scholarly journals Lessons Learned from a Text Messaging Intervention for Young Smokers Experiencing Homelessness (Preprint)

2020 ◽  
Author(s):  
Sebastian Linnemayr ◽  
Rushil Zutshi ◽  
William Shadel ◽  
Eric Pedersen ◽  
Maria DeYoreo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Controlled Trial ◽  
Text Messages ◽  
Lessons Learned ◽  
Randomized Controlled ◽  
Quit Attempt ◽  
Nicotine Patches ◽  
Text Messaging Intervention ◽  
To Receive

BACKGROUND Smoking rates are significantly higher among youth experiencing homelessness (YEH) than in the general population. Despite a willingness to quit, YEH have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. YEH generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. OBJECTIVE This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI), as an adjunct to group-based cessation counseling and provision of nicotine patches, to help YEH quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. METHODS YEH smokers who were interested in quitting (n = 77) were recruited from drop-in centers serving YEH in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches; with n = 40 randomly assigned to receive six weeks of text messages to provide additional support for their quit attempt. Participants were sent the text messages to their own phone, rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow up survey data, as well as backend data from the messaging platform, to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. RESULTS Participants had widespread (smart)phone ownership – only 14% were ineligible for study participation because they either did not have a phone that could receive text messages or did not want to receive messages. Participants experienced interruptions in their phone use but reported being able to receive the majority of messages. These survey results were corroborated by backend data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Participants reported enjoying the group counseling session that preceded the TMI, and suggested to include more such group elements into the intervention. CONCLUSIONS The TMI was well accepted and feasible to support smoking cessation among YEH. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages, and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support YEH, a population urgently in need of effective smoking cessation interventions. CLINICALTRIAL We report on implementation lessons, i.e. do not make use of the randomized controlled trial aspect of the underlying parent study that is registered with the ClinicalTrials.gov Identifier: NCT03874585

scholarly journals Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial

10.2196/23989 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e23989
Author(s):  
Sebastian Linnemayr ◽  
Rushil Zutshi ◽  
William Shadel ◽  
Eric Pedersen ◽  
Maria DeYoreo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Homeless Youth ◽  
Controlled Trial ◽  
Text Messages ◽  
Lessons Learned ◽  
Quit Attempt ◽  
Text Messaging Intervention ◽  
To Receive

Background Smoking rates are significantly higher among young people experiencing homelessness than in the general population. Despite a willingness to quit, homeless youth have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. Homeless youth generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. Objective This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI) as an adjunct to group-based cessation counseling and provision of nicotine patches to help homeless youth quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. Methods Homeless youth smokers aged 18 to 25 years who were interested in quitting (n=77) were recruited from drop-in centers serving homeless youth in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches, with 52% (40/77) randomly assigned to receive 6 weeks of text messages to provide additional support for their quit attempt. Participants received text messages on their own phone rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow-up survey data as well as back-end data from the messaging platform to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. Results Participants had widespread (smart)phone ownership—16.4% (36/219) were ineligible for study participation because they did not have a phone that could receive text messages. Participants experienced interruptions in their phone use (eg, 44% [16/36] changed phone numbers during the follow-up period) but reported being able to receive the majority of messages. These survey results were corroborated by back-end data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Qualitative feedback indicated that participants enjoyed the group counseling session that preceded the TMI and suggested including more such group elements into the intervention. Conclusions The TMI was well accepted and feasible to support smoking cessation among homeless youth. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support homeless youth, a population urgently in need of effective smoking cessation interventions. Trial Registration ClinicalTrials.gov NCT03874585; https://clinicaltrials.gov/ct2/show/NCT03874585 International Registered Report Identifier (IRRID) RR2-10.1186/s13722-020-00187-6

scholarly journals A Digital Smoking Cessation Program for Heavy Drinkers: Pilot Randomized Controlled Trial

2020 ◽  
Vol 4 (6) ◽  
pp. e7570 ◽  
Author(s):  
Christopher W Kahler ◽  
Amy M Cohn ◽  
Catherine Costantino ◽  
Benjamin A Toll ◽  
Nichea S Spillane ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Controlled Trial ◽  
Text Messages ◽  
Smoking Cessation Program ◽  
Web Based ◽  
Randomized Controlled ◽  
To Receive ◽  
Pilot Randomized Controlled Trial

