Cargando…

Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study

BACKGROUND: Mobile health tools such as text messaging programs can support smoking cessation. However, high rates of disengagement from these tools decrease their effectiveness. OBJECTIVE: The purpose of this study was to identify user characteristics associated with retention in an adult text mess...

Descripción completa

Detalles Bibliográficos
Autores principales: Wiseman, Kara P, Coa, Kisha I, Prutzman, Yvonne M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694733/
https://www.ncbi.nlm.nih.gov/pubmed/31373278
http://dx.doi.org/10.2196/13712
_version_ 1783443889188765696
author Wiseman, Kara P
Coa, Kisha I
Prutzman, Yvonne M
author_facet Wiseman, Kara P
Coa, Kisha I
Prutzman, Yvonne M
author_sort Wiseman, Kara P
collection PubMed
description BACKGROUND: Mobile health tools such as text messaging programs can support smoking cessation. However, high rates of disengagement from these tools decrease their effectiveness. OBJECTIVE: The purpose of this study was to identify user characteristics associated with retention in an adult text messaging smoking cessation intervention. METHODS: Adults initiating a quit attempt using the publicly available program SmokefreeTXT between March 6 and June 21, 2016 (n=6215), were included. Data were collected to assess nicotine dependence, frequency of being around other smokers, time of the day for cigarette cravings, extrinsic and intrinsic motivation to quit smoking, confidence in quitting, and long-term intention to be smoke free. Multivariable survival analysis modeling for time to opt out was conducted to identify characteristics associated with opting out over the course of the intervention, adjusting for age, sex, and smoking frequency, reset of the quit date by the user, and the number of days enrolled before initiating the quit attempt. Among those who opted out, multivariable multinomial logistic regression analysis was used to identify predictors of opting out early (within 3 days and between 4 and 7 days into the quit attempt) compared to opting out late (more than 7 days into the quit attempt), adjusting for the same confounders. RESULTS: Survival analyses indicated that younger age, female sex, higher levels of nicotine dependence, lower intention to be smoke free, and enrolling in SmokefreeTXT ≤1 week before initiating the quit attempt were associated with an increased risk of opting out. For example, users who smoked within 5 minutes of waking up were 1.17 times more likely to opt out than those who smoked more than 5 minutes after waking up (95% CI 1.01-1.35). Among users who opted out from SmokefreeTXT, logistic regression modeling indicated that compared to users who were never or rarely around other smokers, those who were sometimes around other smokers had 1.96 times more likely to opt out within the first 3 days of the quit attempt (95% CI 1.18-3.25). In addition, compared to users with high levels of long-term quit intention, users with lower levels of intention had 1.80 times the odds of opting out between 4 and 7 days into the quit attempt (95% CI 1.02-3.18). Users who reset their quit date after initiating a quit attempt were less likely to opt out at either time point compared with those who did not reset their quit date. CONCLUSIONS: Several user characteristics are associated with retention in an adult text messaging smoking cessation program. These results provide guidance on potential characteristics that should be addressed in future text messaging smoking cessation programs. Providing additional support to users with these characteristics may increase retention in text messaging programs and ultimately lead to smoking cessation.
format Online
Article
Text
id pubmed-6694733
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher JMIR Publications
record_format MEDLINE/PubMed
spelling pubmed-66947332019-09-19 Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study Wiseman, Kara P Coa, Kisha I Prutzman, Yvonne M JMIR Mhealth Uhealth Original Paper BACKGROUND: Mobile health tools such as text messaging programs can support smoking cessation. However, high rates of disengagement from these tools decrease their effectiveness. OBJECTIVE: The purpose of this study was to identify user characteristics associated with retention in an adult text messaging smoking cessation intervention. METHODS: Adults initiating a quit attempt using the publicly available program SmokefreeTXT between March 6 and June 21, 2016 (n=6215), were included. Data were collected to assess nicotine dependence, frequency of being around other smokers, time of the day for cigarette cravings, extrinsic and intrinsic motivation to quit smoking, confidence in quitting, and long-term intention to be smoke free. Multivariable survival analysis modeling for time to opt out was conducted to identify characteristics associated with opting out over the course of the intervention, adjusting for age, sex, and smoking frequency, reset of the quit date by the user, and the number of days enrolled before initiating the quit attempt. Among those who opted out, multivariable multinomial logistic regression analysis was used to identify predictors of opting out early (within 3 days and between 4 and 7 days into the quit attempt) compared to opting out late (more than 7 days into the quit attempt), adjusting for the same confounders. RESULTS: Survival analyses indicated that younger age, female sex, higher levels of nicotine dependence, lower intention to be smoke free, and enrolling in SmokefreeTXT ≤1 week before initiating the quit attempt were associated with an increased risk of opting out. For example, users who smoked within 5 minutes of waking up were 1.17 times more likely to opt out than those who smoked more than 5 minutes after waking up (95% CI 1.01-1.35). Among users who opted out from SmokefreeTXT, logistic regression modeling indicated that compared to users who were never or rarely around other smokers, those who were sometimes around other smokers had 1.96 times more likely to opt out within the first 3 days of the quit attempt (95% CI 1.18-3.25). In addition, compared to users with high levels of long-term quit intention, users with lower levels of intention had 1.80 times the odds of opting out between 4 and 7 days into the quit attempt (95% CI 1.02-3.18). Users who reset their quit date after initiating a quit attempt were less likely to opt out at either time point compared with those who did not reset their quit date. CONCLUSIONS: Several user characteristics are associated with retention in an adult text messaging smoking cessation program. These results provide guidance on potential characteristics that should be addressed in future text messaging smoking cessation programs. Providing additional support to users with these characteristics may increase retention in text messaging programs and ultimately lead to smoking cessation. JMIR Publications 2019-08-01 /pmc/articles/PMC6694733/ /pubmed/31373278 http://dx.doi.org/10.2196/13712 Text en ©Kara P Wiseman, Kisha I Coa, Yvonne M Prutzman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 01.08.2019. 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
Wiseman, Kara P
Coa, Kisha I
Prutzman, Yvonne M
Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title_full Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title_fullStr Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title_full_unstemmed Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title_short Predictors of Retention in an Adult Text Messaging Smoking Cessation Intervention Program: Cohort Study
title_sort predictors of retention in an adult text messaging smoking cessation intervention program: cohort study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694733/
https://www.ncbi.nlm.nih.gov/pubmed/31373278
http://dx.doi.org/10.2196/13712
work_keys_str_mv AT wisemankarap predictorsofretentioninanadulttextmessagingsmokingcessationinterventionprogramcohortstudy
AT coakishai predictorsofretentioninanadulttextmessagingsmokingcessationinterventionprogramcohortstudy
AT prutzmanyvonnem predictorsofretentioninanadulttextmessagingsmokingcessationinterventionprogramcohortstudy