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Victor J Strecher - One of the best experts on this subject based on the ideXlab platform.
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the role of engagement in a tailored web based Smoking Cessation Program randomized controlled trial
Journal of Medical Internet Research, 2008Co-Authors: Victor J Strecher, Jennifer Mcclure, Gwen L Alexander, Bibhas Chakraborty, Vijay Nair, Janine Konkel, Sarah M Greene, Mick P Couper, Carola Carlier, Cheryl WieseAbstract:Background: Web-based Programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with Program content predict long-term outcomes? Second, which users are most likely to drop out or disengage from the Program? Third, do particular intervention strategies enhance engagement? Objective: To determine: (1) whether engagement (defined by the number of Web sections opened) in a Web-based Smoking Cessation intervention predicts 6-month abstinence, (2) whether particular sociodemographic and psychographic groups are more likely to have lower engagement, and (3) whether particular components of a Web-based Smoking Cessation Program influence engagement. Methods: A randomized trial of 1866 smokers was used to examine the efficacy of 5 different treatment components of a Web-based Smoking Cessation intervention. The components were: high- versus low-personalized message source, high- versus low-tailored outcome expectation, efficacy expectation, and success story messages. Moreover, the timing of exposure to these sections was manipulated, with participants randomized to either a single unified Web Program with all sections available at once, or sequential exposure to each section over a 5-week period of time. Participants from 2 large health plans enrolled to receive the online behavioral Smoking Cessation Program and a free course of nicotine replacement therapy (patch). The Program included: an introduction section, a section focusing on outcome expectations, 2 sections focusing on efficacy expectations, and a section with a narrative success story (5 sections altogether, each with multiple screens). Most of the analyses were conducted with a stratification of the 2 exposure types. Measures included: sociodemographic and psychosocial characteristics, Web sections opened, perceived message relevance, and Smoking Cessation 6-months following quit date. Results: The total number of Web sections opened was related to subsequent Smoking Cessation. Participants who were younger, were male, or had less formal education were more likely to disengage from the Web-based Cessation Program, particularly when the Program sections were delivered sequentially over time. More personalized source and high-depth tailored self-efficacy components were related to a greater number of Web sections opened. A path analysis model suggested that the impact of high-depth message tailoring on engagement in the sequentially delivered Web Program was mediated by perceived message relevance. Conclusions: Results of this study suggest that one of the mechanisms underlying the impact of Web-based Smoking Cessation interventions is engagement with the Program. The source of the message, the degree of message tailoring, and the timing of exposure appear to influence Web-based Program engagement. [J Med Internet Res 2008;10(5):e36]
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interest in an online Smoking Cessation Program and effective recruitment strategies results from project quit
Journal of Medical Internet Research, 2006Co-Authors: Jennifer B Mcclure, Gwen L Alexander, Sarah M Greene, Cheryl Wiese, Karin E Johnson, Victor J StrecherAbstract:BACKGROUND: The Internet is a promising venue for delivering Smoking Cessation treatment, either as a stand-alone Program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online Smoking Cessation services or how best to recruit smokers to Internet-based Programs. OBJECTIVE: Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support Program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. METHODS: Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). RESULTS: An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. CONCLUSIONS: Smokers were interested in receiving online Smoking Cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this Program were comparable to those seen when smokers are advised to quit and are referred to other forms of Smoking Cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit. [J Med Internet Res 2006;8(3):e14]
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Randomized controlled trial of a web-based computer-tailored Smoking Cessation Program as a supplement to nicotine patch therapy
Addiction, 2005Co-Authors: Victor J Strecher, Saul Shiffman, R WestAbstract:AIM: To assess the efficacy of World Wide Web-based tailored behavioral Smoking Cessation materials among nicotine patch users. DESIGN: Two-group randomized controlled trial. SETTING: World Wide Web in England and Republic of Ireland. PARTICIPANTS: A total of 3971 subjects who purchased a particular brand of nicotine patch and logged-on to use a free web-based behavioral support Program. INTERVENTION: Web-based tailored behavioral Smoking Cessation materials or web-based non-tailored materials. MEASUREMENTS: Twenty-eight-day continuous abstinence rates were assessed by internet-based survey at 6-week follow-up and 10-week continuous rates at 12-week follow-up. FINDINGS: Using three approaches to the analyses of 6- and 12-week outcomes, participants in the tailored condition reported clinically and statistically significantly higher continuous abstinence rates than participants in the non-tailored condition. In our primary analyses using as a denominator all subjects who logged-on to the treatment site at least once, continuous abstinence rates at 6 weeks were 29.0% in the tailored condition versus 23.9% in the non-tailored condition (OR = 1.30; P = 0.0006); at 12 weeks continuous abstinence rates were 22.8% versus 18.1%, respectively (OR = 1.34; P = 0.0006). Moreover, satisfaction with the Program was significantly higher in the tailored than in the non-tailored condition. CONCLUSIONS: The results of this study demonstrate a benefit of the web-based tailored behavioral support materials used in conjunction with nicotine replacement therapy. A web-based Program that collects relevant information from users and tailors the intervention to their specific needs had significant advantages over a web-based non-tailored Cessation Program.