Background Heavy drinking (HD) is far more common among smokers compared with nonsmokers and interferes with successful smoking cessation. Alcohol-focused smoking cessation interventions delivered by counselors have shown promise, but digital versions of these interventions—which could have far greater population reach—have not yet been tested. Objective This pilot randomized controlled trial aimed to examine the feasibility, acceptability, and effect sizes of an automated digital smoking cessation program that specifically addresses HD using an interactive web-based intervention with an optional text messaging component. Methods Participants (83/119, 69.7% female; 98/119, 82.4% white; mean age 38.0 years) were daily smokers recruited on the web from a free automated digital smoking cessation program (BecomeAnEX.org, EX) who met the criteria for HD: women drinking 8+ drinks/week or 4+ drinks on any day and men drinking 15+ drinks/week or 5+ drinks on any day. Participants were randomized to receive EX with standard content (EX-S) or an EX with additional content specific to HD (EX-HD). Outcomes were assessed by web-based surveys at 1 and 6 months. Results Participants reported high satisfaction with the website and the optional text messaging component. Total engagement with both EX-S and EX-HD was modest, with participants visiting the website a median of 2 times, and 52.9% of the participants enrolled to receive text messages. Participants in both the conditions showed substantial, significant reductions in drinking across 6 months of follow-up, with no condition effects observed. Although smoking outcomes tended to favor EX-HD, the condition effects were small and nonsignificant. A significantly smaller proportion of participants in EX-HD reported having a lapse back to smoking when drinking alcohol (7/58, 16%) compared with those in EX-S (18/61, 41%; χ21=6.2; P=.01). Conclusions This is the first trial to examine a digital smoking cessation program tailored to HD smokers. The results provide some initial evidence that delivering such a program is feasible and may reduce the risk of alcohol-involved smoking lapses. However, increasing engagement in this and other web-based interventions is a crucial challenge to address in future work. Trial Registration ClinicalTrials.gov NCT03068611; https://clinicaltrials.gov/ct2/show/NCT03068611

scholarly journals mHealth Messaging to Motivate Quitline Use and Quitting: Protocol for a Community-Based Randomized Controlled Trial in Rural Vietnam (Preprint)

2021 ◽  
Author(s):  
Celine Larkin ◽  
Jessica Wijesundara ◽  
Hoa L Nguyen ◽  
Duc Anh Ha ◽  
Anh Vuong ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Health Workers ◽  
Controlled Trial ◽  
Text Messages ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled

BACKGROUND Tobacco kills more than 8 million people each year, mostly in low- and middle-income countries. In Vietnam, 1 in every 2 male adults smokes tobacco. Vietnam has set up telephone Quitline counseling that is available to all smokers, but it is underused. We previously developed an automated and effective motivational text messaging system to support smoking cessation among US smokers. OBJECTIVE The aim of this study is to adapt the aforementioned system for rural Vietnamese smokers to promote cessation of tobacco use, both directly and by increasing the use of telephone Quitline counseling services and nicotine replacement therapy. Moreover, we seek to enhance research and health service capacity in Vietnam. METHODS We are testing the effectiveness of our culturally adapted motivational text messaging system by using a community-based randomized controlled trial design (N=600). Participants were randomly allocated to the intervention (regular motivational and assessment text messages) or control condition (assessment text messages only) for a period of 6 months. Trial recruitment took place in four communes in the Hung Yen province in the Red River Delta region of Vietnam. Recruitment events were advertised to the local community, facilitated by community health workers, and occurred in the commune health center. We are assessing the impact of the texting system on 6-month self-reported and biochemically verified smoking cessation, as well as smoking self-efficacy, uptake of the Quitline, and use of nicotine replacement therapy. In addition to conducting the trial, the research team also provided ongoing training and consultation with the Quitline during the study period. RESULTS Site preparation, staff training, intervention adaptation, participant recruitment, and baseline data collection were completed. The study was funded in August 2017; it was reviewed and approved by the University of Massachusetts Medical School Institutional Review Board in 2017. Recruitment began in November 2018. A total of 750 participants were recruited from four communes, and 700 (93.3%) participants completed follow-up by March 2021. An analysis of the trial results is in progress; results are expected to be published in late 2022. CONCLUSIONS This study examines the effectiveness of mobile health interventions for smoking in rural areas in low- and middle-income countries, which can be implemented nationwide if proven effective. In addition, it also facilitates significant collaboration and capacity building among a variety of international partners, including researchers, policy makers, Quitline counselors, and community health workers. CLINICALTRIAL ClinicalTrials.gov NCT03567993; https://clinicaltrials.gov/ct2/show/NCT03567993. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30947

