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Rodríguez-Bolaños R, Ramírez-Palacios P, Bolaños A, Lara D, Millan G, Gallegos-Carrillo K, Flores YN, Mejia RM, Cupertino AP, Cartujano-Barrera F. Decídetexto México: Recruitment and baseline characteristics of Mexican individuals who smoke in a cessation study. Tob Use Insights 2023; 16:1179173X231157378. [PMID: 37425216 PMCID: PMC10326465 DOI: 10.1177/1179173x231157378] [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] [Indexed: 09/20/2023] Open
Abstract
The objective of this study was to evaluate the effectiveness of digital and traditional methods and strategies in the recruitment of Mexican individuals who smoke into a cessation study. Recruitment method refers in general to either digital or traditional recruitment. Recruitment strategies refer to the particular recruitment type utilized within each recruitment method. Traditional recruitment strategies included radio interviews, word of mouth, newspaper advertisement, posters/banners placed in primary healthcare clinics, and medical referrals. Digital recruitment strategies involved emails and study advertisements through social media (i.e., Facebook, Instagram and Twitter) and website. In a 4-month period, 100 Mexican individuals who smoke were successfully enrolled into a smoking cessation study. The majority of participants were enrolled via traditional recruitment strategies (86%) compared to the digital recruitment strategies (14%). Individuals screened in the digital method were more likely to be eligible to participate in the study, compared to the traditional method. Similarly, in comparison to the traditional method, individuals in the digital method were more likely to enroll in the study. However, these differences were not statistically significant. Both traditional and digital strategies made important contributions to the overall recruitment effort.
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Affiliation(s)
| | - Paula Ramírez-Palacios
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Alejandra Bolaños
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Daimarelys Lara
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
| | - Gabriel Millan
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Katia Gallegos-Carrillo
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Yvonne N Flores
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Raúl M Mejia
- Departamento de Medicina
Ambulatoria, Universidad de Buenos
Aires, Buenos Aires, Argentina
| | - Ana Paula Cupertino
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
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Cartujano-Barrera F, Cox LS, Catley D, Shah Z, Alpert AB, Cupertino AP. "I'm a transgender man… I have to quit smoking for treatment and surgery": Describing the experience of a Latino transgender man during his attempt to quit smoking. Explore (NY) 2023; 19:131-135. [PMID: 34823998 PMCID: PMC9110554 DOI: 10.1016/j.explore.2021.11.005] [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: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the experience of a Latino transgender man during his attempt to quit smoking using a text messaging intervention. METHODS A Latino transgender man enrolled in a smoking cessation randomized controlled trial for Latino smokers. The participant was randomized to Decídetexto, a smoking cessation mobile intervention. The participant received a 24-week text messaging intervention. We assessed text messaging interactivity with the program, satisfaction, and self-reported abstinence at Week 12 and Month 6. RESULTS During the 24-week intervention period, the participant sent a total of 287 text messages to the program. When analyzing the content of the text messages sent by the participants, four important themes were identified: 1) gender identity, 2) low social support, 3) stressors (e.g., gender dysphoria), and 4) gender affirmation surgery as a reason to quit smoking. At both Week 12 and Month 6, the participant reported being extremely satisfied with the intervention and self-reported cigarette use. CONCLUSION A smoking cessation mobile intervention generated high satisfaction and frequent interactivity among a Latino transgender man. This case report provides important insights into the experience of one Latino transgender man during his attempt to quit smoking. There is an urgent need to develop or adapt existing smoking cessation interventions to better meet the needs of transgender people.