Michele L Ybarra - One of the best experts on this subject based on the ideXlab platform.
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steps in tailoring a text messaging based Smoking Cessation Program for young adults
Journal of Health Communication, 2014Co-Authors: Michele L Ybarra, Tonya L Prescott, Jodi Summers HoltropAbstract:Steps to develop or refine text messaging-based interventions are largely missing from the literature. Here, the authors describe steps in refining Stop My Smoking USA, a text messaging-based Smoking Cessation Program for smokers 18-25 years old. Research activities included the following: needs assessment focus groups (n = 35); a content advisory team to affirm message acceptability (n = 10); and two beta tests to confirm technological feasibility (n = 12 and 28, respectively). Various recruitment strategies were tested to identify the optimal methods to reach young adult smokers ready to quit. Each stage of the refinement process yielded new insights, resulting in improved message content and tone, an effective recruitment strategy, and the identification and subsequent resolution of technology challenges. Findings suggest that young adults prefer messages that provide concrete behavioral strategies to overcome cravings, and which are positive in tone. Craigslist was the most efficient recruitment method and yielded a sample that was racially and economically diverse. Despite a successful beta test of initial technological feasibility, extensive problems were subsequently experienced in a beta test of the technological feasibility of the entire Program. Iterative Program refinement and adaptation on the basis of user input is necessary to ensure salience, while extensive field testing is required to ensure proper functioning of technology-based Programs.
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process evaluation of a mhealth Program lessons learned from stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Patient Education and Counseling, 2014Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, David R StrongAbstract:Abstract Objective Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth Smoking Cessation Program for young adult smokers. Methods 164 18–24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. Results (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of Program messages was the most commonly noted Program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the Program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Conclusion Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and Program features to be even more salient. Practice implications Future young adult mHealth interventions could: Integrate models that are flexible to different “paths” of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys.
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pilot rct results of stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Nicotine & Tobacco Research, 2013Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, Mohammad H Rahbar, David R StrongAbstract:INTRODUCTION: To address the lack of Smoking Cessation Programs available to young adults, Stop My Smoking (SMS) USA, a text messaging-based Smoking Cessation Program, was developed and pilot tested. METHODS: This was a two-arm randomized controlled trial with adaptive randomization (arms were balanced by sex and Smoking level [heavy vs. light]), conducted nationally in the United States. One hundred sixty-four 18- to 25-year-old daily smokers who were seriously thinking about quitting in the next 30 days were randomized to either (a) the 6-week SMS USA intervention (n = 101) or (b) an attention-matched control group aimed at improving sleep and physical activity (n = 63). The main outcome measure was 3-month continuous abstinence, verified by a significant other. Participants but not researchers were blinded to study arm allocation. RESULTS: Based upon intent-to-treat analyses, intervention participants (39%) were significantly more likely than control participants (21%) to have quit at 4 weeks postquit (adjusted odds ratio [aOR] = 3.33, 95% confidence interval [CI]: 1.48, 7.45). Findings were not sustained at 3 months postquit, although rates in the SMS USA group were favored (40% vs. 30%, respectively; aOR = 1.59, 95% CI: 0.78, 3.21). Subsequent analyses suggested that among intervention participants, SMS USA might be more influential for youth not currently enrolled in a higher education (p = .06). CONCLUSIONS: Consistent with pilot studies, the sample was underpowered. Data suggest, however, that the SMS USA Program affects Smoking Cessation rates at 4 weeks postquit. More research is needed before conclusions can be made about long-term impact. Identifying profiles of users for whom the Program may be particularly beneficial also will be important.
