A Multimedia Mobile Phone–Based Youth Smoking Cessation Intervention: Findings From Content Development and Piloting Studies

Abstract

Background While most young people who smoke want to quit, few access cessation support services. Mobile phone–based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention.Objective The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone.Methods Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention.Results Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting “real” and “honest” role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study.Conclusions A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people.

Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.

“…171,172 Two studies 99,177 described electronic aids with single or multiple generic components, 18 studies 103,[158][159][160][161][162][163][164][165][166][167][168][169][170][171]176,180,181 described electronic aids with a single tailored component (with or without a generic component) and six studies [171][172][173][174][175]178 described interventions that had multiple tailored components (with or without generic components). Thus, the balance of studies in the supplementary review is similar to the effectiveness review in that the majority involved interventions with a single tailored component.…”

“…Whittaker et al 171 describe a multimedia cessation intervention delivered to young people by mobile telephone. The same team went on to conduct a trial of the intervention that is included in the effectiveness review.…”

“…Views were sought via four focus groups with 16-to 18-year-old smokers (n = 27) and an online survey of a larger sample (number not specified) via a radio station website. Whittaker et al 171 describe findings from the focus groups regarding the acceptability of such an intervention (p. 5):…”

“…Three studies 171,173,174 describe the process of involving users in the development and piloting of electronic aids and assert that this process improved the acceptability and efficacy of these aids. McDaniel et al 173,174 conducted a cross-sectional pilot study of an interactive computerbased programme designed to increase readiness to quit and report the results in two separate but related articles.…”

3MD for Chronic Conditions, a Model for Motivational mHealth Design: Embedded Case Study (Preprint)

“…The use of instant feedback and positive reinforcement from learning theories are common use in mHealth applications [29,47]; Health Belief Model (HBM) has been used in mHealth interventions for self-management and health promotion [52][53][54]; the Transtheoretical Model (TTM) has been used in mobile solutions for smoke cessation and other addictive behaviors [55][56][57][58]; physical activity and fitness interventions use the Theory of Planned Behavior (TPB) [29,50,59], as well as self-regulation theories [29,[60][61][62][63]. The basis for Social Cognitive Theories (SCT) can be found in many interventions using health apps for disease management [64][65][66] and goal setting is very often used in mHealth apps [60,67].…”