Urban and Rural Disparities in a WeChat-Based Smoking Cessation Intervention among Chinese Smokers

Efficacy of WeChat-based online smoking cessation intervention ('WeChat WeQuit') in China: a randomised controlled trial

Background

China has approximately 300 million current smokers, and smoking cessation services are limited. This study aimed to assess the efficacy of a Cognitive Behavioral Theory-based smoking cessation intervention ('WeChat WeQuit') via the most popular social media platform in China, WeChat.

Methods

A parallel, single-blind, two-arm randomised controlled trial was conducted via WeChat between March 19, 2020 and November 16, 2022. Chinese-speaking adult smokers (n = 2000) willing to quit within one month were recruited and randomised in a 1:1 ratio. The intervention group (n = 1005) received the 'WeChat WeQuit' program and the control group (n = 955) received control messages for 14 weeks (2-week prequit and 12-week postquit). Participants were followed up to 26 weeks after the quit date. The primary outcome was self-reported continuous smoking abstinence rate, biochemically validated at 26 weeks. The secondary outcomes were self-reported 7-day and continuous abstinence rates at 6 months. All analyses were by intention to treat. The trial is registered at ClinicalTrials.gov (NCT03169686).

Findings

By intention-to-treat analysis, the biochemically verified 26-week continuous abstinence rate was 11.94% in the intervention group and 2.81% in the control group (OR = 4.68, 95% CI: 3.07-7.13, p < 0.0001). The self-reported 7-day abstinence rates ranged from 39.70% at week 1-32.04% at week 26 for the intervention group and 14.17%-11.86% in the control group for weeks 1 and 26, respectively; the self-reported continuous abstinence rates at weeks 1 and 26 ranged from 34.33% to 24.28% and 9.65% to 6.13% in the intervention group and the control group respectively (all p < 0.0001). Participants with low nicotine dependence or previous quit attempts were more likely to successfully quit smoking.

Interpretation

The 'WeChat WeQuit' intervention significantly increased smoking abstinence rates at 6 months and should be considered for treatment-seeking smokers in China.

Funding

The research is supported by the Natural Science Foundation of Hunan Province (2020JJ4794, YLiao), the K.C. Wong Postdoctoral Fellowship for YLiao to study at King's College London, and China Medical Board (CMB) Open Competition Program (grant no. 15-226, 22-485, YLiao).

The preferences for the telemedicine and standard health care services from the perspective of the patients with schizophrenia

BACKGROUND

With the rapid development of telemedicine, has enabled new and various ways to deliver health care services for patients with schizophrenia. However, it is not clear that the newly emerged is better than the standard or not from the perspective of patients with schizophrenia. This study aims to explore their preferences between telemedicine and standard health care services and their associated factors.

METHODS

The cross-sectional study was conducted at the Ningan hospital's inpatient department in Yinchuan, and collected socio-demographic and clinical information, the preferences regarding telemedicine (WeChat, telephone, and Email), and the standard health care services (community health center and home visit). The socio-demographic and clinical characteristics associated with the five-health care service delivery ways were assessed by descriptive analysis, and the associated impact factors of preferences of patients with schizophrenia were analyzed by multiple logistic regression.

RESULTS

Among the 300 participants, most of them chose WeChat (46.3%), some of them tended to telephone (35.4%) and community health center (11.3%), and a few of them accepted home visits (4.7%), and Email (2.3%). There are so many associated factors that affected the patients with schizophrenia to choose their favorite health care services, of which age, gender, employment, residence, and duration of illness were the independent impact factors.

CONCLUSIONS

The cross-sectional study surveyed the preferences between telemedicine and standard health care services in patients with schizophrenia's opinion, disclosed independent impact factors, as well as compared the advantage and disadvantages of these. According to our findings, the best health care services should be based on the preferences of the patients with schizophrenia and adapt to realistic conditions. This provides valuable evidence to improve the health care situation, facilitate the continuity of health care services, and achieve holistic rehabilitative outcomes for the patients with schizophrenia.

A WeChat-based smoking cessation intervention for Chinese smokers: A pilot study

Background

China is the largest tobacco producer and has the highest number of tobacco consumers in the world. Extensive research has demonstrated the utility of social media for smoking cessation. WeChat is the most commonly used social media platform in China, but has not yet been utilized for smoking cessation interventions. The objectives of this study are (1) to evaluate the efficacy of a WeChat-based smoking cessation intervention; and (2) to examine a possible additive effect of integrating oral health and smoking-related information into a tailored, Transtheoretical Model (TTM) guided smoking cessation intervention.

Methods

Eligible adults were recruited through WeChat from July 1 to August 6, 2019, to participate in a 3-arm, single-blinded, randomized controlled trial. We enrolled and randomized 403 participants into three groups: the Standard Group, Enhanced Group, or a Waitlist-Control Group. Participants in the Standard Group received 20 smoking cessation-related messages for 2 weeks; participants in the Enhanced Group received this same protocol plus 6 oral health-related messages over an additional week. Participants in the Control Group received smoking cessation-related messages, after the post-intervention assessment. The primary outcome was TTM Stage of Change, and the secondary outcomes were 7-day Point Prevalence Abstinence (PPA), 24-h PPA, daily cigarette use, and nicotine dependence at 4 weeks follow-up post intervention, comparing intervention groups with the control group. The overall program attrition rate was 46%. Paired t-tests, McNemar tests, and linear and logistic regression were used to examine differences in smoking cessation outcomes within and between groups.

Results

Participants in the Enhanced Group (β = -1.28, 95%CI: -2.13, -0.44) and the Standard Group (β = -1.13, 95%CI: -1.95, -0.30) reported larger changes in nicotine dependence scores, compared to participants in the Waitlist Group. No statistically significant differences were found between the Enhanced Group and the Standard Group.

Discussion

This WeChat-based intervention was effective for smoking cessation overall. The addition of oral health information did not significantly improve the intervention.

Intervention of WeChat Group Guidance in Rapid Rehabilitation after Gynecological Laparoscopic Surgery

Gynecological laparoscopic surgery is the current routine treatment. Although the injury is relatively small, it is still a traumatic operation and also increases the recovery speed of patients. This paper mainly explores the intervention effect of rapid rehabilitation after gynecological laparoscopic surgery by means of WeChat group guidance based on the information adoption model and UTAUT model. Gynecological patients who underwent laparoscopic surgery and met the inclusion and exclusion conditions in a provincial maternal and child health hospital were selected as the research objects. The WeChat intervention group was compared with the nonintervention group, and the oral description score (VRS), comfort score (BCS), and 40-item recovery quality rating scale (QoR-40) were used as the scoring criteria. The results showed that the postoperative VRS and BCS scores in the WeChat intervention group were significantly lower than those in the nonintervention group. The total score of QoR-40 in both groups decreased compared with that before operation, reached the lowest on the first day after operation, and began to rise from the second day. This result is consistent with the patient's postoperative recovery process. After operation, the total score of the WeChat intervention group on days 1 and 2 was higher than that of the non-WeChat intervention group. By comparing the results of the patient's postoperative oral description score (VRS), comfort score (BCS), 40-item recovery quality score scale (QoR-40), etc., it can be shown that the overall recovery quality of the WeChat intervention group was better during these two days. In each section, the oral description score (VRS) and the 40-item recovery quality score scale (QoR-40) indicated that the pain sensation and emotional state scores of patients in the WeChat intervention group were higher than those in the nonintervention group, while the comfort score (BCS) was lower, indicating better comfort in the WeChat intervention group.