JMIR Publications

ABSTRACT

Background:

While smartphone applications (apps) have shown promise for smoking cessation, there is a need to enhance their low engagement rates. This study evaluated the application of growth mindset theory, which has demonstrated the potential to improve persistence in behavior change in other domains, as a means to improve engagement and cessation.

Objective:

To explore the feasibility and utility of delivering a web-based growth mindset intervention for addiction in addition to a smartphone app for smoking cessation, and whether the addition of growth mindset intervention improves engagement and cessation for app users.

Methods:

Daily smokers (N = 398) were recruited fully online and randomly assigned to receive either a cessation app alone, or the app plus a web-delivered growth mindset intervention. The primary outcome was engagement: number of logins to the smoking-cessation app. The secondary outcome was 30-day point prevalence abstinence at two-month follow-up collected via online survey.

Results:

The two-month outcome data retention rate was 92% (364/398). Seventy-eight percent (310/398) of the participants in the experimental arm viewed at least one page of their growth mindset intervention and 21% (84/398) of the group viewed all of the growth mindset intervention. Intention-to-treat analysis did not show statistically significant differences between the experimental and comparison arms on log-ins to the app (19.46 vs. 21.61, p =.38). The experimental arm had cessation rates which trended higher than the comparison arm (17% vs. 13%; p = .10). The modified intent-to-treat analysis, including only participants who used their assigned intervention at least once (N=115 in experimental group and N = 151 in the control group) showed that the experimental arm had similar number of log-ins (32.31 vs. 28.48, p = .55) but significantly higher cessation rates (21% vs 13%; p =.03) than the comparison arm.

Conclusions:

A growth mindset intervention for addiction did not increase engagement rates, although it may increase cessation rates when used alongside a smartphone app for smoking cessation. This may be partially a result of lower than desired uptake of the intervention. Future research is required to refine the intervention and assess efficacy with long-term follow-up to evaluate the efficacy of the mindset intervention. Clinical Trial: The study was registered on clinicaltrials.gov (NCT03174730).