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Elliott SA, Bialy L, Scott SD, Hartling L. Exploring methods for creating or adapting knowledge mobilization products for culturally and linguistically diverse audiences: a scoping review. Arch Public Health 2024; 82:111. [PMID: 39034399 PMCID: PMC11265177 DOI: 10.1186/s13690-024-01334-0] [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: 02/12/2024] [Accepted: 06/29/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. METHODS We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations ('surface' and/or 'deep' structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. RESULTS Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. CONCLUSION Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. REGISTRATION Protocol submitted to Open Science Framework on August 16, 2022 ( https://osf.io/9jcw4/ ).
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Liza Bialy
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Shannon D Scott
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Puljević C, Meciar I, Holland A, Stjepanović D, Snoswell CL, Thomas EE, Morphett K, Kang H, Chan G, Grobler E, Gartner CE. Systematic review and meta-analysis of text messaging interventions to support tobacco cessation. Tob Control 2024:tc-2023-058323. [PMID: 38448226 DOI: 10.1136/tc-2023-058323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To review randomised controlled trials (RCTs) investigating the effectiveness of text message-based interventions for smoking cessation, including the effects of dose (number of text messages) and concomitant use of behavioural or pharmacological interventions. DATA SOURCES We searched seven databases (PubMed, CINAHL, PsycINFO, Scopus, EMBASE, Cochrane Library and Web of Science), Google Scholar and the reference lists of relevant publications for RCTs. Eligible studies included participants aged ≥15 years who smoked tobacco at enrolment. STUDY SELECTION One reviewer screened titles and abstracts and two reviewers independently screened full texts of articles. DATA EXTRACTION One of three reviewers independently extracted data on study and intervention characteristics and smoking abstinence rates using Qualtrics software. DATA SYNTHESIS 30 of the 40 included studies reported higher rates of smoking cessation among those receiving text messaging interventions compared with comparators, but only 10 were statistically significant. A meta-analysis of seven RCTs found that participants receiving text messages were significantly more likely to quit smoking compared with participants in no/minimal intervention or 'usual care' conditions (risk ratio 1.87, 95% CI 1.52 to 2.29, p <0.001). Three trials found no benefit from a higher dose of text messages on smoking cessation. Two trials that tested the added benefit of text messaging to pharmacotherapy reported outcomes in favour of adding text messaging. CONCLUSIONS Findings suggest that text messaging-based interventions are effective at promoting smoking cessation. Further research is required to establish if any additional benefit is gained from an increased number of text messages or concurrent pharmacotherapy or behavioural counselling.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Isabel Meciar
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Alice Holland
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Daniel Stjepanović
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Centaine L Snoswell
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Emma E Thomas
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Heewon Kang
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- Seoul National University Institute of Health and Environment, Seoul, South Korea
| | - Gary Chan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Etienne Grobler
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
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Fang YE, Zhang Z, Wang R, Yang B, Chen C, Nisa C, Tong X, Yan LL. Effectiveness of eHealth Smoking Cessation Interventions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e45111. [PMID: 37505802 PMCID: PMC10422176 DOI: 10.2196/45111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/13/2023] [Accepted: 04/24/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Rapid advancements in eHealth and mobile health (mHealth) technologies have driven researchers to design and evaluate numerous technology-based interventions to promote smoking cessation. The evolving nature of cessation interventions emphasizes a strong need for knowledge synthesis. OBJECTIVE This systematic review and meta-analysis aimed to summarize recent evidence from randomized controlled trials regarding the effectiveness of eHealth-based smoking cessation interventions in promoting abstinence and assess nonabstinence outcome indicators, such as cigarette consumption and user satisfaction, via narrative synthesis. METHODS We searched for studies published in English between 2017 and June 30, 2022, in 4 databases: PubMed (including MEDLINE), PsycINFO, Embase, and Cochrane Library. Two independent reviewers performed study screening, data extraction, and quality assessment based on the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. We pooled comparable studies based on the population, follow-up time, intervention, and control characteristics. Two researchers performed an independent meta-analysis