A qualitative study of user experience with a text messaging program for smoking cessation (Preprint)

2021 ◽  
Author(s):  
Alexandra Budenz ◽  
Kisha Coa ◽  
Emily Grenen ◽  
Meredith Grady ◽  
Brian Keefe ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Qualitative Study ◽  
Text Messaging ◽  
Text Message ◽  
Positive Outcome ◽  
Program Completion ◽  
Human Interaction ◽  
Evidence Based ◽  
Opt Out ◽  
Program Retention

BACKGROUND Mobile health (mHealth) strategies for smoking cessation (e.g., text-messaging-based interventions) have been shown to be effective in helping smokers quit. However, further research is needed to better understand user experiences with these platforms. OBJECTIVE This qualitative study explored the experiences of real-world users of a publicly available smoking cessation program (SmokefreeTXT). METHODS Semi-structured phone interviews were conducted with 36 SmokefreeTXT users, between March and July 2014. Questions focused on participants’ perceptions about program structure, content, and reasons for opting out of SmokefreeTXT. A thematic content analysis was conducted, with a focus on themes to increase program engagement and optimization. RESULTS The findings highlighted features of the program that participants found beneficial, as well as some elements that show opportunities for improvement to boost program retention and successful cessation. We also found that program completion does not necessarily indicate successful smoking cessation and that program opt-out, which may be interpreted as a less positive outcome, may occur because of successful cessation. Finally, several participants reported using SmokefreeTXT together with other evidence-based cessation methods, and/or with non-evidence-based strategies. CONCLUSIONS Our findings demonstrate the importance of allowing customization of text message frequency within cessation text programs, the limitations of measuring cessation “success” through program opt-out versus retention, and the importance of recommending evidence-based cessation resources (including live support for participants that prefer human interaction during the cessation process) to be used with smoking cessation text programs.

scholarly journals Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katarina Åsberg ◽  
Marcus Bendtsen
Keyword(s):  
Physical Activity ◽  
Smoking Cessation ◽  
Behaviour Change ◽  
Scoping Review ◽  
Text Messaging ◽  
Text Message ◽  
Feasibility Studies ◽  
Small Sample ◽  
Small Sample Sizes ◽  
Randomised Controlled

Abstract Background Evidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation. Main text This scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes. Conclusion This review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.

scholarly journals Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention

2017 ◽  
Vol 19 (5) ◽  
pp. 572-577 ◽  
Author(s):  
Melanie Sloan ◽  
Sarah Hopewell ◽  
Tim Coleman ◽  
Sue Cooper ◽  
Felix Naughton
Keyword(s):  
Smoking Cessation ◽  
Qualitative Study ◽  
Text Message

scholarly journals Optimizing Text Messages to Promote Engagement With Internet Smoking Cessation Treatment: Results From a Factorial Screening Experiment

10.2196/17734 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e17734 ◽  
Author(s):  
Amanda L Graham ◽  
George D Papandonatos ◽  
Megan A Jacobs ◽  
Michael S Amato ◽  
Sarah Cha ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Text Message ◽  
Smoking Cessation Program ◽  
Smoking Cessation Treatment ◽  
Screening Experiment ◽  
Cessation Intervention ◽  
Cessation Treatment ◽  
Interactive Feature ◽  
Main Effects

