scholarly journals Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation (Preprint)

2017 ◽  
Author(s):  
Neill B Baskerville ◽  
Laura L Struik ◽  
Darly Dash
Keyword(s):  
Social Support ◽  
Smoking Cessation ◽  
Young Adults ◽  
Young Adult ◽  
Focus Groups ◽  
Positive Reinforcement ◽  
Formative Evaluation ◽  
Controlled Trial ◽  
Star Model ◽  
Task Support

BACKGROUND Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. OBJECTIVE The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app. METHODS The Spiral Technology Action Research (STAR) 5-cycle model (listen, plan, do, act, and study) was employed to guide the development, implementation, and dissemination of CTC. The approach to development and formative evaluation included focus groups with young adult smokers (n=78) across 2 phases, analysis of the content of existing apps, 2 sessions with content experts, and Google Analytics to assess user behavior during a 12-month pilot. RESULTS LISTEN—focus groups revealed young adult smoker preferences of (1) positive reinforcement, (2) personalization, (3) social support, (4) quit support, (5) tracking the behavior, and (6) tracking quit benefits. PLAN—informed by evidence for smoking cessation, young adult preferences and an assessment of popular cessation apps, content experts produced a mind map and a storyboard describing app content and structure. DO—focus groups with young adult smokers provided feedback on the first version of the app with opinions on content and suggestions for improvement such as providing alerts and distractions from craving. ACT—refinements were made, and app content was organized using the 4 key design components informed by principles of persuasive technology for behavior change: credibility, task support, dialogue support, and social support. CTC was launched in April 2013 and piloted from the period July 2013 to June 2014 where 1987 Android users had 18,567 sessions, resulting in 59,384 page views and 89.58% (1780/1987) of users returning within the same day to use CTC. STUDY—a pragmatic randomized controlled trial of CTC was launched in August 2014 to demonstrate that including mHealth technology as a population-based intervention can help young adult smokers to quit. The results of this phase will be presented in a subsequent publication. CONCLUSIONS CTC is one of the first smoking cessation apps designed to meet the needs of young adult smokers. The development was informed by the inclusion of young adults in the design and the systematic application of multiple stakeholder input, scientific evidence, and theory. The STAR model approach was followed from the beginning of intervention development, which should facilitate optimization of mHealth interventions in the future. CLINICALTRIAL ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i)

scholarly journals The Crush the Crave Quit Smoking App and Young Adult Smokers: Qualitative Case Study of Affordances (Preprint)

2017 ◽  
Author(s):  
Laura L Struik ◽  
Joan L Bottorff ◽  
Neill Bruce Baskerville ◽  
John L Oliffe
Keyword(s):  
Social Support ◽  
Smoking Cessation ◽  
Young Adults ◽  
Young Adult ◽  
Mobile Phone ◽  
Mobile Apps ◽  
End Users ◽  
Task Support ◽  
Quit Smoking ◽  
Quitting Smoking

BACKGROUND Mobile phone apps have emerged as a promising way to reach young adult smokers, given their high mobile phone ownership rates and openness to receiving cessation support via digital technologies. Although emerging evidence indicates that quit smoking apps are an effective way to reduce smoking among young adults, lacking is formative evaluative research that captures the perspectives of end-users. OBJECTIVE The objective of this study was to contribute insights toward understanding how young adults interact with the Crush the Crave (CTC) app, and how this interaction shapes young adults’ smoking cessation experiences and practices, with consideration of the influence of gender. METHODS Semistructured interviews were conducted with 31 young adult CTC end-users. Guided by sociomateriality theory and an affordances approach, data were inductively analyzed to derive thematic findings in relation to the impacts of CTC on quit efforts, and to expose the underlying affordances (mechanisms) that lend to these outcomes. Findings were grouped according to the 4 design components of CTC: credibility, social support, task support, and dialogue support. RESULTS The credibility component of CTC played an important role in harnessing the trust of young adults because it afforded them promise in relation to its potential effectiveness in assisting them with quitting smoking. The social support component lent to various end-user practices and experiences that rendered this aspect as the weakest component in supporting quit efforts. Although most functions situated in the task and dialogue support components were found to be helpful, there were a few affordances in CTC that resulted in negative experiences, notably weaning from smoking. Gender-related influences were also evident. For example, young men preferred to control and self-manage their quitting and, therefore, did not engage with functions that afforded journaling or reminding to stay on track. Women, in contrast, were more likely to benefit from these affordances. CONCLUSIONS An affordances approach is productive for gaining an in-depth understanding of how mobile apps interact with end-users to lend to particular outcomes. The study findings have implications for developing and improving apps for helping young adults quit smoking, as well as apps that target other health behaviors. Productive affordances may also serve as a framework for leveraging apps for smoking cessation.

