JMIR Publications

ABSTRACT

Background:

Health messages are integral to smoking cessation interventions. Common approaches to health message development include expert-crafted messages and audience-generated messages, which produce messages that can be monotonic, didactic, and limited in number. We introduce an alternative approach to health message development that relies on user-generated content available on open content platforms as a source of health messages.

Objective:

We examined the acceptability of user-generated content curated from X (formerly Twitter) as a source of health support messages in a newly developed smoking cessation mobile intervention, called Quit Journey, and the optimal timing and frequency with which health messages can be deployed to support app users in real time.

Methods:

Twelve semi-structured focus groups were held with 38 young adults with low socioeconomic status who smoked cigarettes, wanted to quit, and were 18-29 years old. Focus groups were held virtually on GoTo Meeting, audio recorded, and transcribed verbatim. Deductive thematic analysis was used with themes based on five Second Unified Theory of Acceptance and Use of Technology constructs (i.e., effort expectancy, facilitating conditions, hedonic motivation, performance expectancy, social influence) and negative, neutral, and positive sentiment.

Results:

Participants perceived user-generated messages positively (n= 56 quotes, 51.85%) and focused on their perceived usefulness (n= 37 quotes, 34.25%). User-generated content was perceived as authentic, non-repetitive support from people with similar real-life experiences. Negative or sarcastic user-generated content elicited negative reactions from participants. Participants preferred receiving 3 or fewer daily messages, ideally before cravings. Suggestions focused on the need to screen user-generated content before its inclusion in the app library and to allow app users to customize message frequency and timing.

Conclusions:

User-generated content was deemed an acceptable source of health messages. This content can im-prove the efficacy and effectiveness of smoking cessation interventions by increasing their pool of unique messages that may be better received and more persuasive than expert-curated content. Us-er-generated content used to curate health messages for all medical conditions and behaviors with relevant publicly available online content for integration in behavioral interventions given its high volume, brevity, and narrative-like nature. Future research is needed to investigate the effects of us-er-generated content on health behaviors and identify the theoretical mechanisms for these effects. Clinical Trial: NA