scholarly journals Automated Mobile Delivery of Financial Incentives for Smoking Cessation among Socioeconomically Disadvantaged Adults: A Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Darla E. Kendzor ◽  
Michael S. Businelle ◽  
Joseph J. C. Waring ◽  
Ashley Mathews ◽  
Daryl W. Geller ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentives ◽  
Credit Card ◽  
Facial Recognition ◽  
Smoking Status ◽  
Telephone Counseling ◽  
Socioeconomically Disadvantaged ◽  
Annual Household Income ◽  
Cessation Treatment

BACKGROUND Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment within socioeconomically disadvantaged populations. OBJECTIVE The purpose of this project was to develop and test the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. METHODS Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from one week before a scheduled quit attempt through 26 weeks after the quit date. All participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified five times per week via smartphone prompts to complete a smoking status assessment and submit a breath sample with a portable breath carbon monoxide monitor that connects with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first four weeks after the scheduled quit date, with additional incentives offered at post-quit weeks eight and 12. RESULTS Participants (N = 16) were predominantly female (75.00%) and non-Hispanic White (68.75%) or Black (25.00%), or Hispanic of any race (6.25%). Most participants (56.25%) reported an annual household income of < $11,000. During the first four weeks after the scheduled quit date, participants were abstinent on 29.46% of days, they completed an average of 68.45% of mobile smoking status assessments. Participants earned an average of $37.56 during the first four weeks post-quit, with an additional $5.00 and $3.00 earned on average during post-quit weeks eight and 12 respectively (M = $45.56 total). Over the 12-week incentive period, 48.58% of facial recognition assessments worked as expected. At the in-person follow-up visits, CO-confirmed 7-day point prevalence abstinence rates were 18.75% and 12.50% at 12 and 26 weeks post-quit-date, respectively. Notably, all feasibility metrics improved between the first half of participants enrolled and the latter half, which suggests improved intervention delivery over time. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. CONCLUSIONS Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status, and automating the delivery of abstinence-contingent incentives to a credit card may be feasible for use among socioeconomically disadvantaged adults. CLINICALTRIAL This study is registered at www.clinicaltrials.gov (NCT03517397).

scholarly journals Automated Mobile Delivery of Financial Incentives for Smoking Cessation Among Socioeconomically Disadvantaged Adults: Feasibility Study

10.2196/15960 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15960 ◽  
Author(s):  
Darla E Kendzor ◽  
Michael S Businelle ◽  
Joseph J C Waring ◽  
Ashley J Mathews ◽  
Daryl W Geller ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentives ◽  
Credit Card ◽  
Smoking Status ◽  
Self Report ◽  
Socioeconomically Disadvantaged ◽  
Quit Attempt ◽  
Cessation Treatment

Background Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment among socioeconomically disadvantaged adults. Objective This study aimed to evaluate the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. Methods Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from 1 week before a scheduled quit attempt through 26 weeks after the quit date. Participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified 5 times per week via smartphone prompts to self-report smoking status and submit a breath sample via a portable carbon monoxide (CO) monitor that was connected with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first 4 weeks after the scheduled quit date, with additional incentives offered during postquit weeks 8 and 12. In total, participants had the opportunity to earn up to US $250 in abstinence-contingent incentives over the first 12 weeks of the quit attempt. Results Participants (N=16) were predominantly female (12/16, 75%) and non-Hispanic white (11/16, 69%), black (4/16, 25%), or Hispanic of any race (1/16, 6%). Most participants (9/16, 56%) reported an annual household income of <US $11,000. During the first 4 weeks after the scheduled quit date, participants completed a median of 16 (out of 21; range 1-21) mobile smoking status assessments, and they earned a median of US $28 in abstinence-contingent incentives (out of a possible US $150; range US $0-US $135). Median earnings did not change during the 8- and 12-week incentivized follow-up periods (total median earnings over 12 weeks=US $28; range US $0-US $167). During the first 4 weeks after the scheduled quit date, participants abstained from smoking on a median of 5 (out of 21) assessment days (range 0-20). At the in-person follow-up visits, the expired CO-confirmed 7-day point prevalence abstinence rates were 19% (3/16) and 13% (2/16) at 12 and 26 weeks postquit, respectively. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. Conclusions Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status and automating the delivery of abstinence-contingent incentives to a credit card is feasible for use among socioeconomically disadvantaged adults. However, continued refinement is warranted.

scholarly journals Financial Incentives for Abstinence Among Socioeconomically Disadvantaged Individuals in Smoking Cessation Treatment