scholarly journals Effect of a Mobile Phone Intervention on Quitting Smoking in a Young Adult Population of Smokers: Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Neill Bruce Baskerville ◽  
Laura Louise Struik ◽  
Godefroy Emmanuel Guindon ◽  
Cameron D Norman ◽  
Robyn Whittaker ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Young Adults ◽  
Young Adult ◽  
Mobile Technology ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Quit Smoking ◽  
Self Help ◽  
Continuous Abstinence

BACKGROUND Digital mobile technology presents a promising medium for reaching young adults with smoking cessation interventions because they are the heaviest users of this technology. OBJECTIVE The aim of this study was to determine the efficacy of an evidence-informed smartphone app for smoking cessation, Crush the Crave (CTC), on reducing smoking prevalence among young adult smokers in comparison with an evidence-informed self-help guide, On the Road to Quitting (OnRQ). METHODS A parallel, double-blind, randomized controlled trial with 2 arms was conducted in Canada to evaluate CTC. In total, 1599 young adult smokers (aged 19 to 29 years) intending to quit smoking in the next 30 days were recruited online and randomized to receive CTC or the control condition OnRQ for a period of 6 months. The primary outcome measure was self-reported continuous abstinence at the 6-month follow-up. RESULTS Overall follow-up rates were 57.41% (918/1599) and 60.48% (967/1599) at 3 and 6 months, respectively. Moreover, 45.34% (725/1599) of participants completed baseline, 3-, and 6-month follow-up. Intention-to-treat analysis (last observation carried forward) showed that continuous abstinence (N=1599) at 6 months was not significantly different at 7.8% (64/820) for CTC versus 9.2% (72/779) for OnRQ (odds ratio; OR 0.83, 95% CI 0.59-1.18). Similarly, 30-day point prevalence abstinence at 6 months was not significantly different at 14.4% (118/820) and 16.9% (132/779) for CTC and OnRQ, respectively (OR 0.82, 95% CI 0.63-1.08). However, these rates of abstinence were favorable compared with unassisted 30-day quit rates of 11.5% among young adults. Secondary measures of quit attempts and the number of cigarettes smoked per day at 6-month follow-up did not reveal any significant differences between groups. For those who completed the 6-month follow-up, 85.1% (359/422) of young adult smokers downloaded CTC as compared with 81.8% (346/423) of OnRQ, χ21(N=845)=1.6, P=.23. Furthermore, OnRQ participants reported significantly higher levels of overall satisfaction (mean 3.3 [SD 1.1] vs mean 2.6 [SD 1.3]; t644=6.87, P<.001), perceived helpfulness (mean 5.8 [SD 2.4] vs mean 4.3 [SD 2.6], t657=8.0, P<.001), and frequency of use (mean 3.6 [SD 1.2] vs mean 3.2 [SD 1.1], t683=5.7, P<.001) compared with CTC participants. CONCLUSIONS CTC was feasible for delivering cessation support but was not superior to a self-help guide in helping motivated young adults to quit smoking. CTC will benefit from further formative research to address satisfaction and usage. As smartphone apps may not serve as useful alternatives to printed self-help guides, there is a need to conduct further research to understand how digital mobile technology smoking cessation interventions for smoking cessation can be improved. CLINICALTRIAL ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i)

scholarly journals Young Adult Identification and Perception of Hashtag-Based Vaping Claims on Instagram

