Treatment Satisfaction in a Randomized Clinical Trial of mHealth Smoking Abstinence Reinforcement

Abstract

The importance of patient satisfaction in modern healthcare is widely recognized, but research on satisfaction in the context of smoking cessation has not kept pace. The purpose of this study was to explore treatment satisfaction in a sample of smokers (N = 84) randomized to one of two smoking cessation treatment interventions (mHealth Reinforcement and mHealth Monitoring) that used cell phone-based procedures to monitor smoking status in individuals’ natural environments for 4 weeks. Starting on the target quit date, participants received usual care smoking cessation treatment consisting of 8 weeks of transdermal nicotine and 4 weeks of twice-weekly telephone counseling, and were also prompted 1 to 3 times daily (with exact number and timing not disclosed beforehand) to use a study cell phone and CO monitor to complete a CO self-test, video-record the process, and submit videos using multimedia messaging within 2 hours. mHealth Reinforcement participants could earn prizes for smoking-negative on-time CO tests. A treatment satisfaction survey was completed at the end of the 4-week monitoring/reinforcement phase. Results indicate that participants overwhelming endorsed high levels of overall satisfaction in both conditions. Treatment adherence did not differ between conditions, but was positively associated with endorsing the highest satisfaction with help quitting with the intervention (p < .01 to .03). mHealth Reinforcement was associated with increased longest duration of abstinence (p < .01). Controlling for relevant participant characteristics and treatment adherence, longest duration of abstinence robustly predicted highest satisfaction with help quitting and mediated the effect of treatment condition on that satisfaction. Further research on treatment satisfaction may aid the development of effective abstinence reinforcement and other smoking cessation interventions.

Psychometric evaluation of a multi‐dimensional measure of satisfaction with behavioral interventions

“…Treatment satisfaction is also important because of its well‐established association with treatment adherence and outcomes. Evidence supports this association in studies of a range of health problems, such as pain (e.g., George & Robinson, ), anxiety (e.g., Smith et al, ), smoking cessation (e.g., Alessi & Rash, ), and substance misuse (e.g., Schulte et al, ). In this paper, we describe and report on the psychometric properties of a self‐report instrument measuring satisfaction with behavioral interventions.…”

“…Treatment satisfaction reflects persons’ valuation of different aspects and/or attributes of the treatment, resulting from their experience with the treatment (Gold et al, ; Kucukarslan, Kee, Patel, & Ruparelia, ; Revicki, ). Such feedback is informative; it reinforces the acceptability and usefulness of aspects of the treatment and points to those that could be modified to enhance their attractiveness to potential users (Alessi & Rash, ; Brod, Christensen, & Bushnell, ; Schulte, Leier, & Stirling, ). Treatment satisfaction is also important because of its well‐established association with treatment adherence and outcomes.…”

“…Variability in theoretical perspectives may have contributed to the development of a range of self‐report instruments measuring treatment satisfaction. The instruments consist of either single items measuring global treatment satisfaction (e.g., Fontana, Rosenheck, Ruzek, & McFall, ; Waltz et al, ) or multiple items assessing the perceived helpfulness of each treatment component (e.g., Alessi & Rash, ; Jennings, Vandelanotte, Caperchione, & Mummery, ; McGregor, Coghlan, & Dennis, ; Smith et al, ) and treatment processes such as group dynamics or climate (e.g., Levenson, Macgowan, Morin, & Cotter, ; Reay, Fisher, Robertson, Adams, & Owen, ), the therapists’ competence (e.g., Openshaw et al, ), and the relationship between therapists and patients (e.g., Oei & Green, ; Tierney & Kane, ). Other measures incorporate items assessing patients’ values or perceptions of different treatment attributes, which often include their benefits, discomfort or side effects, and convenience of use (e.g., Frick, Gutzwiller, Maggiorini, & Christen, ; Gamble et al, ; Gold et al, ; Kucukarslan et al, ; Rejas, Ruiz, Pardo, & Soto, ; Umar et al, ; Wong, Chow, Chen, Wong, & Fielding, ; Wyman et al, ).…”

Contingency management treatment for substance use disorders: How far has it come, and where does it need to go?

“…Cell phone and drug testing technologies allow for frequent assessment and reinforcement of alcohol and cigarette abstinence in the natural environment. These approaches are efficacious and acceptable to patients (Alessi & Petry 2013; Alessi & Rash 2017; Alessi et al, 2016; Kong 2013), as are Internet-based reinforcement procedures (Carpenter et al, 2015; Dallery & Glenn 2005; Dallery, Glenn, & Raiff 2007; Dallery, Raiff, & Grabinski 2013; Hertzberg et al, 2013; Meredith, Grabinski, & Dallery 2011; Raiff, Jarvis, Turturici, & Dallery 2013; Reynolds et al, 2015; Stoops et al, 2009). Coupling these technologies with mobile reinforcement procedures may support abstinence in real-time and lead to more effective and efficient delivery of CM, which may enhance and extend its benefits.…”

Contingency Management: New Directions and Remaining Challenges for An Evidence-Based Intervention

“…Compliance with procedures is high and good outcomes were found with heavy drinkers (Alessi & Petry, 2013) and smokers (Alessi, Rash, & Petry, in press; Carpenter et al, 2015; Hertzberg et al, 2013). In this issue, Alessi and Rash (2017) report high levels of treatment satisfaction among participants using phone-based breath monitoring, with those in the CM condition reporting the highest levels of satisfaction. In addition, those in the CM condition achieved longer durations of smoking abstinence compared to controls, which in turn was associated with higher treatment satisfaction.…”