JMIR Publications

ABSTRACT

Background:

Approach Bias Modification (ApBM) aims to target maladaptive approach tendencies toward substance-related cues and has increasingly been examined as an adjunctive intervention for substance use disorders, including nicotine use. Participants’ subjective experiences of ApBM are likely to influence both its effectiveness and successful implementation, yet systematic investigations remain seldom.

Objective:

The present study explores subjective training experiences reported by participants from two previously conducted randomized controlled trials (RCTs) evaluating virtual reality–based or smartphone app–based ApBM for smoking cessation (versus sham training), delivered over a 14-day training interval.

Methods:

Participants were invited to provide open-ended feedback immediately following the intervention and up to seven weeks after study entry (proximate feedback), as well as again four years later (long-term feedback). Thematic analysis was used to identify core themes related to the training experience.

Results:

In total, 104 of the 178 participants included in the RCTs provided feedback at least once (ApBM: n = 54; sham: n = 50). Four overarching themes were identified, with the fourth emerging only in long-term reflections: (a) perceived treatment effects, spanning beneficial changes and a perceived lack of effects; (b) mechanisms of action, including presumed working mechanisms and impeding factors; (c) feedback on the training and study experience; and (d) attribution of effects to training-specific or external factors. Exploratory frequency analyses indicated more favorable experiences in the ApBM group, whereas participants in the sham condition more often reported impeding factors, particularly difficulties understanding the training rationale. Similarly, descriptive quantitative findings suggested more positive training evaluations and smoking-related outcomes in the ApBM group.

Conclusions:

Overall, this study provides important insights into how ApBM for smoking is experienced both shortly after training and years later, underscoring the importance of incorporating participants’ perspectives into the development and evaluation of ApBM interventions.