2020 ◽  
Vol 47 (4) ◽  
pp. 611-618
Author(s):  
Linnea I. Laestadius ◽  
Kendall Penndorf ◽  
Melissa Seidl ◽  
Pallav Pokhrel ◽  
Ryan Patrick ◽  
...  
Keyword(s):  
Social Media ◽  
Young Adults ◽  
Young Adult ◽  
Focus Groups ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Electronic Cigarette ◽  
Health Related ◽  
Social Media Platforms ◽  
Practical Constraints

Social media platforms are home to large volumes of ambiguous hashtag-based claims about the health, modified-risk, and cessation benefits of electronic cigarette products (e.g., #Vapingsavedmylife). The objective of this study was to qualitatively explore how young adults interpret these hashtags on the popular platform Instagram. Specifically, we sought to identify if they view these hashtags as making health-related claims, and if they find these claims to be credible and valid. We conducted 12 focus groups in 2018 with non–tobacco users, smokers, dual users, and vapers between the ages of 18 and 24 ( n = 69). Using real Instagram posts to guide discussion, participants reflected on the meaning of potentially claims-making hashtags. Participants interpreted the majority of the hashtags as making health-related claims. However, many participants felt that the claims were too exaggerated to be entirely valid. Some participants, including dual users and vapers, argued that smoking and vaping were largely equivalent. Smokers were particularly skeptical of claims. Findings suggest that the U. S. Food and Drug Administration should consider hashtag-based claims in their regulatory efforts. However, further research is needed on how to pragmatically address claims taking the form of hashtags given legal and practical constraints.

Randomized controlled trial of a social support (‘buddy’) intervention for smoking cessation

2006 ◽  
Vol 64 (1-3) ◽  
pp. 235-241 ◽  
Author(s):  
Sylvia May ◽  
Robert West ◽  
Peter Hajek ◽  
Andy McEwen ◽  
Hayden McRobbie
Keyword(s):  
Social Support ◽  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Developing Pictorial Cigarillo Warnings: Insights From Focus Groups

2020 ◽  
Author(s):  
Jennifer Cornacchione Ross ◽  
Jessica L King ◽  
Allison J Lazard ◽  
Seth M Noar ◽  
Beth A Reboussin ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Focus Groups ◽  
Cognitive Effort ◽  
Cigarette Use ◽  
Focus Group Study ◽  
Cognitive Reactions ◽  
Pictorial Warnings ◽  
Youth And Young Adults ◽  
Selection Of

Abstract Introduction The Food and Drug Administration (FDA) selected six text-only warnings for cigarillos to be implemented on packaging and advertising. Pictorial warnings are more effective at discouraging cigarette use than text-only warnings, yet no research exists for cigarillos. We sought to understand what types of images might be most effectively paired with the cigarillo text warnings to inform broad principles for developing pictorial warnings, with a focus on young adults, who have the highest rate of cigarillo use. Methods We conducted five focus groups with a total of N = 30 young adult cigarillo users and susceptible nonusers (53% female, 50% White, and 33% Black). Participants were shown four to eight unique images for each of the six text statements and were asked about visual–verbal congruency, emotional and cognitive reactions, and perceived effectiveness of each image. Sessions were recorded and transcribed; two investigators independently coded transcripts for emergent themes. Results Participants reported images that were graphic or “gross” would best grab attention and discourage use of cigarillos. Participants preferred images that were a direct illustration of the information in the warning text, rather than abstract images that required more cognitive effort to understand. Participants also highlighted that including people in the images, especially youth and young adults making eye contact, helped them relate to the warnings, garner their attention, and positively influence their reactions. Conclusions We identified several principles to inform the selection of images to pair with the FDA-required cigarillo text statements. These insights may also apply to pictorial warnings for other tobacco products. Implications This focus group study identified principles for selecting images to develop pictorial warnings for the six FDA text-only cigarillo warnings. We found that young adult cigarillo users and susceptible nonusers preferred images that were graphic and gross, believable, congruent to the warning text, and included people. Images that match young adults’ visual expectations of a disease and are emotion-provoking may be most effective in pictorial warnings and highlight challenges for developing pictorial warnings for health effects that do not have a visible health consequence.

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