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feasibility and acceptability of a text messaging based Smoking Cessation Program in ankara turkey
Journal of Health Communication, 2013Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tulay Bagci A Bosi, Nazmi Bilir, Josephine D Korchmaros, A Salih K EmriAbstract:Data from high-income countries suggest that cell phone–based Smoking Cessation Programs have the potential to affect Cessation rates. There is a paucity of research, however, about the feasibility of cell phone–based Smoking Cessation Programs in lower income countries that have higher Smoking prevalence rates. A one-arm feasibility and acceptability pilot study of SMS Turkey, a text messaging–based Smoking Cessation Program, was conducted in Ankara, the capital of Turkey. The authors recruited 75 daily smokers who were seriously thinking about quitting in the subsequent 30 days into the 6-week SMS Turkey Program. Recruitment was completed in 4 months. Participant retention was high: Almost all (96%) completed the Program, and 84% provided 12-week follow-up data. Most (89%) of the respondents who completed the 4-week follow-up measures (n = 38, 51%) said that the text messages were easy to understand and referred to what they were experiencing and feeling during the quitting process (78%). On the basis o...
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a text messaging based Smoking Cessation Program for adult smokers randomized controlled trial
Journal of Medical Internet Research, 2012Co-Authors: Michele L Ybarra, Tulay Bagci A Bosi, Josephine D Korchmaros, Salih EmriAbstract:Background: Despite promising data in Western countries, there is a dearth of research into the efficacy of text messaging-based Smoking Cessation Programs in other settings, including the Middle East, where Smoking prevalence rates are higher. Objective: This paper reports Cessation rates observed in SMS Turkey, a text messaging-based Smoking Cessation Program for adult smokers in Ankara, Turkey. Methods: This study was a small-scale, parallel-group randomized controlled trial (RCT) conducted in Ankara, Turkey. Participants were adult daily smokers who were seriously thinking about quitting in the next 15 days and living in Ankara, Turkey. The text messaging intervention, SMS Turkey, provided 6 weeks of daily messages aimed at giving participants skills to help them quit Smoking. Messages were sent in an automated fashion, except 2 days and 7 days after the initial quit day. On days 2 and 7, the research assistant manually assigned participants to content “paths” based on whether they were still not Smoking or had relapsed. The control arm received a brochure that provided similar information about Smoking Cessation. The main outcome measure was self-reported 3-month sustained abstinence, verified by carbon monoxide (CO) readings. Neither participants nor researchers were blinded to arm assignment. Results: The 151 participants were randomly assigned to 1 of 2 groups: 76 to the SMS Turkey intervention group and 75 to the brochure control group. Using intention to treat, all 151 participants were included in analyses. Three-month Cessation trends were not significantly higher in the intervention group: 11% intervention vs 5% control had quit (χ 2 1 =1.4, P =.24; R 2 =2.0, 95% CI 0.62-6.3). When the sample was stratified by sex, female intervention participants (14%, n=5) were significantly more likely to have quit at 3 months than female control participants (0%, n=0; χ 2 1 =3.7, P =.05). Among light smokers (ie, those Smoking less than 20 cigarettes per day), intervention participants (17%, n=5) also were significantly more likely to have quit compared to control participants (0%, n=0; χ 2 1 =5.3, P =.02). We noted no difference in Cessation rates for males or heavy smokers. Participants experienced significant technology problems during the study. Some participants received duplicate text messages at least once during the trial; others failed to receive some Program messages. Neither receiving duplicate messages (χ 2 1 =0.12, P =.73), or missing 5 or more Program messages (χ 2 1 =0.75, P =.39) negatively affected quitting rates. Conclusions: Although the study was not powered to detect statistically significant differences, as the primary aim was to provide estimates of effect size that could be used to better inform a power analysis for a larger trial, findings provide optimism that SMS Turkey may be able to affect quitting rates in environments with high Smoking prevalence, such as Ankara, Turkey. The SMS Turkey software Program did not work as well as it did 2 years previous. The system will need to be updated to maintain software compatibility with ongoing technology evolution. Trial Registration: Clinicaltrials.gov NCT00912795 http://clinicaltrials.gov/ct2/show/NCT00912795 (Archived by WebCite at http://www.webcitation.org/6Ch1cIA8l). [J Med Internet Res 2012;14(6):e172]
David R Strong - One of the best experts on this subject based on the ideXlab platform.
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process evaluation of a mhealth Program lessons learned from stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Patient Education and Counseling, 2014Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, David R StrongAbstract:Abstract Objective Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth Smoking Cessation Program for young adult smokers. Methods 164 18–24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. Results (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of Program messages was the most commonly noted Program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the Program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Conclusion Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and Program features to be even more salient. Practice implications Future young adult mHealth interventions could: Integrate models that are flexible to different “paths” of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys.
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pilot rct results of stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Nicotine & Tobacco Research, 2013Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, Mohammad H Rahbar, David R StrongAbstract:INTRODUCTION: To address the lack of Smoking Cessation Programs available to young adults, Stop My Smoking (SMS) USA, a text messaging-based Smoking Cessation Program, was developed and pilot tested. METHODS: This was a two-arm randomized controlled trial with adaptive randomization (arms were balanced by sex and Smoking level [heavy vs. light]), conducted nationally in the United States. One hundred sixty-four 18- to 25-year-old daily smokers who were seriously thinking about quitting in the next 30 days were randomized to either (a) the 6-week SMS USA intervention (n = 101) or (b) an attention-matched control group aimed at improving sleep and physical activity (n = 63). The main outcome measure was 3-month continuous abstinence, verified by a significant other. Participants but not researchers were blinded to study arm allocation. RESULTS: Based upon intent-to-treat analyses, intervention participants (39%) were significantly more likely than control participants (21%) to have quit at 4 weeks postquit (adjusted odds ratio [aOR] = 3.33, 95% confidence interval [CI]: 1.48, 7.45). Findings were not sustained at 3 months postquit, although rates in the SMS USA group were favored (40% vs. 30%, respectively; aOR = 1.59, 95% CI: 0.78, 3.21). Subsequent analyses suggested that among intervention participants, SMS USA might be more influential for youth not currently enrolled in a higher education (p = .06). CONCLUSIONS: Consistent with pilot studies, the sample was underpowered. Data suggest, however, that the SMS USA Program affects Smoking Cessation rates at 4 weeks postquit. More research is needed before conclusions can be made about long-term impact. Identifying profiles of users for whom the Program may be particularly beneficial also will be important.
Cheryl Wiese - One of the best experts on this subject based on the ideXlab platform.