Background Smoking remains a leading cause of preventable death and illness. Internet interventions for smoking cessation have the potential to significantly impact public health, given their broad reach and proven effectiveness. Given the dose-response association between engagement and behavior change, identifying strategies to promote engagement is a priority across digital health interventions. Text messaging is a proven smoking cessation treatment modality and a powerful strategy to increase intervention engagement in other areas of health, but it has not been tested as an engagement strategy for a digital cessation intervention. Objective This study examined the impact of 4 experimental text message design factors on adult smokers’ engagement with an internet smoking cessation program. Methods We conducted a 2×2×2×2 full factorial screening experiment wherein 864 participants were randomized to 1 of 16 experimental conditions after registering with a free internet smoking cessation program and enrolling in its automated text message program. Experimental factors were personalization (on/off), integration between the web and text message platforms (on/off), dynamic tailoring of intervention content based on user engagement (on/off), and message intensity (tapered vs abrupt drop-off). Primary outcomes were 3-month measures of engagement (ie, page views, time on site, and return visits to the website) as well as use of 6 interactive features of the internet program. All metrics were automatically tracked; there were no missing data. Results Main effects were detected for integration and dynamic tailoring. Integration significantly increased interactive feature use by participants, whereas dynamic tailoring increased the number of features used and page views. No main effects were found for message intensity or personalization alone, although several synergistic interactions with other experimental features were observed. Synergistic effects, when all experimental factors were active, resulted in the highest rates of interactive feature use and the greatest proportion of participants at high levels of engagement. Measured in terms of standardized mean differences (SMDs), effects on interactive feature use were highest for Build Support System (SMD 0.56; 95% CI 0.27 to 0.81), Choose Quit Smoking Aid (SMD 0.38; 95% CI 0.10 to 0.66), and Track Smoking Triggers (SMD 0.33; 95% CI 0.05 to 0.61). Among the engagement metrics, the largest effects were on overall feature utilization (SMD 0.33; 95% CI 0.06 to 0.59) and time on site (SMD 0.29; 95% CI 0.01 to 0.57). As no SMD >0.30 was observed for main effects on any outcome, results suggest that for some outcomes, the combined intervention was stronger than individual factors alone. Conclusions This factorial experiment demonstrates the effectiveness of text messaging as a strategy to increase engagement with an internet smoking cessation intervention, resulting in greater overall intervention dose and greater exposure to the core components of tobacco dependence treatment that can promote abstinence. Trial Registration ClinicalTrials.gov NCT02585206; https://clinicaltrials.gov/ct2/show/NCT02585206. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2015-010687

scholarly journals Predictors of Smoking Cessation in a Lifestyle-Focused Text-Message Support Programme Delivered to People with Coronary Heart Disease: An Analysis From the Tobacco Exercise and Diet Messages (TEXTME) Randomised Clinical Trial

2020 ◽  
Vol 13 ◽  
pp. 1179173X2090148
Author(s):  
Harry Klimis ◽  
Simone Marschner ◽  
Amy Von Huben ◽  
Aravinda Thiagalingam ◽  
Clara K Chow
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
A Priori ◽  
Univariate Analysis ◽  
Intervention Group ◽  
Text Message ◽  
Prevention Programs ◽  
Text Messages ◽  
Baseline Risk ◽  
Quitting Smoking

Background: Studies have demonstrated the effectiveness of text message-based prevention programs on smoking cessation, including our recently published TEXTME randomised controlled trial. However, little is known about the predictors of smoking cessation in this context and if other clinically important factors interact with the program to lead to quitting. Hence, the objective of this study was to first assess the predictors of smoking cessation in TEXTME and then determine if the effect of texting on quitting was modified by interactions with important clinical variables. This will allow us to better understand how text messaging works and thus help optimise future text-message based prevention programs. Methods This sub-analysis used data collected as part of the TEXTME trial which recruited 710 participants (377 current smokers at baseline) between September 2011 and November 2013 from a large tertiary hospital in Sydney, Australia. Smokers at baseline were analysed at 6 months and grouped into those who quit and those who did not. Univariate analyses were performed to determine associations between the main outcome and clinically important baseline factors selected a priori. A multiple binominal logistic regression analysis was conducted to develop a predictive model for the dependent variable smoking cessation. A test of interaction between the intervention group and baseline variables selected a priori with the outcome smoking cessation was performed. Results Univariate analysis identified receiving text-messages, age, and mean number of cigarettes smoked each day as being associated with quitting smoking. After adjusting for age, receiving the text-messaging program (OR 2.34; 95%CI 1.43-3.86; p<0.01) and mean number of cigarettes smoked per day (OR 1.02; 95%CI 1.00-1.04; p=0.03) were independent predictors for smoking cessation. LDL-C showed a significant interaction effect with the intervention (High LDL*Intervention OR 3.77 (95%CI 2.05-6.94); Low LDL*Intervention OR 1.42 (95%CI 0.77-2.60); P=0.03). Conclusions Smoking quantity at baseline is independently associated with smoking cessation and higher LDL-C may interact with the intervention to result in quitting smoking. Those who have a higher baseline risk maybe more motivated towards beneficial lifestyle change including quitting smoking, and thus more likely to respond to mHealth smoking cessation programs. The effect of text-messages on smoking cessation was independent of age, gender, psychosocial parameters, education, and baseline control of risk factors in a secondary prevention cohort.