scholarly journals A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Elexis C. Kierstead ◽  
Emily Harvey ◽  
Denisse Sanchez ◽  
Kimberly Horn ◽  
Lorien C. Abroms ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Self Efficacy ◽  
Text Messaging ◽  
Controlled Trial ◽  
P Value ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Living With Hiv ◽  
Pilot Randomized Controlled Trial

Abstract Objective Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. Results The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. Clinical trial: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.

scholarly journals Positive psychotherapy for smoking cessation enhanced with text messaging: Protocol for a randomized controlled trial

2018 ◽  
Vol 71 ◽  
pp. 146-153
Author(s):  
Christopher W. Kahler ◽  
Anthony Surace ◽  
Rebecca E.F. Gordon ◽  
Patricia A. Cioe ◽  
Nichea S. Spillane ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Controlled Trial ◽  
Positive Psychotherapy ◽  
Randomized Controlled

scholarly journals Effects of a Tailored Text Messaging Intervention Among Diverse Adults With Type 2 Diabetes: Evidence From the 15-Month REACH Randomized Controlled Trial

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Lyndsay A. Nelson ◽  
Robert A. Greevy ◽  
Andrew Spieker ◽  
Kenneth A. Wallston ◽  
Tom A. Elasy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Text Messaging ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Text Messaging Intervention

scholarly journals Six-Month Outcomes from the NEXit Junior Trial of a Text Messaging Smoking Cessation Intervention for High School Students: Randomized Controlled Trial With Bayesian Analysis

10.2196/29913 ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. e29913
Author(s):  
Marcus Bendtsen ◽  
Preben Bendtsen ◽  
Ulrika Müssener
Keyword(s):  
High School ◽  
Smoking Cessation ◽  
High School Students ◽  
Text Messaging ◽  
Controlled Trial ◽  
School Students ◽  
Bayesian Analyses ◽  
Randomized Controlled ◽  
Prolonged Abstinence

Background The prevalence of daily or occasional smoking among high school students in Sweden was approximately 20% in 2019, which is problematic since lifestyle behaviors are established in adolescence and track into adulthood. The Nicotine Exit (NEXit) Junior trial was conducted in response to a lack of evidence for the effects of text message smoking cessation interventions among high school students in Sweden. Objective The aim of this study was to estimate the 3- and 6-month effects of a text messaging intervention among high school students in Sweden on smoking cessation outcomes. Methods A 2-arm, single-blind randomized controlled trial was employed to estimate the effects of the intervention on smoking cessation in comparison to treatment as usual. Participants were recruited from high schools in Sweden using advertising and promotion by school staff from January 10, 2018, to January 10, 2019. Weekly or daily smokers who were willing to make a quit attempt were eligible for inclusion. Prolonged abstinence and point prevalence of smoking cessation were measured at 3 and 6 months after randomization. Results Complete case analysis was possible on 57.9% (310/535) of the participants at 6 months, with no observed statistically significant effect on 5-month prolonged abstinence (odds ratio [OR] 1.27, 95% CI 0.73-2.20; P=.39) or 4-week smoking cessation (OR 1.42; 95% CI 0.83-2.46; P=.20). Sensitivity analyses using imputation yielded similar findings. Unplanned Bayesian analyses showed that the effects of the intervention were in the anticipated direction. The findings were limited by the risk of bias induced by high attrition (42.1%). The trial recruited high school students in a pragmatic setting and included both weekly and daily smokers; thus, generalization to the target population is more direct compared with findings obtained under more strict study procedures. Conclusions Higher than expected attrition rates to follow-up 6 months after randomization led to null hypothesis tests being underpowered; however, unplanned Bayesian analyses found that the effects of the intervention were in the anticipated direction. Future trials of smoking cessation interventions targeting high school students should aim to prepare strategies for increasing retention to mid- and long-term follow-up. Trial Registration IRCTN Registry ISRCTN15396225; https://www.isrctn.com/ISRCTN15396225 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-018-3028-2

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