on smoking abstinence using the Sidik-Jonkman random-effects model and log risk ratio (RR) as the effect measurement. For studies not included in the meta-analysis, the outcomes were narratively synthesized. RESULTS A total of 464 studies were identified through an initial database search after removing duplicates. Following screening and full-text assessments, we deemed 39 studies (n=37,341 participants) eligible for this review. Of these, 28 studies were shortlisted for meta-analysis. According to the meta-analysis, SMS or app text messaging can significantly increase both short-term (3 months) abstinence (log RR=0.50, 95% CI 0.25-0.75; I2=0.72%) and long-term (6 months) abstinence (log RR=0.77, 95% CI 0.49-1.04; I2=8.65%), relative to minimal cessation support. The frequency of texting did not significantly influence treatment outcomes. mHealth apps may significantly increase abstinence in the short term (log RR=0.76, 95% CI 0.09-1.42; I2=88.02%) but not in the long term (log RR=0.15, 95% CI -0.18 to 0.48; I2=80.06%), in contrast to less intensive cessation support. In addition, personalized or interactive interventions showed a moderate increase in cessation for both the short term (log RR=0.62, 95% CI 0.30-0.94; I2=66.50%) and long term (log RR=0.28, 95% CI 0.04-0.53; I2=73.42%). In contrast, studies without any personalized or interactive features had no significant impact. Finally, the treatment effect was similar between trials that used biochemically verified or self-reported abstinence. Among studies reporting outcomes besides abstinence (n=20), a total of 11 studies reported significantly improved nonabstinence outcomes in cigarette consumption (3/14, 21%) or user satisfaction (8/19, 42%). CONCLUSIONS Our review of 39 randomized controlled trials found that recent eHealth interventions might promote smoking cessation, with mHealth being the dominant approach. Despite their success, the effectiveness of such interventions may diminish with time. The design of more personalized interventions could potentially benefit future studies. TRIAL REGISTRATION PROSPERO CRD42022347104; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347104.
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Affiliation(s)
- Yichen E Fang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Zhixian Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Ray Wang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Bolu Yang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Claudia Nisa
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Division of Social Sciences, Duke Kunshan University, Kunshan, China
| | - Xin Tong
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Data Science Research Center, Duke Kunshan University, Kunshan, China
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Institute for Global Health and Development, Peking University, Beijing, China
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He L, Balaji D, Wiers RW, Antheunis ML, Krahmer E. Effectiveness and Acceptability of Conversational Agents for Smoking Cessation: A Systematic Review and Meta-analysis. Nicotine Tob Res 2023; 25:1241-1250. [PMID: 36507916 PMCID: PMC10256885 DOI: 10.1093/ntr/ntac281] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Conversational agents (CAs; computer programs that use artificial intelligence to simulate a conversation with users through natural language) have evolved considerably in recent years to support healthcare by providing autonomous, interactive, and accessible services, making them potentially useful for supporting smoking cessation. We performed a systematic review and meta-analysis to provide an overarching evaluation of their effectiveness and acceptability to inform future development and adoption. AIMS AND METHODS PsycInfo, Web of Science, ACM Digital Library, IEEE Xplore, Medline, EMBASE, Communication and Mass Media Complete, and CINAHL Complete were searched for studies examining the use of CAs for smoking cessation. Data from eligible studies were extracted and used for random-effects meta-analyses. RESULTS The search yielded 1245 publications with 13 studies eligible for systematic review (total N = 8236) and six studies for random-effects meta-analyses. All studies reported positive effects on cessation-related outcomes. A meta-analysis with randomized controlled trials reporting on abstinence yielded a sample-weighted odds ratio of 1.66 (95% CI = 1.33% to 2.07%, p < .001), favoring CAs over comparison groups. A narrative synthesis of all included studies showed overall high acceptability, while some barriers were identified from user feedback. Overall, included studies were diverse in design with mixed quality, and evidence of publication bias was identified. A lack of theoretical foundations was noted, as well as a clear need for relational communication in future designs. CONCLUSIONS The effectiveness and acceptability of CAs for smoking cessation are promising. However, standardization of reporting and designing of the agents is warranted for a more comprehensive evaluation. IMPLICATIONS This is the first systematic review to provide insight into the use of CAs to support smoking cessation. Our findings demonstrated initial promise in the effectiveness and user acceptability of these agents. We also identified a lack of theoretical and methodological limitations to improve future study design and intervention delivery.
