Text Messaging to Enhance Mindfulness-Based Smoking Cessation Treatment: Program Development Through Qualitative Research

Abstract

BackgroundMindfulness-based programs show promise for promoting smoking cessation in diverse populations. Mobile health strategies could increase treatment engagement and in-the-moment support, thus enhancing the effects of mindfulness-based smoking cessation interventions. However, most mobile health programs have been developed without sufficient input from the target population.ObjectiveBy eliciting input from the target population, predominantly low socioeconomic status (SES) African American adult smokers, throughout the development of an SMS (short message service) text messaging program that teaches mindfulness for smoking cessation, we aimed for the resulting program to be optimally effective and consistent with participants’ needs and preferences.MethodsTwo qualitative studies (N=25) were conducted with predominantly low SES, African American adult smokers. In Study 1 (initial qualitative input; n=15), participants engaged in focus groups to provide suggestions for program development. In Study 2 (abbreviated trial; n=10), participants received a 1-week version of the SMS text messaging program and provided feedback through in-depth interviews.ResultsIn Study 1, participants suggested that the SMS text messaging program should be personalized and interactive (ie, involve two-way messaging); provide strategies for coping with cravings and recovering from smoking lapses; involve relatively short, to-the-point messages; and include pictures. In Study 2, participants were highly engaged with the texts, indicated that the program was useful, and provided additional suggestions for improvement.ConclusionsEliciting feedback from the target population throughout the intervention development process allowed for iterative revisions to increase feasibility, acceptability, and effectiveness. Overall, SMS text messaging appears to be a feasible, appealing way to provide in-the-moment personalized support and encourage mindfulness among low-income African American smokers.

Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study

“…With regard to the development of an SMS text messaging smoking cessation program, we found that strategies or tips for managing their cravings and motivational or encouraging messages were the most common desired content among the smokers in our study. This is consistent with the findings from previous studies on adult smokers in the United States [ 34 , 35 ]. In addition, Vietnamese smokers in our study valued content about the harmful effects of smoking not only on smokers themselves but also for their family members.…”

“…Another difference between our study and previous qualitative studies of text messaging for smoking cessation (most of which were conducted in the United States or other high-income countries) is that most smokers in our study did not want to receive more than 2 messages per day. Studies indicate that smokers in developed countries may prefer to receive more messages, even 5 to 6 messages per day around their quit date [ 12 , 34 , 35 ]. This difference might be explained by the large number of spam messages sent to cell phone subscribers in Vietnam, which made Vietnamese cell phone users reluctant to receive text messages.…”

The Feasibility of Implementing Text Messaging System to Support Smoking Cessation for Smokers in Hanoi

“…Most subjects participated in the reading and using messages programs every day (82.5%). The level of interaction of research participants with the program was very high, which is similar to the results found in other studies [12], [13]. Our results once again show that text messaging-based smoking cessation intervention programs are highly feasible, because the messages in the program are directly delivered to the smokers for the sake of smoking cessation [11], [12].…”

Participant Perceptions on a Fitbit and Facebook Intervention for Young Adult Cancer Survivors: A Qualitative Study

“…This feedback is consistent with studies demonstrating that participants in mHealth interventions prefer frequent and personalized text messages with a positive and encouraging tone, as well as those that offer strategies and tips for the desired behavioral change. [26][27][28] Two systematic reviews of RCTs offering individual ''computer-tailored'' feedback showed positive effects in changing health behaviors, including PA. 29,30 Such feedback may improve future PA interventions for our target population.…”