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Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, United States
| | - Zainab Shah
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ash B Alpert
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ana Paula Cupertino
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
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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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Telehealth interventions for substance use disorders in low- and- middle income countries: A scoping review. PLOS DIGITAL HEALTH 2022; 1:e0000125. [PMID: 36812539 PMCID: PMC9931245 DOI: 10.1371/journal.pdig.0000125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/09/2022] [Indexed: 02/24/2023]
Abstract
The increasing prevalence and magnitude of harmful effects of substance use disorders (SUDs) in low- and middle-income countries (LMICs) make it imperative to embrace interventions which are acceptable, feasible, and effective in reducing this burden. Globally, the use of telehealth interventions is increasingly being explored as possible effective approaches in the management of SUDs. Using a scoping review of literature, this article summarizes and evaluates evidence for the acceptability, feasibility, and effectiveness of telehealth interventions for SUDs in LMICs. Searches were conducted in five bibliographic databases: PubMed, Psych INFO, Web of Science, Cumulative Index of Nursing and Allied Professionals and the Cochrane database of systematic review. Studies from LMICs which described a telehealth modality, identified at least one psychoactive substance use among participants, and methods that either compared outcomes using pre- and post-intervention data, treatment versus comparison groups, post-intervention data, behavioral or health outcome, and outcome of either acceptability, feasibility, and/or effectiveness were included. Data is presented in a narrative summary using charts, graphs, and tables. The search produced 39 articles across 14 countries which fulfilled our eligibility criteria over a period of 10 years (2010 to 2020). Research on this topic increased remarkably in the latter five years with the highest number of studies in 2019. The identified studies were heterogeneous in their methods and various telecommunication modalities were used to evaluate substance use disorder, with cigarette smoking as the most assessed. Most studies used quantitative methods. The highest number of included studies were from China and Brazil, and only two studies from Africa assessed telehealth interventions for SUDs. There has been an increasingly significant body of literature which evaluates telehealth interventions for SUDs in LMICs. Overall, telehealth interventions showed promising acceptability, feasibility, and effectiveness for SUDs. This article identifies gaps and strengths and suggests directions for future research.
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Cartujano-Barrera F, Cox LS, Castro EM, Lara D, Quiñones Z, McIntosh S, Ossip DJ, Cupertino AP. Cigarro or Cigarrillo? The Pressing Need to Use Culturally and Linguistically Appropriate Terminology for Tobacco Control Among Spanish-speaking Latinos. Nicotine Tob Res 2022; 24:1840-1841. [PMID: 35536746 DOI: 10.1093/ntr/ntac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eida M Castro
- Department of Psychiatry and Human Behavior, Ponce Health Sciences University, Ponce, PR, USA
| | - Daimarelys Lara
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Zahira Quiñones
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Santiago-Torres M, Mull KE, Sullivan BM, Zvolensky MJ, Bricker JB. Can a smartphone application help Hispanic/Latinx adults quit smoking? A randomized trial secondary analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 26:261-270. [PMID: 36437818 PMCID: PMC9683384 DOI: 10.1016/j.jcbs.2022.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction There are no known efficacious digital smoking cessation interventions for Hispanic/Latinx adults who smoke. This study is a secondary analysis using data from a randomized trial to evaluate whether Acceptance and Commitment Therapy (ACT) delivered via a smartphone app (iCanQuit) would be more efficacious for smoking cessation than the US Clinical Practice (USCPG)-based app (QuitGuide) in a sample of Hispanic/Latinx participants. Methods A total of 210 Hispanic/Latinx adults who smoke were randomized to receive the iCanQuit or QuitGuide app for 12-months. Participants self-reported on 30-day abstinence from cigarette smoking at the 3-month, 6-month, and 12-month follow-ups; 7-day abstinence at all follow-ups; abstinence from other nicotine/tobacco products at 12-months; and continuous prolonged abstinence from 3 to 12-months. Participants also reported on their willingness to accept cues to smoke without smoking and satisfaction with their apps. Results A total of 176 (84%) participants reported on study outcomes at the 12-month follow-up. Compared to QuitGuide participants, iCanQuit participants were significantly more likely to report 30-day abstinence from cigarette smoking at 12-months (34% iCanQuit, 20% QuitGuide; p=0.026). iCanQuit participants utilized their app more frequently and reported greater satisfaction with their assigned app than those who received the QuitGuide app. Increases in participants' willingness to accept cues to smoke mediated the intervention effect on abstinence from cigarette smoking at 12-months. Conclusions Acceptance and Commitment Therapy-delivered via a smartphone app may be efficacious for helping Hispanic/Latinx adults abstain from cigarette smoking. Replication in a fully powered randomized trial that focuses on an independent sample of Hispanic/Latinx adults is now needed.