2015 ◽  
Vol 105 (6) ◽  
pp. 1198-1205 ◽  
Author(s):  
Darla E. Kendzor ◽  
Michael S. Businelle ◽  
Insiya B. Poonawalla ◽  
Erica L. Cuate ◽  
Anshula Kesh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Financial Incentives ◽  
Socioeconomically Disadvantaged ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment

scholarly journals Depression, anxiety, stress, and motivation over the course of smoking cessation treatment

2015 ◽  
Vol 41 (5) ◽  
pp. 433-439 ◽  
Author(s):  
Maritza Muzzi Cardozo Pawlina ◽  
Regina de Cássia Rondina ◽  
Mariano Martinez Espinosa ◽  
Clóvis Botelho
Keyword(s):  
Smoking Cessation ◽  
Rhode Island ◽  
Smoking Status ◽  
Behavioral Therapy ◽  
Treatment Success ◽  
Wilcoxon Test ◽  
Patient Anxiety ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Anxiety Depression

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded.

scholarly journals Gender differences in personality patterns and smoking status after a smoking cessation treatment

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Bárbara Piñeiro ◽  
Ana López-Durán ◽  
Elena Fernández del Río ◽  
Úrsula Martínez ◽  
Elisardo Becoña
Keyword(s):  
Gender Differences ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Personality Patterns

scholarly journals Identifying Barriers to Entering Smoking Cessation Treatment Among Socioeconomically Disadvantaged Smokers

2010 ◽  
Vol 5 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Amy L. Copeland ◽  
Michael S. Businelle ◽  
Diana W. Stewart ◽  
Scott M. Patterson ◽  
Carla J. Rash ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Nicotine Dependence ◽  
Stage Of Change ◽  
Psychosocial Treatment ◽  
Treatment Programs ◽  
Smoking Rate ◽  
Socioeconomically Disadvantaged ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Professional Assistance

AbstractBackground:Efficacious smoking cessation interventions exist, yet few smokers utilise available resources such as psychosocial treatment programs and pharmacotherapy. The goals of the present study were to (1) identify perceived barriers to entering smoking cessation treatment programs among socioeconomically disadvantaged smokers, who are presently underrepresented in smoking cessation interventions; (2) determine what variables are most important in predicting the barriers identified (i.e., age, gender, ethnicity, income, nicotine dependence level, smoking rate, years smoking, stage of change, presence of smoking-related illness and medical insurance status).Methods:Responses from socioeconomically disadvantaged smokers (N= 343) were collected in 2004–2005 and analysed to develop the Treatment Barriers Questionnaire, a 40-item measure of reasons for not entering smoking cessation programs. Study methods were approved by the Institutional Review Board of Louisiana State University; informed consent procedures were employed.Results:Principal components analysis yielded seven scales named for their theme: (1) Preparedness to Quit Smoking; (2) Work and Time Constraints; (3) Smokers Can or Should Quit on Own; (4) Opinions about Professional Assistance; (5) Mobility Limitations; (6) Insurance Limitations and (7) Misinformation about Professional Assistance. Gender, ethnicity, daily smoking rate, nicotine dependence and stage of change were significant predictors in regression analyses for scales 1,F(10, 201) = 7.83,p< .001,R2= .29, 2F(10, 201) = 2.30,p< .05,R2= .11, and 3,F(10, 201) = 3.58,p< .001,R2= .16. Conclusions: Results can inform efforts to facilitate entry and retention of smokers in cessation programs.

A Pilot Study of Nicotine Replacement Therapy Sampling and Selection to Increase Medication Adherence in Low-Income Smokers

2021 ◽  
Author(s):  
Karen L Cropsey ◽  
Caitlin Wolford-Clevenger ◽  
Michelle L Sisson ◽  
Keith R Chichester ◽  
Mickeah Hugley ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Medication Adherence ◽  
Low Income ◽  
Gold Standard ◽  
Short Form ◽  
Nicotine Patch ◽  
Smoking Behavior ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment

Abstract Introduction Adherence to smoking cessation medications remains suboptimal, particularly among low-income smokers. Guided, experiential sampling of nicotine replacement therapies (NRTs) may increase NRT adherence and smoking cessation over gold standard counseling plus NRT. The present pilot study aimed to examine feasibility, acceptability, and preliminary efficacy of a novel experiential intervention. Aims and Methods This pilot randomized controlled trial (N = 83) compared gold standard smoking cessation treatment (four weekly sessions of behavioral counseling followed by self-selected combination NRT in week 5) to a novel experiential approach (ie, In Vivo; four weekly sessions of sampling each short form of NRT-gum, lozenge, inhaler, nasal spray-in-session while wearing the nicotine patch followed by NRT selection in week 5). Both groups received 8 weeks of nicotine patch plus their selected additional short form NRT for smoking cessation followed by a 1-month assessment. Results Screening and enrollment rates supported feasibility. In Vivo was comparable in acceptability with the gold standard of care intervention; however, there was greater attrition in the In Vivo group compared with the gold standard of care group. Results suggested higher medication adherence and improvements in smoking behavior in the In Vivo intervention; with generally small-to-medium effect sizes. Conclusions This experiential approach to sampling NRT is feasible and acceptable to low-income people who smoke. This intervention may increase adherence and reduce harmful smoking behavior but needs to be tested on a larger scale. Implications Medication adherence remains a significant impediment to the successful smoking cessation. The results of this study suggest that guided sampling of NRT products improves adherence among low-income smokers. Additionally, this approach yielded greater improvements in smoking behavior compared with gold standard smoking cessation treatment. This intervention shows promise as a feasible smoking cessation treatment for low-income smokers.

