JMIR Publications

ABSTRACT

Background:

Tobacco smoking remains the leading cause of preventable morbidity and mortality in the United States (US), with significant rural-urban disparities. Adults who live in rural areas of the US have among the highest tobacco smoking rates in the nation and experience a higher prevalence of smoking-related deaths and deaths due to chronic diseases for which smoking is a causal risk factor. Barriers to accessing tobacco use cessation treatments are a major contributing factor to these disparities. Adults living in rural areas experience difficulty accessing tobacco cessation services due to geographical challenges, lack of insurance coverage, and lack of healthcare providers who treat tobacco use disorders. The use of digital technology could be a practical answer to these barriers.

Objective:

This report describes a protocol for a study whose main objectives are to develop and beta-test an innovative intervention that uses a private, moderated Facebook group platform to deliver peer support and faith-based cessation messaging to enhance the reach and uptake of existing evidence-based cessation treatment (EBCT) resources (e.g., state quitline coaching programs) for rural adults who smoke.

Methods:

We will use the Integrated Theory of Health Behavior Change, surface/deep structure frameworks to guide intervention development, and the community-based participatory research (CBPR) approach to identify and engage with community stakeholders. The initial content library of moderator postings (videos and text/image postings) will be developed using existing EBCT material from the CDC Tips from Former Smokers Campaign. The content library will feature topics related to quitting smoking, such as coping with cravings and withdrawal, and using EBCTs with faith-based message integration (e.g., Bible quotes). A Community Advisory Board and a Community Engagement Studio will provide feedback to refine the content library. We will also conduct a beta test of the intervention with n=15 rural adults who smoke to assess recruitment feasibility and preliminary intervention uptake such as engagement, ease of use, usefulness, and satisfaction to further refine the intervention based on participant feedback.

Results:

The result of this study will create an intervention prototype that will be used for a future randomized control trial.

Conclusions:

Our CBPR project will create a prototype of a Facebook-delivered faith-based messaging and peer support intervention that may assist rural adults who smoke to utilize EBCT. This study is crucial in establishing a self-sufficient smoking cessation program for the rural community. The project is unique in using a moderated social media platform providing peer support and culturally relevant faith-based content to encourage adult people who smoke to seek treatment and quit smoking.