JMIR Publications

ABSTRACT

Background:

There is little consensus regarding effective digital health interventions for diverse populations due in part to the difficulty of quantifying the impact of various media and content, and the lack of consensus on how to evaluate and report dosage and outcomes. Particularly, digital smoking behavior change intervention is an area where consistency of measurement has been a challenge due to the emerging products and rapid policy changes. This study reviews the contents and outcomes of digital smoking interventions and the consistency of reporting to inform future research.

Objective:

This paper aims to 1) systematically review the current practice of digital smoking behavior change interventions, and 2) evaluate the consistency in measuring and reporting intervention contents, channels, and dose and response outcomes in this field.

Methods:

PubMed, Embase, Scopus, Psych INFO, and PAIS were used to search literature. Literature was searched between January and May 2021. General search and journal-based search were combined to find literature that was directly related to the scope of the study. All records were imported to COVIDENCE, a screening tool designed for systematic reviews, and duplicates were removed. Titles and abstracts were screened by four trained reviewers to determine eligible full-text literature. The data synthesis scheme was designed under the concept that exposure to digital interventions can be divided into 1) intended doses that were planned by the intervention, and 2) enacted doses that were completed by participants. The intended dose consisted of frequency and lengths of interventions, and the enacted dose was assessed as engagement. Response measures were assessed for behaviors, intentions, and psychosocial outcomes. Measurement of dose-response relationship was reviewed for all literature.

Results:

A total of 2,916 articles were identified through a database search. Title and abstract review yielded 324 articles for possible eligibility, and 19 articles on digital smoking behavior change interventions were ultimately included for data extraction and synthesis. The analysis revealed the lack of prevention studies (0%, 0/19) and dose-response studies (16%, 3/19) in this field. 6 studies (32%, 6/19) reported multiple behavioral measures and 5 studies (23%, 5/19) reported multiple psychosocial measures as outcomes. For dosage measures, 7 studies (37%, 7/19) used frequency of exposure, and 4 studies (21%, 4/19) mentioned the length of exposure to the intervention. The assessment of clarity of reporting revealed that duration of intervention and data collection tend to be reported vaguely in literature.

Conclusions:

This review revealed the lack of studies that assess the effects of digital media interventions on smoking outcomes. Data synthesis showed that both measurement and reporting were not consistent across studies, illustrating current challenges in this field. Although most studies paid attention to reporting outcomes, measurement of exposure including intended and enacted doses was unclear in a large proportion of studies. Clear and consistent reporting of both outcomes and exposures is needed to develop further evidence in digital smoking behavior change intervention research.