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the role of engagement in a tailored web based Smoking Cessation Program randomized controlled trial
Journal of Medical Internet Research, 2008Co-Authors: Victor J Strecher, Jennifer Mcclure, Gwen L Alexander, Bibhas Chakraborty, Vijay Nair, Janine Konkel, Sarah M Greene, Mick P Couper, Carola Carlier, Cheryl WieseAbstract:Background: Web-based Programs for health promotion, disease prevention, and disease management often experience high rates of attrition. There are 3 questions which are particularly relevant to this issue. First, does engagement with Program content predict long-term outcomes? Second, which users are most likely to drop out or disengage from the Program? Third, do particular intervention strategies enhance engagement? Objective: To determine: (1) whether engagement (defined by the number of Web sections opened) in a Web-based Smoking Cessation intervention predicts 6-month abstinence, (2) whether particular sociodemographic and psychographic groups are more likely to have lower engagement, and (3) whether particular components of a Web-based Smoking Cessation Program influence engagement. Methods: A randomized trial of 1866 smokers was used to examine the efficacy of 5 different treatment components of a Web-based Smoking Cessation intervention. The components were: high- versus low-personalized message source, high- versus low-tailored outcome expectation, efficacy expectation, and success story messages. Moreover, the timing of exposure to these sections was manipulated, with participants randomized to either a single unified Web Program with all sections available at once, or sequential exposure to each section over a 5-week period of time. Participants from 2 large health plans enrolled to receive the online behavioral Smoking Cessation Program and a free course of nicotine replacement therapy (patch). The Program included: an introduction section, a section focusing on outcome expectations, 2 sections focusing on efficacy expectations, and a section with a narrative success story (5 sections altogether, each with multiple screens). Most of the analyses were conducted with a stratification of the 2 exposure types. Measures included: sociodemographic and psychosocial characteristics, Web sections opened, perceived message relevance, and Smoking Cessation 6-months following quit date. Results: The total number of Web sections opened was related to subsequent Smoking Cessation. Participants who were younger, were male, or had less formal education were more likely to disengage from the Web-based Cessation Program, particularly when the Program sections were delivered sequentially over time. More personalized source and high-depth tailored self-efficacy components were related to a greater number of Web sections opened. A path analysis model suggested that the impact of high-depth message tailoring on engagement in the sequentially delivered Web Program was mediated by perceived message relevance. Conclusions: Results of this study suggest that one of the mechanisms underlying the impact of Web-based Smoking Cessation interventions is engagement with the Program. The source of the message, the degree of message tailoring, and the timing of exposure appear to influence Web-based Program engagement. [J Med Internet Res 2008;10(5):e36]
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interest in an online Smoking Cessation Program and effective recruitment strategies results from project quit
Journal of Medical Internet Research, 2006Co-Authors: Jennifer B Mcclure, Gwen L Alexander, Sarah M Greene, Cheryl Wiese, Karin E Johnson, Victor J StrecherAbstract:BACKGROUND: The Internet is a promising venue for delivering Smoking Cessation treatment, either as a stand-alone Program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online Smoking Cessation services or how best to recruit smokers to Internet-based Programs. OBJECTIVE: Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support Program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. METHODS: Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). RESULTS: An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. CONCLUSIONS: Smokers were interested in receiving online Smoking Cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this Program were comparable to those seen when smokers are advised to quit and are referred to other forms of Smoking Cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit. [J Med Internet Res 2006;8(3):e14]
Jodi Summers Holtrop - One of the best experts on this subject based on the ideXlab platform.
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steps in tailoring a text messaging based Smoking Cessation Program for young adults
Journal of Health Communication, 2014Co-Authors: Michele L Ybarra, Tonya L Prescott, Jodi Summers HoltropAbstract:Steps to develop or refine text messaging-based interventions are largely missing from the literature. Here, the authors describe steps in refining Stop My Smoking USA, a text messaging-based Smoking Cessation Program for smokers 18-25 years old. Research activities included the following: needs assessment focus groups (n = 35); a content advisory team to affirm message acceptability (n = 10); and two beta tests to confirm technological feasibility (n = 12 and 28, respectively). Various recruitment strategies were tested to identify the optimal methods to reach young adult smokers ready to quit. Each stage of the refinement process yielded new insights, resulting in improved message content and tone, an effective recruitment strategy, and the identification and subsequent resolution of technology challenges. Findings suggest that young adults prefer messages that provide concrete behavioral strategies to overcome cravings, and which are positive in tone. Craigslist was the most efficient recruitment method and yielded a sample that was racially and economically diverse. Despite a successful beta test of initial technological feasibility, extensive problems were subsequently experienced in a beta test of the technological feasibility of the entire Program. Iterative Program refinement and adaptation on the basis of user input is necessary to ensure salience, while extensive field testing is required to ensure proper functioning of technology-based Programs.