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Affiliation(s)
- Margarita Santiago-Torres
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington, USA
| | - Kristin E. Mull
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington, USA
| | - Brianna M. Sullivan
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington, USA
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology, 3695 Cullen Blvd., Room 126, Houston, Texas, 77204, USA
- University of Houston, HEALTH Institutive, 4849 Calhoun Rd. Houston, Texas, 77204, USA
- University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Houston, Texas, 77030, USA
| | - Jonathan B. Bricker
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington, USA
- University of Washington, Department of Psychology, Seattle, Washington, USA
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Desmal AJ, Hamid S, Othman MK, Zolait A. A user satisfaction model for mobile government services: a literature review. PeerJ Comput Sci 2022; 8:e1074. [PMID: 36091981 PMCID: PMC9455267 DOI: 10.7717/peerj-cs.1074] [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: 05/16/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
User satisfaction is essential for the success of an organisation. With the development of government service delivery through mobile platforms, a compatible measurement model must be found to measure user satisfaction with performing such services through a mobile government portal. Measuring user satisfaction with mobile government services is necessary nowadays due to the increasing popularity of smart devices. Research on mGovernment users' satisfaction is lacking, leading to difficulties in understanding users' expectations. In the present study, systematic literature reviews have been used to analyze users' satisfaction with mGovernment portals and propose a comprehensive model compatible with such contexts. The results show that government agencies can evaluate users' satisfaction using the proposed model of six quality constructs: usability, interaction, consistency, information, accessibility, and privacy and security. The study recommends improving the evaluation strategies of mGovernment portals regularly to ensure they fit with challenges. Measuring user satisfaction at mGovernment services encourages the user to perform the transactions through such online platforms, increasing the digitalization process and reducing the cost and efforts for both the service provider and end-users.
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Affiliation(s)
- Abdulla Jaafar Desmal
- Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Suraya Hamid
- Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Khalit Othman
- Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ali Zolait
- College of Information Technology, University of Bahrain, Sakheer, Bahrain
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Web-delivered Acceptance and Commitment Therapy (ACT) for smoking cessation: Is it engaging and efficacious for US Hispanic/Latinx adult smokers? Prev Med Rep 2022; 29:101952. [PMID: 36161119 PMCID: PMC9501988 DOI: 10.1016/j.pmedr.2022.101952] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 11/23/2022] Open
Abstract
Hispanic/Latinx adult smokers in the United States (US) face barriers to receiving and utilizing evidenced-based cessation treatments compared with other racial/ethnic groups. The lack of efficacious and accessible smoking cessation treatments for this population further contributes to such smoking disparities. In a secondary analysis, we explored the efficacy of an Acceptance and Commitment Therapy (ACT)-based website (WebQuit.org) versus a US Clinical Practice Guidelines (USCPG)-based website (Smokefree.gov) for smoking cessation in a subset of Hispanic/Latinx adult participants enrolled in the WebQuit trial. Of the 2,637 participants who were randomized in the parent trial, 222 were Hispanic/Latinx (n = 101 in WebQuit, n = 121 in Smokefree). Smoking cessation outcomes were measured at 3, 6, and 12-months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12-months. Treatment engagement and satisfaction, change in acceptance of urges to smoke, and commitment to quitting smoking were compared across conditions. Retention rate was 88% at 12-months. WebQuit participants had higher odds of smoking cessation compared to Smokefree participants at 12-months (40% vs. 25%; OR = 1.93 95% CI: 1.04, 3.59). Findings were similar using multiple imputation. WebQuit participants engaged more with the website than Smokefree participants through multiple indicators of engagement, including spending more time using the website (IRR = 2.32; 95% CI: 1.68, 3.20). Although WebQuit participants engaged more with the website than Smokefree participants, there was no evidence that differences in quit rates were mediated by engagement level. This study provides initial empirical evidence that digital interventions may be efficacious for helping Hispanic/Latinx adults quit smoking.