scholarly journals Characterising the ‘Txt2Stop’ Smoking Cessation Text Messaging Intervention in Terms of Behaviour Change Techniques

2012 ◽  
Vol 7 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Susan Michie ◽  
Caroline Free ◽  
Robert West
Keyword(s):  
Smoking Cessation ◽  
Behaviour Change ◽  
Text Messaging ◽  
Self Regulation ◽  
Text Message ◽  
Behaviour Change Techniques ◽  
Rater Reliability ◽  
Communication Techniques ◽  
Regulatory Capacity ◽  
Text Messaging Intervention

The ‘Txt2Stop’ SMS messaging programme has been found to double smokers’ chances of stopping. It is important to characterise the content of this information in terms of specific behaviour change techniques (BCTs) for the purpose of future development. This study aimed to (i) extend a proven system for coding BCTs to text messaging and (ii) characterise Txt2Stop using this system. A taxonomy previously used to specify BCTs in face-to-face behavioural support for smoking cessation was adapted for the Txt2Stop messages and inter-rater reliability for the adapted system assessed. The system was then applied to all the messages in the Txt2Stop programme to determine its profile in terms of BCTs used. The text message taxonomy comprised 34 BCTs. Inter-rater reliability was moderate, reaching a ceiling of 61% for the core program messages with all discrepancies readily resolved. Of 899 texts delivering BCTs, 218 aimed to maintain motivation to remain abstinent, 870 to enhance self-regulatory capacity or skills, 39 to promote use of adjuvant behaviours such as using stop-smoking medication, 552 to maintain engagement with the intervention and 24 were general communication techniques. The content of Txt2Stop focuses on helping smokers with self-regulation and maintaining engagement with the intervention. The intervention focuses to a lesser extent on boosting motivation to remain abstinent; little attention is given to promoting effective use of adjuvant behaviours such as use of nicotine replacement therapy. As new interventions of this kind are developed it will be possible to compare their effectiveness and relate this to standardised descriptions of their content using this system.

scholarly journals Comparing the Efficacy of an Identical, Tailored Smoking Cessation Intervention Delivered by Mobile Text Messaging Versus Email: Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Inger Torhild Gram ◽  
Dillys Larbi ◽  
Silje Camilla Wangberg
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Controlled Trial ◽  
Text Message ◽  
Population Level ◽  
Randomized Controlled ◽  
Cessation Intervention ◽  
Double Blinded ◽  
Time Point

BACKGROUND There is a need to deliver smoking cessation support at a population level, both in developed and developing countries. Studies on internet-based and mobile phone–based smoking cessation interventions have shown that these methods can be as effective as other methods of support, and they can have a wider reach at a lower cost. OBJECTIVE This randomized controlled trial (RCT) aimed to compare, on a population level, the efficacy of an identical, tailored smoking cessation intervention delivered by mobile text messaging versus email. METHODS We conducted a nationwide 2-arm, double-blinded, fully automated RCT, close to a real-world setting, in Norway. We did not offer incentives to increase participation and adherence or to decrease loss to follow-up. We recruited users of the website, slutta.no, an open, free, multi-component Norwegian internet-based smoking cessation program, from May 2010 until October 2012. Enrolled smokers were considered as having completed a time point regardless of their response status if it was 1, 3, 6, or 12 months post cessation. We assessed 7315 participants using the following inclusion criteria: knowledge of the Norwegian language, age 16 years or older, ownership of a Norwegian cell phone, having an email account, current cigarette smoker, willingness to set a cessation date within 14 days (mandatory), and completion of a baseline questionnaire for tailoring algorithms. Altogether, 6137 participants were eligible for the study and 4378 participants (71.33%) provided informed consent to participate in the smoking cessation trial. We calculated the response rates for participants at the completed 1, 3, 6, and 12 months post cessation. For each arm, we conducted an intention-to-treat (ITT) analysis for each completed time point. The main outcome was 7-day self-reported point prevalence abstinence (PPA) at the completed 6 months post cessation. We calculated effect size of the 7-day self-reported PPA in the text message arm compared with the email arm as odds ratios (ORs) with 95% CIs for the 4 time points post cessation. RESULTS At 6 months follow-up, 21.06% (384/1823) of participants in the text message arm and 18.62% (333/1788) in the email arm responded (<italic>P</italic>=.07) to the surveys. In the ITT analysis, 11.46% (209/1823) of participants in the text message arm compared with 10.96% (196/1788) in the email arm (OR 1.05, 95% CI 0.86-1.30) reported to have achieved 7 days PPA. CONCLUSIONS This nationwide, double-blinded, large, fully automated RCT found that 1 in 9 enrolled smokers reported 7-day PPA in both arms, 6 months post cessation. Our study found that identical smoking cessation interventions delivered by mobile text messaging and email may be equally successful at a population level. CLINICALTRIAL ClinicalTrials.gov NCT01103427; https://clinicaltrials.gov/ct2/show/NCT01103427

