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Accepted for/Published in: JMIR mHealth and uHealth

Date Submitted: Dec 6, 2018
Open Peer Review Period: Dec 10, 2018 - Jan 16, 2019
Date Accepted: Jan 30, 2019
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

A Smartphone App to Assist Smoking Cessation Among Aboriginal Australians: Findings From a Pilot Randomized Controlled Trial

Peiris D, Wright L, News M, Rogers K, Redfern J, Chow C, Thomas D

A Smartphone App to Assist Smoking Cessation Among Aboriginal Australians: Findings From a Pilot Randomized Controlled Trial

JMIR Mhealth Uhealth 2019;7(4):e12745

DOI: 10.2196/12745

PMID: 30938691

PMCID: 6538311

A smartphone app to assist smoking cessation amongst Aboriginal Australians: findings from a pilot randomised controlled trial

  • David Peiris; 
  • Lachlan Wright; 
  • Madeline News; 
  • Kris Rogers; 
  • Julie Redfern; 
  • Clara Chow; 
  • David Thomas

ABSTRACT

Background:

Mobile health (mHealth) apps have potential to increase smoking cessation but little research has been conducted with Aboriginal communities in Australia.

Objective:

We conducted a pilot study to assess the feasibility, acceptability and explore the effectiveness of a novel mHealth application to assist Aboriginal people to quit smoking.

Methods:

Design: A single-blinded, pilot, randomised, controlled trial (RCT) and a process evaluation comprising usage analytics data and in-depth interviews Setting and participants: Aboriginal current smokers (aged >16 years willing to make a quit attempt in the next month) recruited from Aboriginal Community Controlled Health Services and a government telephone coaching service in New South Wales Intervention: A multifaceted Android or iOS app comprising a personalised profile and quit plan, text and in app motivational messages, and a challenge feature allowing users to ‘compete’ with others vs usual cessation support services Outcomes: Self-reported continuous smoking abstinence, verified by carbon monoxide breath testing at 6 months. Secondary outcomes included point prevalence of abstinence and use of smoking cessation therapies and services.

Results:

A total of 49 participants were recruited for the pilot RCT. Competing service delivery priorities, the lack of resources for research and lack of support for randomisation to a control group were the major recruitment barriers. At baseline, 47% of participants had tried to quit in recent weeks with very few having accessed support services, medication or nicotine replacement therapy. At 6 months follow-up only one participant (intervention arm) was abstinent. There were however, non-significant increases in smoking cessation medication/ nicotine replacement use in the intervention arm (18% intervention vs 9% control) and use of cessation support services (41% intervention vs 28% control). The process evaluation highlighted low to moderate app usage (3-10 new users/ month and 4–8 returning users/month), an average of 2.9 sessions/user/month and 6.3 minutes per session. Key themes from interviews with intervention participants (n=15) included: (1) the powerful influence of prevailing social norms around acceptability of smoking; (2) high usage of mobile devices for phone, text and social media but very low use of other smartphone apps; (3) the role of family and social group support in supporting quit attempts; and (4) low awareness and utilisation of smoking cessation support services. Despite broad acceptability of the app, participants also recommended technical improvements to improve functionality, greater customisation of text messages, integration with existing social media platforms and gamification features.

Conclusions:

Smoking cessation apps need to be integrated with commonly used functions of mobile phones and draw on social networks to support their use. Although they have potential to increase utilisation of cessation support services and treatments, more research is needed to identify optimal implementation models. Robust evaluation is critical to determine their impact, however, an RCT design is unlikely to be feasible in this setting and alternative approaches are recommended. Clinical Trial: ACTRN12616001550493


 Citation

Please cite as:

Peiris D, Wright L, News M, Rogers K, Redfern J, Chow C, Thomas D

A Smartphone App to Assist Smoking Cessation Among Aboriginal Australians: Findings From a Pilot Randomized Controlled Trial

JMIR Mhealth Uhealth 2019;7(4):e12745

DOI: 10.2196/12745

PMID: 30938691

PMCID: 6538311

Per the author's request the PDF is not available.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.