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Affiliation(s)
- Linwei He
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
| | - Divyaa Balaji
- Amsterdam School for Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolijn L Antheunis
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
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Nguyen A, Eschiti V, Bui TC, Nagykaldi Z, Dwyer K. Mobile Health Interventions to Improve Health Behaviors and Healthcare Services among Vietnamese Individuals: A Systematic Review. Healthcare (Basel) 2023; 11:1225. [PMID: 37174767 PMCID: PMC10178109 DOI: 10.3390/healthcare11091225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/14/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this review is to summarize the feasibility, acceptability, and efficacy of interventions that utilize mobile health (mHealth) technology to promote health behavior changes or improve healthcare services among the Vietnamese population. Ovid MEDLINE, CINAHL, EMBASE, Scopus, and Web of Science were used to identify studies published from 2011-2022. Studies utilizing mHealth to promote behavior change and/or improve healthcare services among Vietnamese were included. Studies that included Vietnamese people among other Asians but did not analyze the Vietnamese group separately were excluded. Three independent researchers extracted data using Covidence following PRISMA guidelines. Measures of feasibility, acceptability, and efficacy were synthesized. The ROBINS-I and RoB2 tools were used to evaluate methodological quality. Fourteen articles met inclusion criteria and included 5660 participants. Participants rated high satisfaction, usefulness, and efficacy of mHealth interventions. Short message service was most frequently used to provide health education, support smoking cessation, monitor chronic diseases, provide follow-up, and manage vaccination. Measures of feasibility, acceptability, and efficacy varied across studies; overall findings indicated that mHealth is promising for promoting lifestyle behavior change and improving healthcare services. Cost effectiveness and long-term outcomes of mHealth interventions among the Vietnamese population are unknown and merit further research. Recommendations to integrate mHealth interventions are provided to promote the health of Vietnamese people.
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Affiliation(s)
- Anna Nguyen
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Valerie Eschiti
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Thanh C. Bui
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Zsolt Nagykaldi
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
| | - Kathleen Dwyer
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
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Amiri S, Khan MAB. Digital interventions for smoking abstinence: a systematic review and meta-analysis of randomized control trials. J Addict Dis 2023; 41:4-29. [PMID: 35426355 DOI: 10.1080/10550887.2022.2058300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Technological advancements have improved patients' health and clinical care through digital interventions. This study investigated the effects of digital interventions on smoking abstinence. METHODS PubMed, the Cochrane Library, and Scopus were systematically searched from inception until December 2021. Meta-analysis was carried out using a random-effects model. The degree of heterogeneity, quality, and publication bias of the selected studies was further evaluated. RESULTS A total of 43 randomized control trial studies were eligible for this study. 38,814 participants from 18 countries were included in the analysis. Digital interventions on seven-day point prevalence abstinence (1 month) showed increased smoking abstinence. The odds ratio was 2.02 and confidence interval (CI) was 1.67-2.43; p < 0.001; I2 = 55.1%) . The result for a 30-day point prevalence abstinence (1 month) was 1.63 (CI 1.09-2.46; p = 0.018; I2 = 0%). Digital intervention also had a significant effect on continuous abstinence (odds ratio = 1.68; CI 1.29-2.18; p < 0.001; I2 = 70.1%) and prolonged abstinence (odds ratio = 1.60; CI 1.19-2.15; p = 0.002; I2 = 53.6%). There was evidence of heterogeneity and publication bias. CONCLUSIONS Digital interventions led to increased smoking abstinence and can be a valuable tool in smoking cessation. Further research is required to evaluate the long-term impact of digital interventions on outcomes related to smoking cessation.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Moien A B Khan
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.,Primary Care, NHS North West London, London, UK
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Su Z, Wei X, Cheng A, Zhou X, Li J, Qin R, Liu Y, Xia X, Song Q, Liu Z, Zhao L, Xiao D, Wang C. Real-world utilization and effectiveness of Message-Based Tobacco Cessation Program (mCessation) in Chinese general population (Preprint). J Med Internet Res 2022; 25:e44840. [PMID: 37129934 DOI: 10.2196/44840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/25/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Randomized controlled trials on text message interventions for smoking cessation have shown they are effective and recommended for tobacco control. However, the effectiveness in real-world settings is largely unknown, especially in low- and middle-income countries. OBJECTIVE This study aimed to provide real-world evidence about the utilization and effectiveness of a message-based tobacco cessation program (mCessation) in China. METHODS From