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Key Words
- ACT, Acceptance and Commitment Therapy
- Acceptance and commitment therapy
- CI, 95% confidence interval
- FTND, Fagerström Test for Nicotine Dependence
- Hispanic
- IRR, Incidence Rate Ratio
- LGB, lesbian, gay, or bisexual
- Latino(a) or Latinx
- OR, odds ratio
- PE, point estimate
- PPA, point-prevalence abstinence
- RCT, randomized clinical trial
- Smokefree.gov
- Smoking cessation
- US, United States
- USCPG, US Clinical Practice Guidelines
- Web-based interventions
- WebQuit.org
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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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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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Larkin C, Wijesundara J, Nguyen HL, Ha DA, Vuong A, Nguyen CK, Amante D, Ngo CQ, Phan PT, Pham QTL, Nguyen BN, Nguyen ATP, Nguyen PTT, Person S, Allison JJ, Houston TK, Sadasivam R. mHealth Messaging to Motivate Quitline Use and Quitting: Protocol for a Community-Based Randomized Controlled Trial in Rural Vietnam. JMIR Res Protoc 2021; 10:e30947. [PMID: 34617915 PMCID: PMC8532014 DOI: 10.2196/30947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tobacco kills more than 8 million people each year, mostly in low- and middle-income countries. In Vietnam, 1 in every 2 male adults smokes tobacco. Vietnam has set up telephone Quitline counseling that is available to all smokers, but it is underused. We previously developed an automated and effective motivational text messaging system to support smoking cessation among US smokers. OBJECTIVE The aim of this study is to adapt the aforementioned system for rural Vietnamese smokers to promote cessation of tobacco use, both directly and by increasing the use of telephone Quitline counseling services and nicotine replacement therapy. Moreover, we seek to enhance research and health service capacity in Vietnam. METHODS We are testing the effectiveness of our culturally adapted motivational text messaging system by using a community-based randomized controlled trial design (N=600). Participants were randomly allocated to the intervention (regular motivational and assessment text messages) or control condition (assessment text messages only) for a period of 6 months. Trial recruitment took place in four communes in the Hung Yen province in the Red River Delta region of Vietnam. Recruitment events were advertised to the local community, facilitated by community health workers, and occurred in the commune health center. We are assessing the impact of the texting system on 6-month self-reported and biochemically verified smoking cessation, as well as smoking self-efficacy, uptake of the Quitline, and use of nicotine replacement therapy. In addition to conducting the trial, the research team also provided ongoing training and consultation with the Quitline during the study period. RESULTS Site preparation, staff training, intervention adaptation, participant recruitment, and baseline data collection were completed. The study was funded in August 2017; it was reviewed and approved by the University of Massachusetts Medical School Institutional Review Board in 2017. Recruitment began in November 2018. A total of 750 participants were recruited from four communes, and 700 (93.3%) participants completed follow-up by March 2021. An analysis of the trial results is in progress; results are expected to be published in late 2022. CONCLUSIONS This study examines the effectiveness of mobile health interventions for smoking in rural areas in low- and middle-income countries, which can be implemented nationwide if proven effective. In addition, it also facilitates significant collaboration and capacity building among a variety of international partners, including researchers, policy makers, Quitline counselors, and community health workers. TRIAL REGISTRATION ClinicalTrials.gov NCT03567993; https://clinicaltrials.gov/ct2/show/NCT03567993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30947.