scholarly journals Comparing the Efficacy of an Identical, Tailored Smoking Cessation Intervention Delivered by Mobile Text Messaging Versus Email: Randomized Controlled Trial

10.2196/12137 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e12137 ◽  
Author(s):  
Inger Torhild Gram ◽  
Dillys Larbi ◽  
Silje Camilla Wangberg
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Controlled Trial ◽  
Text Message ◽  
Population Level ◽  
Randomized Controlled ◽  
Cessation Intervention ◽  
Double Blinded ◽  
Time Point

Background There is a need to deliver smoking cessation support at a population level, both in developed and developing countries. Studies on internet-based and mobile phone–based smoking cessation interventions have shown that these methods can be as effective as other methods of support, and they can have a wider reach at a lower cost. Objective This randomized controlled trial (RCT) aimed to compare, on a population level, the efficacy of an identical, tailored smoking cessation intervention delivered by mobile text messaging versus email. Methods We conducted a nationwide 2-arm, double-blinded, fully automated RCT, close to a real-world setting, in Norway. We did not offer incentives to increase participation and adherence or to decrease loss to follow-up. We recruited users of the website, slutta.no, an open, free, multi-component Norwegian internet-based smoking cessation program, from May 2010 until October 2012. Enrolled smokers were considered as having completed a time point regardless of their response status if it was 1, 3, 6, or 12 months post cessation. We assessed 7315 participants using the following inclusion criteria: knowledge of the Norwegian language, age 16 years or older, ownership of a Norwegian cell phone, having an email account, current cigarette smoker, willingness to set a cessation date within 14 days (mandatory), and completion of a baseline questionnaire for tailoring algorithms. Altogether, 6137 participants were eligible for the study and 4378 participants (71.33%) provided informed consent to participate in the smoking cessation trial. We calculated the response rates for participants at the completed 1, 3, 6, and 12 months post cessation. For each arm, we conducted an intention-to-treat (ITT) analysis for each completed time point. The main outcome was 7-day self-reported point prevalence abstinence (PPA) at the completed 6 months post cessation. We calculated effect size of the 7-day self-reported PPA in the text message arm compared with the email arm as odds ratios (ORs) with 95% CIs for the 4 time points post cessation. Results At 6 months follow-up, 21.06% (384/1823) of participants in the text message arm and 18.62% (333/1788) in the email arm responded (P=.07) to the surveys. In the ITT analysis, 11.46% (209/1823) of participants in the text message arm compared with 10.96% (196/1788) in the email arm (OR 1.05, 95% CI 0.86-1.30) reported to have achieved 7 days PPA. Conclusions This nationwide, double-blinded, large, fully automated RCT found that 1 in 9 enrolled smokers reported 7-day PPA in both arms, 6 months post cessation. Our study found that identical smoking cessation interventions delivered by mobile text messaging and email may be equally successful at a population level. Trial Registration ClinicalTrials.gov NCT01103427; https://clinicaltrials.gov/ct2/show/NCT01103427

scholarly journals Efficacy of an SMS-Based Smoking Intervention Using Message Self-Authorship: A Pilot Study

2016 ◽  
Vol 13 (1) ◽  
pp. 55-58
Author(s):  
Krista L. DeStasio ◽  
Anne P. Hill ◽  
Elliot T. Berkman
Keyword(s):  
Smoking Cessation ◽  
Text Messaging ◽  
Psychological Symptoms ◽  
Implementation Intentions ◽  
Controlled Trial ◽  
Text Message ◽  
Experimental Conditions ◽  
Smoking Intervention ◽  
Text Messaging Intervention ◽  
Self Authorship

