Background: Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Materials and Methods: Young adult smokers 18-30 years old (n = 102) participated in a randomized pretest-posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Selfreported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Results: Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (p < 0.05) than REQ-Mobile. Use of both services predicted increased 30-day abstinence at 12 weeks (used, 47%; not used, 20%; p = 0.03). Conclusions: REQ-Mobile was feasible for delivering cessation support but appeared to not move smokers to quit as quickly as text messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging.

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The Internet is a new technology for health communication in communities. The 5 a Day, the Rio Grande Way website intended to increase fruits and vegetables (FV) consumption was evaluated in a rural region enrolling 755 adults (65% Hispanic, 9% Native American, 88% female) in a randomized pretest-posttest controlled trial in [2002][2003][2004]. A total of 473 (63%) adults completed a 4-month follow-up. The change in daily intake on a food frequency questionnaire (control: mean = − 0.26 servings; intervention: mean = 0.38; estimated difference = 0.64, SD = 0.52, t(df = 416) = 1.22, p = 0.223) and single item (13.9% eating 5+ servings at pretest, 19.8% posttest for intervention; 17.4%, 13.8% for controls; odds ratio (OR) = 1.84, 95% CI = 1.07, 3.17) was in the expected direction but significant only for the single item. Website use was low and variable (logins: M = 3.3, range = 1 to 39.0; total time: M = 22.2 minutes, range = 0 to 322.7), but it was associated positively with fruit and vegetable intake (total time: Spearman r = 0.14, p = 0.004 for food frequency; Spearman r = 0.135, p = 0.004 for single item). A nutrition website may improve FV intake. The comparison on the food frequency measure may have been undermined by its high variability. Websites may be successful in community settings only when they are used enough by adults to influence them.The Internet is a relatively new medium for health communication. It has several characteristics that might be used to improve health promotion: Its ability to span large distances at low cost with standardized information in multimedia formats that promote learning among populations with diverse ages, education, literacy levels, and social circumstances may help to address lower access to health care and transportation problems (Benton Foundation, 1998; U.S. Congress & Office of Technology Assessment, 1991;Walther, Pingree, Hawkins, & Buller, 2005). This article contains a report on diet changes produced by an Internet website among adults in a rural region in the southwestern United States. Rural communities present unique challenges to using this technology-lower Internet use, slower Internet connections, wide variations in computer and Internet skills, and limited training resources and technical support than in urban communities (Benton Foundation, 1998;Horrigan, 2005;Rainie & Horrigan, 2005 Efficacy of Internet-based Nutrition Education for Rural CommunitiesDiet, nutrition, vitamins, and nutritional supplements rank as the third most popular Internet health topic (Fox, 2005), but there is little evidence that it is effective to deliver nutrition education over the Internet in community settings. Internet-based health communication has produced positive changes in diet and related behaviors (Celio et al., 2000;Oenema, Brug, & Lechner, 2001;Oenema, Tan, & Brug, 2005;Papadaki & Scott, 2005;Rothert et al., 2006;Tate, Wing, & Winett, 2001;White et al., 2004;Williamson et al., 2005;Williamson et al., 2006;Winzelberg et al., 2000), although not in all studie...

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Background At-risk populations can be reached with Web-based disease prevention and behavior change programs. However, such eHealth applications on the Internet need to generate return usage to be effective. Limited evidence is available on how continued usage can be encouraged.Objective This analysis tested whether routine email notification about a nutrition education website promoted more use of the website.Methods Adults from six rural counties in Colorado and New Mexico, United States (n = 755) participating in a randomized trial and assigned to the intervention group (n = 380) received, over a period of 4 months, email messages alerting them to updates on the website, along with hyperlinks to new content. Update alerts were sent approximately every 5 weeks (each participant received up to 4 messages). Log-ons to the website were the primary outcome for this analysis.ResultsA total of 23.5% (86/366) of the participants responded to at least one email, and 51.2% (44/86) of these participants responded to half of the email messages by logging on to the website. Significantly more log-ons occurred on email notification days compared to all other days (OR = 3.71, 95% CI = 2.72-5.06). More log-ons also occurred just after the notification but declined each day thereafter (OR = 0.97, 95% CI = 0.96-0.98 one day further from mass email). Non-Hispanics (OR = 0.46, 95% CI = 0.26-0.84), older participants (OR = 1.04, 95% CI = 1.04-1.06), and those using the Internet most recently (OR = 0.62, 95% CI = 0.51-0.77) were more likely to log on. Responders to the messages had a more positive change in fruit and vegetable intake (mean change = +1.69) than nonresponders (+0.05), as measured with a food frequency assessment (adjusted Spearman partial correlation coefficient = 0.14, P = .049). Compared to nonresponders, responders were more likely to be non-Hispanic (P = .01), older (P < .001), and had used the Internet more recently (P < .001).Conclusions Messages sent by email appeared to promote a modest short-lived increase in use of a disease prevention website by some adults. Those who responded to the messages by logging on to the website may have been influenced to improve their diet.