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Affiliation(s)
- Celine Larkin
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jessica Wijesundara
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Hoa L Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Duc Anh Ha
- Vietnam Ministry of Health, Hanoi, Vietnam
| | - Anh Vuong
- Institute of Population, Health and Development, Hanoi, Vietnam
| | | | - Daniel Amante
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Chau Quy Ngo
- Respiratory Center, Bach Mai Hospital, Hanoi, Vietnam
| | | | | | | | | | | | - Sharina Person
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jeroan J Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Thomas K Houston
- Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC, United States
| | - Rajani Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 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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Pérez-Rubio G, López-Flores LA, Cupertino AP, Cartujano-Barrera F, Reynales-Shigematsu LM, Ramírez M, Ellerbeck EF, Rodríguez-Bolaños R, Falfan-Valencia R. Genetic Variants in Smoking-Related Genes in Two Smoking Cessation Programs: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126597. [PMID: 34205269 PMCID: PMC8296383 DOI: 10.3390/ijerph18126597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 12/15/2022]
Abstract
Previous studies have identified variants in genes encoding proteins associated with the degree of addiction, smoking onset, and cessation. We aimed to describe thirty-one single nucleotide polymorphisms (SNPs) in seven candidate genomic regions spanning six genes associated with tobacco-smoking in a cross-sectional study from two different interventions for quitting smoking: (1) thirty-eight smokers were recruited via multimedia to participate in e-Decídete! program (e-Dec) and (2) ninety-four attended an institutional smoking cessation program on-site. SNPs genotyping was done by real-time PCR using TaqMan probes. The analysis of alleles and genotypes was carried out using the EpiInfo v7. on-site subjects had more years smoking and tobacco index than e-Dec smokers (p < 0.05, both); in CYP2A6 we found differences in the rs28399433 (p < 0.01), the e-Dec group had a higher frequency of TT genotype (0.78 vs. 0.35), and TG genotype frequency was higher in the on-site group (0.63 vs. 0.18), same as GG genotype (0.03 vs. 0.02). Moreover, three SNPs in NRXN1, two in CHRNA3, and two in CHRNA5 had differences in genotype frequencies (p < 0.01). Cigarettes per day were different (p < 0.05) in the metabolizer classification by CYP2A6 alleles. In conclusion, subjects attending a mobile smoking cessation intervention smoked fewer cigarettes per day, by fewer years, and by fewer cumulative pack-years. There were differences in the genotype frequencies of SNPs in genes related to nicotine metabolism and nicotine dependence. Slow metabolizers smoked more cigarettes per day than intermediate and normal metabolizers.
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Affiliation(s)
- Gloria Pérez-Rubio
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, Mexico City 14080, Mexico; (G.P.-R.); (L.A.L.-F.)
| | - Luis Alberto López-Flores
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, Mexico City 14080, Mexico; (G.P.-R.); (L.A.L.-F.)
| | - Ana Paula Cupertino
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ 07601, USA; (A.P.C.); (F.C.-B.)
| | - Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ 07601, USA; (A.P.C.); (F.C.-B.)
| | | | - Mariana Ramírez
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.R.); (E.F.E.)
| | - Edward F. Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.R.); (E.F.E.)
| | - Rosibel Rodríguez-Bolaños
- Department of Tobacco Research, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (L.M.R.-S.); (R.R.-B.)
| | - Ramcés Falfan-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, Mexico City 14080, Mexico; (G.P.-R.); (L.A.L.-F.)
- Correspondence: ; Tel.: +52-55-5487-1700 (ext. 5152)
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14
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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, 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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16
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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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17
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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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18
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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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19
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Pallejà-Millán M, Rey-Reñones C, Barrera Uriarte ML, Granado-Font E, Basora J, Flores-Mateo G, Duch J. Evaluation of the Tobbstop Mobile App for Smoking Cessation: Cluster Randomized Controlled Clinical Trial. JMIR Mhealth Uhealth 2020; 8:e15951. [PMID: 32589153 PMCID: PMC7381259 DOI: 10.2196/15951] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/09/2019] [Accepted: 03/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mobile apps provide an accessible way to test new health-related methodologies. Tobacco is still the primary preventable cause of death in industrialized countries, constituting an important public health issue. New technologies provide novel opportunities that are effective in the cessation of smoking tobacco. OBJECTIVE This paper aims to evaluate the efficacy and usage of a mobile app for assisting adult smokers to quit smoking. METHODS We conducted a cluster randomized clinical trial. We included smokers older than 18 years who were motivated to stop smoking and used a mobile phone compatible with our mobile app. We carried out follow-up visits at 15, 30, and 45 days, and at 2, 3, 6, and 12 months. Participants of the intervention group had access to the Tobbstop mobile app designed by the research team. The primary outcomes were continuous smoking abstinence at 3 and 12 months. RESULTS A total of 773 participants were included in the trial, of which 602 (77.9%) began the study on their D-Day. Of participants in the intervention group, 34.15% (97/284) did not use the app. The continuous abstention level was significantly larger in the intervention group participants who used the app than in those who did not use the app at both 3 months (72/187, 38.5% vs 13/97, 13.4%; P<.001) and 12 months (39/187, 20.9% vs 8/97, 8.25%; P=.01). Participants in the intervention group who used the app regularly and correctly had a higher probability of not being smokers at 12 months (OR 7.20, 95% CI 2.14-24.20; P=.001) than the participants of the CG. CONCLUSIONS Regular use of an app for smoking cessation is effective in comparison with standard clinical practice. TRIAL REGISTRATION Clinicaltrials.gov NCT01734421; https://clinicaltrials.gov/ct2/show/NCT01734421.
