinence. A planned randomized controlled trial will assess the SMSF app's efficacy as an intervention tool to help women quit smoking.
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Affiliation(s)
- Chris A Schmidt
- College of Public Health, University of Arizona, Tucson, AZ, United States
| | - James K Romine
- College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Melanie L Bell
- College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Family and Community Medicine, University of Arizona, Tucson, AZ, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
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11
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Gordon JS, Armin J, D Hingle M, Giacobbi P, Cunningham JK, Johnson T, Abbate K, Howe CL, Roe DJ. Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers. Transl Behav Med 2017; 7:172-184. [PMID: 28155107 PMCID: PMC5526811 DOI: 10.1007/s13142-017-0463-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.
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Affiliation(s)
- Judith S Gordon
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Julie Armin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Peter Giacobbi
- College of Physical Activity and Sports Sciences, University of West Virginia, Morgantown, WV, USA
| | - James K Cunningham
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Thienne Johnson
- Departments of Computer Science and Electrical and Computer Engineering, University of Arizona, Tucson, AZ, USA
| | | | - Carol L Howe
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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