Introduction: Text-message-based interventions hold great potential for intervention and are increasingly feasible, given advances in information technology.Aims: This pilot randomized controlled trial (RCT) aims to compare the efficacy of self-versus expert-authored content delivered via text-messaging for smoking cessation.Methods: Sixty-two participants aged 25–66 attended laboratory sessions pre- and post-30 days of text-messaging intervention. Participants were randomised to one of two experimental conditions – self-authorship (SA) only and SA with implementation intentions (SA+ii) – or active control. Participants composed 30–60 brief motivational cessation messages for use during their cessation attempt. SA+ii participants were further instructed to anticipate obstacles and form simple if-then plans to overcome them. Experimental groups received their self-authored texts during the intervention phase, whereas control participants received expert-authored messages.Results: Overall, smoking decreased as measured by change in exhaled carbon monoxide (CO), F(1,59) = 4.43, p = 0.04. The SA+ii group showed slightly greater CO reduction (M = 3.63, SD = 5.39) than control (M = 0.03, SD = 5.80; t(40) = 2.08, p = 0.04). SA alone (M = 1.97, SD = 9.30) was not more effective than control.Conclusions: SA does not appear to increase efficacy. However, this pilot supports prior research, indicating that text-based interventions can increase smoking cessation success and may decrease psychological symptoms of withdrawal. Much research is needed to identify ways to bolster intervention efficacy.

scholarly journals Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study

10.2196/13712 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13712 ◽  
Author(s):  
Kara P Wiseman ◽  
Kisha I Coa ◽  
Yvonne M Prutzman
Keyword(s):  
Smoking Cessation ◽  
Logistic Regression ◽  
Text Messaging ◽  
User Characteristics ◽  
Opting Out ◽  
Quit Attempt ◽  
Cessation Intervention ◽  
Opt Out ◽  
Waking Up

Background Mobile health tools such as text messaging programs can support smoking cessation. However, high rates of disengagement from these tools decrease their effectiveness. Objective The purpose of this study was to identify user characteristics associated with retention in an adult text messaging smoking cessation intervention. Methods Adults initiating a quit attempt using the publicly available program SmokefreeTXT between March 6 and June 21, 2016 (n=6215), were included. Data were collected to assess nicotine dependence, frequency of being around other smokers, time of the day for cigarette cravings, extrinsic and intrinsic motivation to quit smoking, confidence in quitting, and long-term intention to be smoke free. Multivariable survival analysis modeling for time to opt out was conducted to identify characteristics associated with opting out over the course of the intervention, adjusting for age, sex, and smoking frequency, reset of the quit date by the user, and the number of days enrolled before initiating the quit attempt. Among those who opted out, multivariable multinomial logistic regression analysis was used to identify predictors of opting out early (within 3 days and between 4 and 7 days into the quit attempt) compared to opting out late (more than 7 days into the quit attempt), adjusting for the same confounders. Results Survival analyses indicated that younger age, female sex, higher levels of nicotine dependence, lower intention to be smoke free, and enrolling in SmokefreeTXT ≤1 week before initiating the quit attempt were associated with an increased risk of opting out. For example, users who smoked within 5 minutes of waking up were 1.17 times more likely to opt out than those who smoked more than 5 minutes after waking up (95% CI 1.01-1.35). Among users who opted out from SmokefreeTXT, logistic regression modeling indicated that compared to users who were never or rarely around other smokers, those who were sometimes around other smokers had 1.96 times more likely to opt out within the first 3 days of the quit attempt (95% CI 1.18-3.25). In addition, compared to users with high levels of long-term quit intention, users with lower levels of intention had 1.80 times the odds of opting out between 4 and 7 days into the quit attempt (95% CI 1.02-3.18). Users who reset their quit date after initiating a quit attempt were less likely to opt out at either time point compared with those who did not reset their quit date. Conclusions Several user characteristics are associated with retention in an adult text messaging smoking cessation program. These results provide guidance on potential characteristics that should be addressed in future text messaging smoking cessation programs. Providing additional support to users with these characteristics may increase retention in text messaging programs and ultimately lead to smoking cessation.

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