Development and usability of a Spanish/English smoking cessation website: lessons learned

Abstract

Background: Smoking cessation Internet interventions have been shown to be comparable in effectiveness to the nicotine patch. The aim of this study was to develop a Spanish/English smoking cessation web app using input from low-income smokers, and to evaluate modifications to the online intervention in terms of its ability to engage smokers.Methods: Three versions of a smoking cessation web app were developed and tested. Measures of engagement, such as completion of study registration, utilization of cigarette, mood, and craving trackers, and completion of follow-up assessments, were collected to determine whether changes in the website resulted in increased engagement. Results:The third version of the website, which featured improved look-and-feel and fewer barriers to engagement, markedly increased tracker engagement from the first two versions. However, follow-up rates remained low across all three versions. Conclusions:The increase in engagement was attributed to the following modifications: A more inviting landing page with key intervention elements available immediately; an easily accessible dashboard with users' data; and tracking tools that were more user friendly. We conclude that in addition to adequate and functional elements, design principles are key factors in increasing engagement in online interventions.

The Barriers and Facilitators of eHealth-Based Lifestyle Intervention Programs for People With a Low Socioeconomic Status: Scoping Review

“…Several RCTs and observational studies evaluated eHealth interventions on health outcomes (eg, BMI, blood pressure, and hemoglobin A 1c ) [ 30 , 34 , 35 - 37 , 40 , 43 , 45 , 47 , 48 , 53 , 78 ], nutrition-related behavior outcomes [ 32 , 38 , 39 , 79 , 80 ], physical activity–related outcomes, smoking-related outcomes [ 23 , 31 , 46 , 51 , 81 , 82 ], usage outcomes [ 33 , 49 , 54 ], and reach [ 44 ], as well as feasibility and acceptability outcomes [ 47 , 80 ] ( Multimedia Appendix 3 ). Design studies examined recruitment [ 57 ], usability, feasibility [ 57 - 65 ], development, or acceptability of eHealth interventions [ 58 - 60 , 64 , 65 , 67 , 68 , 70 ]. The interventions were aimed at weight loss (n=9), physical activity (n=9), healthy eating (n=11), smoking (n=13), and alcohol use (n=2), and 17 interventions focused on multiple behaviors.…”

“…Researchers used focus groups to map the needs and problems of the (potential) users [ 58 , 59 , 61 , 62 , 66 , 68 , 70 , 73 ] and to gain input from stakeholders to adapt existing interventions [ 61 , 70 , 77 , 86 ]. These methods also helped the researchers to gain insight into the challenges that participants experienced while using the intervention [ 65 , 73 , 86 ] and their thoughts on the requirements of successful participation [ 65 , 66 , 68 , 77 , 86 ]. Furthermore, other methods used the Community Engagement Studio [ 74 ], a consumer panel [ 32 ], and a collective discussion group [ 60 ].…”

“…Several RCTs and observational studies evaluated eHealth interventions on health outcomes (eg, BMI, blood pressure, and hemoglobin A 1c ) [30, 34, 35-37, 40, 43, 45, 47, 48, 53, 78], nutrition-related behavior outcomes [32,38,39,79,80], physical activity-related outcomes, smoking-related outcomes [23,31,46,51,81,82], usage outcomes [33,49,54], and reach [44], as well as feasibility and acceptability outcomes [47,80] (Multimedia Appendix 3). Design studies examined recruitment [57], usability, feasibility [57][58][59][60][61][62][63][64][65], development, or acceptability of eHealth interventions [58][59][60]64,65,67,68,70].…”

“…In the various stages of the development and evaluation of the intervention (ie, problem definition, development, and implementation for the study) [48,50,59,60,64,66,69,70,84], several studies involved stakeholders, which included family members, experts, key informants [50,61,69,75,84,86], health professionals, and end users [48,54,[64][65][66][68][69][70]73,75,83]. However, some studies provided little information on the identification of stakeholders and did not clarify the level of involvement of stakeholders and end users [37,44,50,56,66,70,78,79,81,83,87].…”

“…However, some studies provided little information on the identification of stakeholders and did not clarify the level of involvement of stakeholders and end users [37,44,50,56,66,70,78,79,81,83,87]. The studies used multiple methods, such as interviews, focus groups, and user testing [50,54,57,[64][65][66][67][68][69][70]73,75,83], to gain insights from end users and stakeholders. Researchers used focus groups to map the needs and problems of the (potential) users [58,59,61,62,66,68,70,73] and to gain input from stakeholders to adapt existing interventions [61,70,77,86].…”