Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 19, 2021
Date Accepted: May 16, 2021
A web-based intervention to increase smokers’ intentions to participate in a cessation study offered at the point of lung screening: Factorial randomized trial.
ABSTRACT
Background:
Screen ASSIST is a cessation trial offered to current smokers at the point of lung cancer screening. Due to the unique position of promoting a prevention behavior (smoking cessation) within the context of a detection behavior (lung cancer screening), the current study employed prospect theory to design and formatively evaluate a targeted recruitment video prior to trial launch.
Objective:
Identify which message frames were most effective at promoting intent to participate in a smoking cessation study.
Methods:
Participants were randomized to a 2 (benefits of quitting vs. risks of continuing to smoke at the time of lung screening) x 2 (gains of participating vs. losses of not participating in a cessation study) message design experiment (N=296). The primary outcome was intent to participate in a smoking cessation study. Message effectiveness and lung cancer risk perception measures were also collected. ANOVA examined the main effect of the two message factors and a LASSO approach identified predictors of intent to participate in a multivariable model. A mediation analysis was conducted to determine the direct and indirect effects of message factors on intent to participate in a cessation study.
Results:
There were no significant differences in intent to participate in a smoking cessation study between message frames. In the multivariable model, quit importance (<.001), perceived message relevance (<.001), and affective risk response (i.e., worry about developing lung cancer; <.001) were significant predictors of intent to participate. The benefits of quitting frame significantly increased affective risk response (Mbenefits = 2.60 vs. Mrisk = 2.40, p = .036), which mediated the relationship between message frame and intent to participate (b = 0.24, 95% CI, 0.01—0.47, p = .037).
Conclusions:
The current study provides theoretical and practical guidance on how to design and evaluate proactive recruitment messages for a cessation trial. Based on our findings, we conclude that heavy smokers are more responsive to recruitment messages that frame the benefits of quitting as it increased affective risk response, which predicted greater intention to participate in a smoking cessation study.
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