Optimizing Text Messaging to Improve Adherence to Web-Based Cessation Treatment
Study Details
Study Description
Brief Summary
This study is comprised of 2 phases to study the impact of a text message system on overall adherence to a web-based smoking cessation program. Phase I uses a full factorial design to identify the most optimal text message intervention to maximize adherence to the BecomeAnEX.org smoking cessation program. Phase II is a randomized controlled trial that compares regular BecomeAnEX users to those who will receive the optimized text message intervention (from Phase I) in conjunction with BecomeAnEX for impact on long-term abstinence.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
This study is comprised of 2 active phases, all conducted with registered users on BecomeAnEX.org, a well-established smoking cessation website.
Phase I involves the initial development and optimization of the text message intervention. The investigators will examine the impact of 4 experimental text message intervention features on smokers' adherence to a web-based cessation intervention during the first 3 months of program enrollment. The investigators will utilize a full factorial design where participants will be randomized to 1 of 2 levels of each of the following features: 1) personalization (yes/no), 2) integration (yes/no), 3) dynamic tailoring (yes/no), and 4) message intensity (standard vs. decreasing). The primary outcome in Phase I will be a composite metric of utilization.
Phase II involves a 2-arm randomized trial that compares WEB alone to WEB plus the text message intervention from Phase I that yields optimal adherence (WEB+OA_TXT). The randomized trial will use a repeated measures design, with assessments at baseline, 3, 9, and 15 months. Follow-ups at 3, 9, and 15 months correspond to 0, 6, and 12 months post-treatment. The primary outcome is 30-day point prevalence abstinence (ppa) at 9-months. The investigators will assess and validate smoking status at all follow-ups. Other outcomes include motivation to quit, quit attempts, and continuous abstinence.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Arm 1 All 4 factors off - standard text message program Personalization OFF Integration OFF Dynamic Tailoring OFF Message Intensity OFF |
|
| Active Comparator: Arm 2 Personalization OFF Integration OFF Dynamic Tailoring OFF Message Intensity ON |
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 3 Personalization OFF Integration OFF Dynamic Tailoring ON Message Intensity OFF |
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
|
| Active Comparator: Arm 4 Personalization OFF Integration OFF Dynamic Tailoring ON Message Intensity ON |
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 5 Personalization OFF Integration ON Dynamic Tailoring OFF Message Intensity OFF |
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
|
| Active Comparator: Arm 6 Personalization OFF Integration ON Dynamic Tailoring OFF Message Intensity ON |
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 7 Personalization OFF Integration ON Dynamic Tailoring ON Message Intensity OFF |
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
|
| Active Comparator: Arm 8 Personalization OFF Integration ON Dynamic Tailoring ON Message Intensity ON |
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 9 Personalization ON Integration OFF Dynamic Tailoring OFF Message Intensity OFF |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
|
| Active Comparator: Arm 10 Personalization ON Integration OFF Dynamic Tailoring OFF Message Intensity ON |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 11 Personalization ON Integration OFF Dynamic Tailoring ON Message Intensity OFF |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
|
| Active Comparator: Arm 12 Personalization ON Integration OFF Dynamic Tailoring ON Message Intensity ON |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 13 Personalization ON Integration ON Dynamic Tailoring OFF Message Intensity OFF |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
|
| Active Comparator: Arm 14 Personalization ON Integration ON Dynamic Tailoring OFF Message Intensity ON |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| Active Comparator: Arm 15 Personalization ON Integration ON Dynamic Tailoring ON Message Intensity OFF |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
|
| Active Comparator: Arm 16 Personalization ON Integration ON Dynamic Tailoring ON Message Intensity ON |
Behavioral: Personalization
Phase I Factor
Personalized text messages using the participant's username and gender ("Check out the EX Community for tips/support from other men who have quit. They've been there and can help you do this, QuitForever!"). Both data points will be pulled from BecomeAnEX registration data.
Behavioral: Integration
Phase I Factor
Interactive messages to facilitate engagement via text with the 6 interactive intervention components of the BecomeAnEX web intervention:
Set your quit date Cigarette tracker Beat your smoking triggers Build your support system Choose a quit smoking aid Community
Integration will allow interaction with the web-based program via text message; for example, when a user sets a quit date via the website, it will trigger text messages tailored to the quit date; likewise, if a user sets a quit date via the text system, it will be populated in the website and drive the user experience online.
Behavioral: Dynamic Tailoring
Individually tailored message to remind/reinforce users about BecomeAnEX information/tools they have already used, or to prompt users to take actions they have not yet taken.
Behavioral: Message Intensity
Phase I Factor
Varying levels of text message intensity over a 12-week period.
|
| No Intervention: WEB Phase II arm. Full access to standard BecomeAnEX.org web-based smoking cessation program. |
|
| Active Comparator: WEB+OA_TXT Phase II arm. Full access to standard BecomeAnEX.org web-based smoking cessation program PLUS optimal-adherence text message program from Phase I. |
Behavioral: Optimal-Adherence Text
Optimal-adherence text message intervention developed in Phase I
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Phase I - Composite adherence metric [3 months]
The investigators will create a composite metric of adherence for each Phase I participant using a weighted sum of their total number of number of visits, as well as of their page views, time on site, and use of the 6 interactive components of the site per visit during 3 months post-enrollment.
- Phase II - 30-day point prevalence abstinence [9 months post randomization]
Self-reported 30-day point prevalence abstinence at 9 months post randomization
Secondary Outcome Measures
- Phase II - 30day point prevalence abstinence [3 months post randomization]
Self-reported 30-day point prevalence abstinence at 3 months post randomization
- Phase II - 30day point prevalence abstinence [15 months post randomization]
Self-reported 30-day point prevalence abstinence at 15 months post randomization
Eligibility Criteria
Criteria
Inclusion Criteria:
-
US residency
-
Current smoker
-
Access to and willingness to receive text messages on a mobile phone
-
Access to Internet
-
Access to and willingness to receive email communication from study personnel
Exclusion Criteria:
- None
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Truth Initiative | Washington | District of Columbia | United States | 20001 |
Sponsors and Collaborators
- Truth Initiative
Investigators
- Principal Investigator: Amanda L Graham, PhD, Truth Initiative
Study Documents (Full-Text)
None provided.More Information
Publications
- 1R01DA038139