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Affiliation(s)
- Meritxell Pallejà-Millán
- Unitat de Suport a la Recerca Camp de Tarragona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Reus, Spain.,Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Reus, Spain
| | - Cristina Rey-Reñones
- Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Reus, Spain.,Institut Català de la Salut, Unitat de Suport a la Recerca Camp de Tarragona, Reus, Spain
| | - Maria Luisa Barrera Uriarte
- Institut Català de la Salut, Unitat de Suport a la Recerca Camp de Tarragona, Reus, Spain.,Equip d'Atenció Primaria La Granja (Tarragona-2), Direcció d'Atenció Primaria Camp de Tarragona, Institut Català de la Salut, Torreforta, Spain
| | - Esther Granado-Font
- Institut Català de la Salut, Unitat de Suport a la Recerca Camp de Tarragona, Reus, Spain.,Equip d'Atenció Primaria Horts de Miró (Reus-4), Direcció d'Atenció Primaria Camp de Tarragona, Institut Català de la Salut, Reus, Spain
| | - Josep Basora
- Unitat de Suport a la Recerca Camp de Tarragona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Reus, Spain.,Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Reus, Spain
| | - Gemma Flores-Mateo
- Unitat de Suport a la Recerca Camp de Tarragona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Reus, Spain.,Unitat d'Anàlisi i Qualitat, Xarxa Sanitària i Social Santa Tecla, Tarragona, Spain
| | - Jordi Duch
- Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Tarragona, Spain
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20
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Cartujano-Barrera F, Rodríguez-Bolaños R, Arana-Chicas E, Gallegos-Carrillo K, N Flores Y, Pérez-Rubio G, Falfán-Valencia R, F Ellerbeck E, Reynales-Shigematsu LM, Cupertino AP. Enhancing nicotine replacement therapy usage and adherence through a mobile intervention: Secondary data analysis of a single-arm feasibility study in Mexico. Tob Induc Dis 2020; 18:36. [PMID: 32395099 PMCID: PMC7206510 DOI: 10.18332/tid/120076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/25/2020] [Accepted: 04/05/2020] [Indexed: 11/24/2022] Open
Abstract
INSTRODUCTION Nicotine Replacement Therapy (NRT) is an effective treatment for smoking cessation. However, medication usage and adherence remain a challenge that contributes to low smoking cessation rates. In Mexico, 8 in 10 smokers are interested in quitting. However, only 6% of Mexican smokers use medication for smoking cessation. The objective of this study is to assess the feasibility and acceptability of a mobile health (mHealth) intervention to increase usage and adherence of NRT in Mexico. METHODS The study involves a secondary data analysis. Forty smokers were recruited to participate in a single-arm pilot study. Participants received an mHealth intervention that uses tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. The intervention allows two-way interactivity text messaging between participants and a tobacco treatment specialist. NRT was offered to participants in accordance with practice guidelines in Mexico. Outcome measures included utilization of NRT, text messaging interactivity with the program, and biochemically verified abstinence at 12 weeks. RESULTS Thirty smokers met the criteria for use of NRT. Average age of participants was 38.1 years (SD=10.7), and they were primarily male (56.7%) with at least an undergraduate degree (60%). All participants requested NRT at baseline, and 60% requested a refill at week 4. During the 12-week intervention period, participants sent 620 messages to the program (mean=20.6, SD=18.34) of which 79 messages (12.7%) were related to NRT. Three themes were identified in the messages related to NRT: enthusiasm, instructions, and side effects. At 12 weeks, 40% of participants reported using NRT <75% of the days. Finally, 30% of participants (9/30) were biochemically verified abstinent using intention-to-treat analysis at 12 weeks. CONCLUSIONS An mHealth intervention appears to offer a promising strategy to increase usage and adherence of NRT in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, United States
| | | | - Evelyn Arana-Chicas
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, United States
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, United States
| | - Gloria Pérez-Rubio
- Laboratorio HLA, Instituto Nacional de Enfermedades Respiratorias, Ciudad de Mexico, Mexico
| | - Ramcés Falfán-Valencia
- Laboratorio HLA, Instituto Nacional de Enfermedades Respiratorias, Ciudad de Mexico, Mexico
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, United States
| | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, United States
