Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 26, 2021
Date Accepted: Sep 3, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Adaptation and assessment of a text messaging smoking cessation intervention in Viet Nam: A pilot randomized controlled trial
ABSTRACT
Background:
Text message (i.e., short message service, SMS) smoking cessation interventions have demonstrated efficacy in high-income countries, but are less well studied in low- and middle-income countries.
Objective:
To assess the feasibility, acceptability, and preliminary efficacy of a fully-automated bidirectional SMS cessation intervention adapted for smokers in Viet Nam.
Methods:
We adapted the SMS library from two US-based SMS cessation programs. The adaptation process consisted of 7 focus groups to provide data on culturally relevant patterns of tobacco use and to assess message preferences, and a single-arm pilot test of a 6-week SMS intervention. We then conducted a two-arm pilot randomized controlled trial and randomized 100 smokers to receive either the 6-week SMS program (intervention arm; n=50) or weekly text assessment on smoking status (control arm; n=50). Surveys assessed engagement and acceptability at 6 weeks (end of intervention), and biochemically confirmed smoking abstinence at 6 and 12 weeks. Post-intervention in-depth interviews further explored user experiences and perceptions among participants in the intervention arm.
Results:
Participants in both arms reported high levels of program acceptability and engagement. Compared to the control arm, a higher proportion of participants in the intervention arm reported being satisfied with the program (98% vs. 82%). Biochemically verified abstinence was higher in the intervention arm at 6 weeks (20.0% vs. 2.0%; P=.01), but the effect was not significant at 12 weeks (12.0% vs. 6.0%; P=.49). Qualitative interviews suggested additional modifications to enhance the program including tailoring the timing of messages, adding more opportunities to interact with the program, and placing a greater emphasis on messages that described the harms of tobacco use.
Conclusions:
The study supported the feasibility and acceptability of a SMS program adapted for Vietnamese smokers. Future studies are needed to assess whether, with additional modifications, the program is associated with prolonged abstinence. Clinical Trial: ClinicalTrials.gov NCT03219541
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