scholarly journals Smoking Cessation Treatment among Rural Individuals

2020 ◽  
pp. 1-2
Author(s):  
Steven S. Coughlin ◽  
Steven S. Coughlin
Keyword(s):  
Smoking Cessation ◽  
Rural Areas ◽  
Evidence Based ◽  
Socioeconomically Disadvantaged ◽  
Smoking Cessation Treatment ◽  
Randomized Controlled Studies ◽  
Cessation Treatment ◽  
Poor Access ◽  
Access To Primary Care ◽  
Out Of Pocket Expenses

Rural population in the U.S. have higher smoking prevalence rates and consume a higher number of cigarettes per day. Socioeconomically disadvantaged smokers, such as those who reside in rural areas, are less likely to use and have access to evidence-based tobacco cessation treatments than the general population of smokers. Randomized controlled studies are needed to examine the effectiveness of evidence-based smoking cessation interventions among rural residents. Of particular interest are interventions that overcome barriers to smoking cessation treatment such as poor access to primary care, travel, time, lack of health insurance, an inability to pay out-of-pocket expenses for pharmacotherapy, and communal norms that influence smoking cessation.

scholarly journals Population-based estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) prevalence and characteristics: A cross-sectional study

2021 ◽  
Author(s):  
Jana L. Hirschtick ◽  
Andrea R. Titus ◽  
Elizabeth Slocum ◽  
Laura E. Power ◽  
Robert E. Hirschtick ◽  
...  
Keyword(s):  
Low Income ◽  
Smoking Status ◽  
Prevalence Ratio ◽  
Population Based ◽  
Outcome Data ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Cross Sectional ◽  
Persistent Symptoms ◽  
Initial Symptoms

AbstractImportanceEmerging evidence suggests many people have persistent symptoms after acute COVID-19 illness.ObjectiveTo estimate the prevalence and correlates of persistent COVID-19 symptoms 30 and 60 days post onset using a population-based sample.Design & SettingThe Michigan COVID-19 Recovery Surveillance Study is a population-based cross-sectional survey of a probability sample of adults with confirmed COVID-19 in the Michigan Disease Surveillance System (MDSS). Respondents completed a survey online or via telephone in English, Spanish, or Arabic between June - December 2020.ParticipantsLiving non-institutionalized adults (aged 18+) in MDSS with COVID-19 onset through mid-April 2020 were eligible for selection (n=28,000). Among 2,000 adults selected, 629 completed the survey. We excluded 79 cases during data collection due to ineligibility, 6 asymptomatic cases, 7 proxy reports, and 24 cases missing outcome data, resulting in a sample size of 593. The sample was predominantly female (56.1%), aged 45 and older (68.2%), and Non-Hispanic White (46.3%) or Black (34.8%).ExposuresDemographic (age, sex, race/ethnicity, and annual household income) and clinical factors (smoking status, body mass index, diagnosed comorbidities, and illness severity).Main outcomes and MeasuresWe defined post-acute sequelae of SARS-CoV-2 infection (PASC) as persistent symptoms 30+ days (30-day COVID-19) or 60+ days (60-day COVID-19) post COVID-19 onset.Results30- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among respondents reporting mild symptoms (29.2% and 24.5%) and non-hospitalized respondents (43.7% and 26.9%, respectively). Low income was statistically significantly associated with 30-day COVID-19 in adjusted models. Respondents reporting very severe (vs. mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 (Adjusted Prevalence Ratio [aPR] 2.25, 95% CI 1.46-3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR 1.71, 95% 1.02-2.88). Hospitalized (vs. non-hospitalized) respondents had about 40% higher prevalence of both 30-day (aPR 1.37, 95% CI 1.12-1.69) and 60-day COVID-19 (aPR 1.40, 95% CI 1.02-1.93).Conclusions and RelevancePASC is highly prevalent among cases with severe initial symptoms, and, to a lesser extent, cases with mild and moderate symptoms.

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