May 2021 to September 2022, 16,746 people from the general population participated in the mCessation program provided by the World Health Organization. All participants received text messages on smoking cessation via instant messaging for 6 months, and they were also required to report smoking status. We randomly selected 2500 participants and interviewed them by telephone to determine the 7-day point prevalence abstinence rate at 6 months. Descriptive statistics were used to analyze population characteristics and abstinence rate. Logistic regression analysis was performed to explore risk factors for the abstinence rate. RESULTS Among the 2500 participants, the mean age was 35 years, and most (2407/2500, 96.20%) were male. The prevalence of tobacco dependence and light degree of tobacco dependence were 85.70% (2142/2500) and 89.10% (2228/2500), respectively. For respondents (953/2500, 38.10%), the 7-day point prevalence abstinence rate at 6 months was 21.90% (209/953). Participants older than 40 years or with tobacco dependence had significantly higher abstinence rates than those who were younger than 30 years old (odds ratio [OR] 1.77, 95% CI 1.06-3.29) or without dependence (OR 1.64, 95% CI 1.08-2.51), respectively. However, married people or heavily dependent smokers tended to find it more difficult to successfully quit smoking compared with unmarried people (OR 0.57, 95% CI 0.34-0.93) or lightly dependent smokers (OR 0.16, 95% CI 0.02-0.98), respectively. CONCLUSIONS In a real-world setting, mCessation China was generally acceptable to men and lightly dependent smokers, and it could help 1 in 5 smokers aged 18 years to 67 years quit smoking. However, strategies to increase awareness of young and married adults may improve implementation and abstinence rates.
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Affiliation(s)
- Zheng Su
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaowen Wei
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Anqi Cheng
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinmei Zhou
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinxuan Li
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Rui Qin
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Liu
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Xia
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingqing Song
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Zhao Liu
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Liang Zhao
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dan Xiao
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chen Wang
- Department of Tobacco Control and Prevention of Respiratory Diseases, China-Japan Friendship Hospital, Center of Respiratory Medicine, Beijing, China
- World Health Organization Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Shelley D, Alvarez GG, Nguyen T, Nguyen N, Goldsamt L, Cleland C, Tozan Y, Shuter J, Armstrong-Hough M. Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study. Implement Sci Commun 2022; 3:112. [PMID: 36253834 PMCID: PMC9574833 DOI: 10.1186/s43058-022-00361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking rates remain high in Vietnam, particularly among people living with HIV/AIDS (PLWH), but tobacco cessation services are not available in outpatient HIV clinics (OPCs). The research team is conducting a type II hybrid randomized controlled trial (RCT) comparing the cost-effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV clinics in Vietnam. The study is simultaneously evaluating the implementation processes and outcomes of strategies aimed at increasing the implementation of tobacco dependence treatment (TDT) in the context of HIV care. This paper describes the systematic, theory-driven process of adapting intervention components and implementation strategies with demonstrated effectiveness in high-income countries, and more recently in Vietnam, to a new population (i.e., PLWH) and new clinical setting, prior to launching the trial. METHODS Data collection and analyses were guided by two implementation science frameworks and the socio-ecological model. Qualitative interviews were conducted with 13 health care providers and 24 patients in three OPCs. Workflow analyses were conducted in each OPC. Qualitative data were analyzed using rapid qualitative analysis procedures. Based on findings, components of the intervention and implementation strategies were adapted, followed by a 3-month pilot study in one OPC with 16 patients randomized to one of two intervention arms. RESULTS The primary adaptations included modifying the TDT intervention counseling content to address barriers to quitting among PLWH and Vietnamese sociocultural norms that support smoking cessation. Implementation strategies (i.e., training and system changes) were adapted to respond to provider- and clinic-level determinants of implementation effectiveness (e.g., knowledge gaps, OPC resource constraints, staffing structure, compatibility). CONCLUSIONS Adaptations were facilitated through a mixed method, stakeholder (patient and health care provider, district health leader)-engaged evaluation of context-specific influences on intervention and implementation effectiveness. This data-driven approach to refining and adapting components aimed to optimize intervention effectiveness and implementation in the context of HIV care. Balancing pragmatism with rigor through the use of rapid analysis procedures and multiple methods increased the feasibility of the adaptation process. TRIAL REGISTRATION ClinicalTrials.gov NCT05162911 . Registered on December 16, 2021.