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Carrasco-Hernandez L, Jódar-Sánchez F, Núñez-Benjumea F, Moreno Conde J, Mesa González M, Civit-Balcells A, Hors-Fraile S, Parra-Calderón CL, Bamidis PD, Ortega-Ruiz F. A Mobile Health Solution Complementing Psychopharmacology-Supported Smoking Cessation: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e17530. [PMID: 32338624 PMCID: PMC7215523 DOI: 10.2196/17530] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/03/2020] [Accepted: 03/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background Smoking cessation is a persistent leading public health challenge. Mobile health (mHealth) solutions are emerging to improve smoking cessation treatments. Previous approaches have proposed supporting cessation with tailored motivational messages. Some managed to provide short-term improvements in smoking cessation. Yet, these approaches were either static in terms of personalization or human-based nonscalable solutions. Additionally, long-term effects were neither presented nor assessed in combination with existing psychopharmacological therapies. Objective This study aimed to analyze the long-term efficacy of a mobile app supporting psychopharmacological therapy for smoking cessation and complementarily assess the involved innovative technology. Methods A 12-month, randomized, open-label, parallel-group trial comparing smoking cessation rates was performed at Virgen del Rocío University Hospital in Seville (Spain). Smokers were randomly allocated to a control group (CG) receiving usual care (psychopharmacological treatment, n=120) or an intervention group (IG) receiving psychopharmacological treatment and using a mobile app providing artificial intelligence–generated and tailored smoking cessation support messages (n=120). The secondary objectives were to analyze health-related quality of life and monitor healthy lifestyle and physical exercise habits. Safety was assessed according to the presence of adverse events related to the pharmacological therapy. Per-protocol and intention-to-treat analyses were performed. Incomplete data and multinomial regression analyses were performed to assess the variables influencing participant cessation probability. The technical solution was assessed according to the precision of the tailored motivational smoking cessation messages and user engagement. Cessation and no cessation subgroups were compared using t tests. A voluntary satisfaction questionnaire was administered at the end of the intervention to all participants who completed the trial. Results In the IG, abstinence was 2.75 times higher (adjusted OR 3.45, P=.01) in the per-protocol analysis and 2.15 times higher (adjusted OR 3.13, P=.002) in the intention-to-treat analysis. Lost data analysis and multinomial logistic models showed different patterns in participants who dropped out. Regarding safety, 14 of 120 (11.7%) IG participants and 13 of 120 (10.8%) CG participants had 19 and 23 adverse events, respectively (P=.84). None of the clinical secondary objective measures showed relevant differences between the groups. The system was able to learn and tailor messages for improved effectiveness in supporting smoking cessation but was unable to reduce the time between a message being sent and opened. In either case, there was no relevant difference between the cessation and no cessation subgroups. However, a significant difference was found in system engagement at 6 months (P=.04) but not in all subsequent months. High system appreciation was reported at the end of the study. Conclusions The proposed mHealth solution complementing psychopharmacological therapy showed greater efficacy for achieving 1-year tobacco abstinence as compared with psychopharmacological therapy alone. It provides a basis for artificial intelligence–based future approaches. Trial Registration ClinicalTrials.gov NCT03553173; https://clinicaltrials.gov/ct2/show/NCT03553173 International Registered Report Identifier (IRRID) RR2-10.2196/12464
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Affiliation(s)
- Laura Carrasco-Hernandez
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Carlos III Institute of Health, Madrid, Spain
| | - Francisco Jódar-Sánchez
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Francisco Núñez-Benjumea
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Jesús Moreno Conde
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Marco Mesa González
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Seville, Spain
| | - Antón Civit-Balcells
- Department of Architecture and Computer Technology, School of Computer Engineering, Universidad de Sevilla, Seville, Spain
| | | | - Carlos Luis Parra-Calderón
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital, Spanish National Research Council, University of Seville, Seville, Spain
| | - Panagiotis D Bamidis
- Medical Physics Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Francisco Ortega-Ruiz
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Seville, Spain
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22
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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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23
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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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