JMIR Publications

ABSTRACT

Background:

Secondhand smoke (SHS) exposure in children in adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in measurement of urinary cotinine, a major metabolite of nicotine. Intervening directly with exposed children is a novel method that has been proposed, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time/cost-effective and feasible for adolescent populations.

Objective:

In this pilot study, we assessed both the feasibility and efficacy of a 30-day text message based, mHealth intervention targeted at reducing SHS exposure in low SES adolescent populations.

Methods:

Non-smoking or vaping participants between the ages of 12-21 exposed to SHS were enrolled in the study (N=14). The intervention consisted of a daily text message sent to participants over the course of a month. Text message types included facts/information about SHS, behavioral methods for SHS avoidance, or true/false questions. Participants were asked to respond to each message within 24-hours as confirmation of receipt. Feasibility outcomes included rate of intervention completion, accessibility of receiving text messages, participants’ responses to messages and feedback on the messages. Efficacy outcomes included reduction in urinary cotinine, accuracy of true/false responses and participants’ perceptions of effectiveness.

Results:

N=14 participants were enrolled and N=13 completed the intervention. All participants had their own cell phones with unlimited text messaging plans. Of the completers, 91% of messages sent received on-time responses. Participant feedback was generally positive with most requesting more informational and true/false questions. In terms of efficacy, 54% reduced their cotinine levels, however there was no statistically significant reduction overall. The majority (77%) of true/false questions were answered correctly, and participants gave the messages an average score of 85 out of 100 in effectiveness.

Conclusions:

In this small pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged in responses to the messages. The efficacy of the study requires further replication as only half of the participants reduced their cotinine levels. However, participants answered the majority of true/false questions accurately and reported the messages were efficacious.