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Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation
BACKGROUND: Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research de...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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JMIR Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856923/ https://www.ncbi.nlm.nih.gov/pubmed/29500157 http://dx.doi.org/10.2196/mhealth.9011 |
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author | Baskerville, Neill B Struik, Laura L Dash, Darly |
author_facet | Baskerville, Neill B Struik, Laura L Dash, Darly |
author_sort | Baskerville, Neill B |
collection | PubMed |
description | BACKGROUND: Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. OBJECTIVE: The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app. METHODS: The Spiral Technology Action Research (STAR) 5-cycle model (listen, plan, do, act, and study) was employed to guide the development, implementation, and dissemination of CTC. The approach to development and formative evaluation included focus groups with young adult smokers (n=78) across 2 phases, analysis of the content of existing apps, 2 sessions with content experts, and Google Analytics to assess user behavior during a 12-month pilot. RESULTS: LISTEN—focus groups revealed young adult smoker preferences of (1) positive reinforcement, (2) personalization, (3) social support, (4) quit support, (5) tracking the behavior, and (6) tracking quit benefits. PLAN—informed by evidence for smoking cessation, young adult preferences and an assessment of popular cessation apps, content experts produced a mind map and a storyboard describing app content and structure. DO—focus groups with young adult smokers provided feedback on the first version of the app with opinions on content and suggestions for improvement such as providing alerts and distractions from craving. ACT—refinements were made, and app content was organized using the 4 key design components informed by principles of persuasive technology for behavior change: credibility, task support, dialogue support, and social support. CTC was launched in April 2013 and piloted from the period July 2013 to June 2014 where 1987 Android users had 18,567 sessions, resulting in 59,384 page views and 89.58% (1780/1987) of users returning within the same day to use CTC. STUDY—a pragmatic randomized controlled trial of CTC was launched in August 2014 to demonstrate that including mHealth technology as a population-based intervention can help young adult smokers to quit. The results of this phase will be presented in a subsequent publication. CONCLUSIONS: CTC is one of the first smoking cessation apps designed to meet the needs of young adult smokers. The development was informed by the inclusion of young adults in the design and the systematic application of multiple stakeholder input, scientific evidence, and theory. The STAR model approach was followed from the beginning of intervention development, which should facilitate optimization of mHealth interventions in the future. TRIAL REGISTRATION: ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i) |
format | Online Article Text |
id | pubmed-5856923 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-58569232018-03-26 Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation Baskerville, Neill B Struik, Laura L Dash, Darly JMIR Mhealth Uhealth Original Paper BACKGROUND: Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. OBJECTIVE: The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app. METHODS: The Spiral Technology Action Research (STAR) 5-cycle model (listen, plan, do, act, and study) was employed to guide the development, implementation, and dissemination of CTC. The approach to development and formative evaluation included focus groups with young adult smokers (n=78) across 2 phases, analysis of the content of existing apps, 2 sessions with content experts, and Google Analytics to assess user behavior during a 12-month pilot. RESULTS: LISTEN—focus groups revealed young adult smoker preferences of (1) positive reinforcement, (2) personalization, (3) social support, (4) quit support, (5) tracking the behavior, and (6) tracking quit benefits. PLAN—informed by evidence for smoking cessation, young adult preferences and an assessment of popular cessation apps, content experts produced a mind map and a storyboard describing app content and structure. DO—focus groups with young adult smokers provided feedback on the first version of the app with opinions on content and suggestions for improvement such as providing alerts and distractions from craving. ACT—refinements were made, and app content was organized using the 4 key design components informed by principles of persuasive technology for behavior change: credibility, task support, dialogue support, and social support. CTC was launched in April 2013 and piloted from the period July 2013 to June 2014 where 1987 Android users had 18,567 sessions, resulting in 59,384 page views and 89.58% (1780/1987) of users returning within the same day to use CTC. STUDY—a pragmatic randomized controlled trial of CTC was launched in August 2014 to demonstrate that including mHealth technology as a population-based intervention can help young adult smokers to quit. The results of this phase will be presented in a subsequent publication. CONCLUSIONS: CTC is one of the first smoking cessation apps designed to meet the needs of young adult smokers. The development was informed by the inclusion of young adults in the design and the systematic application of multiple stakeholder input, scientific evidence, and theory. The STAR model approach was followed from the beginning of intervention development, which should facilitate optimization of mHealth interventions in the future. TRIAL REGISTRATION: ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i) JMIR Publications 2018-03-02 /pmc/articles/PMC5856923/ /pubmed/29500157 http://dx.doi.org/10.2196/mhealth.9011 Text en ©Neill B Baskerville, Laura L Struik, Darly Dash. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.03.2018. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Baskerville, Neill B Struik, Laura L Dash, Darly Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title | Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title_full | Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title_fullStr | Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title_full_unstemmed | Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title_short | Crush the Crave: Development and Formative Evaluation of a Smartphone App for Smoking Cessation |
title_sort | crush the crave: development and formative evaluation of a smartphone app for smoking cessation |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856923/ https://www.ncbi.nlm.nih.gov/pubmed/29500157 http://dx.doi.org/10.2196/mhealth.9011 |
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