Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 24, 2021
Date Accepted: May 31, 2021
Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: An Observational Study
ABSTRACT
Background:
Smartphone mobile applications (apps) are frequently used to deliver standalone or multimodal smoking cessation interventions. However, factors that impede or improve app usage are poorly understood.
Objective:
This study used the supportive accountability model to investigate factors that influence app usage in the context of a trial designed to reduce parental smoking in low-income and predominantly minority communities.
Methods:
We conducted a secondary analysis of data (N=181) from a randomized controlled trial that included a smoking cessation app (QuitPal-m). Supportive accountability was measured by the frequency of times a participant was advised by their cessation counselor to use QuitPal-m. Participants reported app use helpfulness and barriers. Investigators tracked reported phone and technical problems that impeded app use.
Results:
Most participants rated the app as very helpful (66.5%) or somewhat helpful (16.8%), but daily use declined rapidly over time. App use was positively related to the level of education (P=.002) and inversely related to perceived barriers (P=.003) and phone technical problems (P<.001). Participants opened the app a greater proportion of the days following than preceding app advice (45% vs. 34%; P<001). The positive relation between counselor app advice and app usage 24 hours after receiving advice was stronger among smokers with no plan to quit than those planning to quit (P=.026), independent of education and phone or app problems.
Conclusions:
Findings show the utility of supportive accountability for increasing smoking cessation app use in a predominantly low-income, minority population, particularly if quit motivation is low. Results also highlight the importance of addressing personal and phone/technical barriers in addition to adding supportive accountability. Clinical Trial: NCT02602288
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