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Affiliation(s)
- Donna Shelley
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA.
| | | | - Trang Nguyen
- Institute of Social and Medical Studies, 810 CT1A ĐN1, Ham Nghi Street, My Dinh 2 Ward, South Tu Liem District, Hanoi, Vietnam
| | - Nam Nguyen
- Institute of Social and Medical Studies, 810 CT1A ĐN1, Ham Nghi Street, My Dinh 2 Ward, South Tu Liem District, Hanoi, Vietnam
| | - Lloyd Goldsamt
- Rory Meyers College of Nursing, New York University, 433 First Avenue, 7th Floor, New York, NY, USA
| | - Charles Cleland
- Grossman School of Medicine, New York University, 180 Madison Avenue, 2-53, New York, NY, 10016, USA
| | - Yesim Tozan
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA
| | - Jonathan Shuter
- Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th Street, Schiff Pavilion, Bronx, NY, USA
| | - Mari Armstrong-Hough
- School of Global Public Health, New York University, 708 Broadway, New York, NY, USA
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Jiang N, Rogers ES, Cupertino P, Zhao X, Cartujano-Barrera F, Lyu JC, Hu L, Sherman SE. Development of a WeChat-based Mobile Messaging Smoking Cessation Intervention for Chinese Immigrant Smokers: Qualitative Interview Study. JMIR Form Res 2022; 6:e36091. [PMID: 35771603 PMCID: PMC9284363 DOI: 10.2196/36091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 12/01/2022] Open
Abstract
Background Smoking remains a major public health issue among Chinese immigrants. Smoking cessation programs that focus on this population are scarce and have a limited population-level impact due to their low reach. Mobile messaging interventions have the potential to reach large audiences and expand smokers’ access to smoking cessation treatment. Objective This study describes the development of a culturally and linguistically appropriate mobile messaging smoking cessation intervention for Chinese immigrant smokers delivered via WeChat, the most frequently used social media platform among Chinese people globally. Methods This study had 2 phases. In phase 1, we developed a mobile message library based on social cognitive theory and the US Clinical Practice Guidelines for Treating Tobacco Use and Dependence. We culturally adapted messages from 2 social cognitive theory-based text messaging smoking cessation programs (SmokefreeTXT and Decídetexto). We also developed new messages targeting smokers who were not ready to quit smoking and novel content addressing Chinese immigrant smokers’ barriers to quitting and common misconceptions related to willpower and nicotine replacement therapy. In phase 2, we conducted in-depth interviews with 20 Chinese immigrant smokers (including 7 women) in New York City between July and August 2021. The interviews explored the participants’ smoking and quitting experiences followed by assessment of the text messages. Participants reviewed 17 text messages (6 educational messages, 3 self-efficacy messages, and 8 skill messages) via WeChat and rated to what extent the messages enhanced their motivation to quit, promoted confidence in quitting, and increased awareness about quitting strategies. The interviews sought feedback on poorly rated messages, explored participant preferences for content, length, and format, discussed their concerns with WeChat cessation intervention, and solicited recommendations for frequency and timing of messages. Results Overall, participants reported that the messages enhanced their motivation to quit, offered encouragement, and made them more informed about how to quit. Participants particularly liked the messages about the harms of smoking and strategies for quitting. They reported barriers to applying some of the quitting strategies, including coping with stress and staying abstinent at work. Participants expressed strong interest in the WeChat mobile messaging cessation intervention and commented on its potential to expand their access to smoking cessation treatment. Conclusions Mobile messages are well accepted by Chinese immigrant smokers. Research is needed to assess the feasibility, acceptability, and efficacy of WeChat mobile messaging smoking cessation interventions for promoting abstinence among Chinese immigrant smokers.
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Affiliation(s)
- Nan Jiang
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Erin S Rogers
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Paula Cupertino
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Xiaoquan Zhao
- Department of Communication, College of Humanities and Social Sciences, George Mason University, Fairfax, VA, United States
| | | | - Joanne Chen Lyu
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, United States
| | - Lu Hu
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Scott E Sherman
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
- Department of Medicine, Veterans Affairs New York Harbor Healthcare System, New York, NY, United States
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