A Pilot Randomized Controlled Trial of a Web-Based Growth Mindset Intervention to Enhance the Effectiveness of a Smartphone App for Smoking Cessation

Abstract

Background Although smartphone apps have shown promise for smoking cessation, there is a need to enhance their low engagement rates. This study evaluated the application of the growth mindset theory, which has demonstrated the potential to improve persistence in behavior change in other domains, as a means to improve engagement and cessation. Objective This study aimed to explore the feasibility, utility, and efficacy of a Web-based growth mindset intervention for addiction when used alongside a smoking cessation app. Methods Daily smokers (N=398) were all recruited on the Web and randomly assigned to receive either a cessation app alone or the app plus a Web-delivered growth mindset intervention. The primary outcome was engagement, that is, the number of log-ins to the smoking cessation app. The secondary outcome was 30-day point prevalence abstinence at 2-month follow-up collected through a Web-based survey. Results The 2-month outcome data retention rate was 91.5% (364/398). In addition, 77.9% (310/398) of the participants in the experimental arm viewed at least 1 page of their growth mindset intervention, and 21.1% (84/398) of the group viewed all the growth mindset intervention. The intention-to-treat analysis did not show statistically significant differences between the experimental and comparison arms on log-ins to the app (19.46 vs 21.61; P =.38). The experimental arm had cessation rates, which trended higher than the comparison arm (17% vs 13%; P =.10). The modified intent-to-treat analysis, including only participants who used their assigned intervention at least once (n=115 in experimental group and n=151 in the control group), showed that the experimental arm had a similar number of log-ins (32.31 vs 28.48; P =.55) but significantly higher cessation rates (21% vs 13%; P =.03) than the comparison arm. Conclusions A growth mindset intervention for addiction did not increase engagement rates, although it may increase cessation rates when used alongside a smartphone app for smoking cessation. Future research is required to refine the intervention and assess efficacy with long-term follow-up to evaluate the efficacy of the mindset intervention. Trial Registration ClinicalTrials.gov NCT03174730; https://clinicaltrials.gov/ct2/show/NCT03174730

Mobile or Web-Based Intervention for Smoking Cessation

“…Only 5% of smokers who want to quit smoking access a smoking cessation service each year. Nevertheless, the drop out is still higher [5]. There were some evidences found that using mobile and web-based intervention can promote smoking cessation.…”

Effect of Growth Mindset on Mental Health Two Years Later: The Role of Smartphone Use

“…Of the various smartphone uses, the role of smartphone use for entertainment on mental health is controversial [ 10 ]. Unlike some other smartphone use behaviors that contribute to problem solving (e.g., using a smartphone to ask for help or gather useful information) [ 27 , 28 ], using a smartphone for entertainment, while distracting from a negative event or situation in the short term [ 29 ], may not be beneficial to mental health in the long term [ 30 ]. In various theoretical models, the use of ICT for entertainment has been identified as an antecedent of problematic technology use (e.g., problematic smartphone use, PSU) [ 31 , 32 , 33 ].…”

Smartphone app-based interventions to support smoking cessation in smokers with mental health conditions: A systematic review

“…However, there has been little assessment of the quality of content, engagement and reach of apps that are underpinned by research or theory, compared with apps commonly used in the marketplace [46,[59][60][61][62][63][64][65][66][67][68][69] that purport to assist smokers with mental health issues to quit [71,72].…”

“…Research suggests that smoking cessation apps can engage smokers with mental health issues, [28] including those who are not already receiving nor seeking professional help [68], and may promote smoking cessation or reduction of tobacco consumption [69], and improve mental health status [46]. With the proliferation of smartphones, mobile health tools are uniquely positioned to reach and in uence the smoking populations that need both smoking cessation and mental health support [70].However, there has been little assessment of the quality of content, engagement and reach of apps that are underpinned by research or theory, compared with apps commonly used in the marketplace [46,[59][60][61][62][63][64][65][66][67][68][69] that purport to assist smokers with mental health issues to quit [71,72].…”