TY - JOUR
T1 - Design considerations for mhealth programs targeting smokers not yet ready to quit
T2 - Results of a sequential mixed-methods study
AU - McClure, Jennifer B.
AU - Heffner, Jaimee
AU - Hohl, Sarah
AU - Klasnja, Predrag
AU - Catz, Sheryl L.
N1 - Funding Information:
Survey participants (n=116) were recruited via Craigslist ads and through ResearchMatch.org, a Web-based service funded by the US National Institutes of Health Clinical and Translational Science Award (CTSA) program which matches prescreened volunteers with relevant medical research studies. Advertisements were placed in 21 states representing all US geographic regions, but focused more heavily on states in the southeast and midwest due to higher smoking prevalence in these regions [21]. Persons interested in learning more about the study were directed to a study website where they were screened for eligibility, provided consent, and completed the survey. Completely Automated Public Turing test to tell Computers and Humans Apart (CAPTCHA) verification was used to exclude nonhuman respondents. Persons were eligible if they (1) were 18-60 years old; (2) were current smokers interested in quitting someday, but not in the next month; (3) were able to speak and read in English; (4) owned a smartphone; and (5) used any app on their phone. Participation was limited to 1 survey per person, enforced with a combination of cookies and cross-referencing participant names and email addresses to ensure that there were no duplicates. A total of 250 people were screened for eligibility; of which, 123 screened ineligible (primarily because they were trying to quit smoking or had plans to quit within the month; n=92), and 1 person broke off before completing screening. Additionally, 10 eligible respondents declined participation, leaving 116 enrolled participants. Participants were provided a US $20 Amazon gift card code as a thank you for their time.
Funding Information:
Funding for this project was provided by the Group Health Research Institute and the National Institute for Drug Abuse (R34DA034612; J McClure, Principal Investigator). The authors are grateful to the smokers who participated in this research and to Zoe Bermet and Susan Brandzel for their assistance recruiting participants, conducting the key qualitative interviews, and managing study incentives; and to Annie Shaffer for her assistance preparing this manuscript.
PY - 2017/3
Y1 - 2017/3
N2 - Background: Mobile health (mHealth) smoking cessation programs are typically designed for smokers who are ready to quit smoking. In contrast, most smokers want to quit someday but are not yet ready to quit. If mHealth apps were designed for these smokers, they could potentially encourage and assist more people to quit smoking. No prior studies have specifically examined the design considerations of mHealth apps targeting smokers who are not yet ready to quit. Objective: To inform the user-centered design of mHealth apps for smokers who were not yet ready to quit by assessing (1) whether these smokers were interested in using mHealth tools to change their smoking behavior; (2) their preferred features, functionality, and content of mHealth programs addressing smoking; and (3) considerations for marketing or distributing these programs to promote their uptake. Methods: We conducted a sequential exploratory, mixed-methods study. Qualitative interviews (phase 1, n=15) were completed with a demographically diverse group of smokers who were smartphone owners and wanted to quit smoking someday, but not yet. Findings informed a Web-based survey of smokers from across the United States (phase 2, n=116). Data were collected from April to September, 2016. Results: Findings confirmed that although smokers not yet ready to quit are not actively seeking treatment or using cessation apps, most would be interested in using these programs to help them reduce or change their smoking behavior. Among phase 2 survey respondents, the app features, functions, and content rated most highly were (1) security of personal information; (2) the ability to track smoking, spending, and savings; (3) content that adaptively changes with one's needs; (4) the ability to request support as needed; (5) the ability to earn and redeem awards for program use; (6) guidance on how to quit smoking; and (7) content specifically addressing management of nicotine withdrawal, stress, depression, and anxiety. Results generally did not vary by stage of change for quitting smoking (precontemplation vs contemplation). The least popular feature was the ability to share progress via social media. Relevant to future marketing or distribution considerations, smokers were price-sensitive and valued empirically validated programs. Program source, expert recommendations, and user ratings were also important considerations. Conclusions: Smokers who are not yet ready to quit represent an important target group for intervention. Study findings suggest that many of these individuals are receptive to using mHealth tools to reduce or quit smoking, despite not having made a commitment to quit yet. The preferences for specific mHealth intervention features, functionality, and content outlined in this paper can aid addiction treatment experts, design specialists, and software developers interested in creating engaging interventions for smokers who want to quit in the future but are not yet committed to this important health goal.
AB - Background: Mobile health (mHealth) smoking cessation programs are typically designed for smokers who are ready to quit smoking. In contrast, most smokers want to quit someday but are not yet ready to quit. If mHealth apps were designed for these smokers, they could potentially encourage and assist more people to quit smoking. No prior studies have specifically examined the design considerations of mHealth apps targeting smokers who are not yet ready to quit. Objective: To inform the user-centered design of mHealth apps for smokers who were not yet ready to quit by assessing (1) whether these smokers were interested in using mHealth tools to change their smoking behavior; (2) their preferred features, functionality, and content of mHealth programs addressing smoking; and (3) considerations for marketing or distributing these programs to promote their uptake. Methods: We conducted a sequential exploratory, mixed-methods study. Qualitative interviews (phase 1, n=15) were completed with a demographically diverse group of smokers who were smartphone owners and wanted to quit smoking someday, but not yet. Findings informed a Web-based survey of smokers from across the United States (phase 2, n=116). Data were collected from April to September, 2016. Results: Findings confirmed that although smokers not yet ready to quit are not actively seeking treatment or using cessation apps, most would be interested in using these programs to help them reduce or change their smoking behavior. Among phase 2 survey respondents, the app features, functions, and content rated most highly were (1) security of personal information; (2) the ability to track smoking, spending, and savings; (3) content that adaptively changes with one's needs; (4) the ability to request support as needed; (5) the ability to earn and redeem awards for program use; (6) guidance on how to quit smoking; and (7) content specifically addressing management of nicotine withdrawal, stress, depression, and anxiety. Results generally did not vary by stage of change for quitting smoking (precontemplation vs contemplation). The least popular feature was the ability to share progress via social media. Relevant to future marketing or distribution considerations, smokers were price-sensitive and valued empirically validated programs. Program source, expert recommendations, and user ratings were also important considerations. Conclusions: Smokers who are not yet ready to quit represent an important target group for intervention. Study findings suggest that many of these individuals are receptive to using mHealth tools to reduce or quit smoking, despite not having made a commitment to quit yet. The preferences for specific mHealth intervention features, functionality, and content outlined in this paper can aid addiction treatment experts, design specialists, and software developers interested in creating engaging interventions for smokers who want to quit in the future but are not yet committed to this important health goal.
KW - Mobile health
KW - Motivation
KW - Smartphone
KW - Smoking cessation
KW - Telemedicine
KW - Tobacco
UR - http://www.scopus.com/inward/record.url?scp=85029397162&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029397162&partnerID=8YFLogxK
U2 - 10.2196/mhealth.6845
DO - 10.2196/mhealth.6845
M3 - Article
AN - SCOPUS:85029397162
VL - 5
JO - JMIR mHealth and uHealth
JF - JMIR mHealth and uHealth
SN - 2291-5222
IS - 3
M1 - e31
ER -