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process evaluation of a mhealth Program lessons learned from stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Patient Education and Counseling, 2014Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, David R StrongAbstract:Abstract Objective Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth Smoking Cessation Program for young adult smokers. Methods 164 18–24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. Results (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of Program messages was the most commonly noted Program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the Program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Conclusion Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and Program features to be even more salient. Practice implications Future young adult mHealth interventions could: Integrate models that are flexible to different “paths” of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys.
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pilot rct results of stop my Smoking usa a text messaging based Smoking Cessation Program for young adults
Nicotine & Tobacco Research, 2013Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tonya L Prescott, Mohammad H Rahbar, David R StrongAbstract:INTRODUCTION: To address the lack of Smoking Cessation Programs available to young adults, Stop My Smoking (SMS) USA, a text messaging-based Smoking Cessation Program, was developed and pilot tested. METHODS: This was a two-arm randomized controlled trial with adaptive randomization (arms were balanced by sex and Smoking level [heavy vs. light]), conducted nationally in the United States. One hundred sixty-four 18- to 25-year-old daily smokers who were seriously thinking about quitting in the next 30 days were randomized to either (a) the 6-week SMS USA intervention (n = 101) or (b) an attention-matched control group aimed at improving sleep and physical activity (n = 63). The main outcome measure was 3-month continuous abstinence, verified by a significant other. Participants but not researchers were blinded to study arm allocation. RESULTS: Based upon intent-to-treat analyses, intervention participants (39%) were significantly more likely than control participants (21%) to have quit at 4 weeks postquit (adjusted odds ratio [aOR] = 3.33, 95% confidence interval [CI]: 1.48, 7.45). Findings were not sustained at 3 months postquit, although rates in the SMS USA group were favored (40% vs. 30%, respectively; aOR = 1.59, 95% CI: 0.78, 3.21). Subsequent analyses suggested that among intervention participants, SMS USA might be more influential for youth not currently enrolled in a higher education (p = .06). CONCLUSIONS: Consistent with pilot studies, the sample was underpowered. Data suggest, however, that the SMS USA Program affects Smoking Cessation rates at 4 weeks postquit. More research is needed before conclusions can be made about long-term impact. Identifying profiles of users for whom the Program may be particularly beneficial also will be important.
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feasibility and acceptability of a text messaging based Smoking Cessation Program in ankara turkey
Journal of Health Communication, 2013Co-Authors: Michele L Ybarra, Jodi Summers Holtrop, Tulay Bagci A Bosi, Nazmi Bilir, Josephine D Korchmaros, A Salih K EmriAbstract:Data from high-income countries suggest that cell phone–based Smoking Cessation Programs have the potential to affect Cessation rates. There is a paucity of research, however, about the feasibility of cell phone–based Smoking Cessation Programs in lower income countries that have higher Smoking prevalence rates. A one-arm feasibility and acceptability pilot study of SMS Turkey, a text messaging–based Smoking Cessation Program, was conducted in Ankara, the capital of Turkey. The authors recruited 75 daily smokers who were seriously thinking about quitting in the subsequent 30 days into the 6-week SMS Turkey Program. Recruitment was completed in 4 months. Participant retention was high: Almost all (96%) completed the Program, and 84% provided 12-week follow-up data. Most (89%) of the respondents who completed the 4-week follow-up measures (n = 38, 51%) said that the text messages were easy to understand and referred to what they were experiencing and feeling during the quitting process (78%). On the basis o...