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| Name | Class |
|---|---|
| American Cancer Society, Inc. | OTHER |
| George Washington University | OTHER |
| London School of Economics and Political Science | OTHER |
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Despite the availability of a variety of effective treatments for smoking cessation, uptake of treatments is low. The increasing use of smartphone technology presents an exceptional opportunity to expand access to low-cost smoking cessation services. In this pilot study, the investigators will use a text-messaging platform to test peer mentoring for smoking cessation, delivered by former smokers. While peer mentoring is a common approach to health behavior change, it has rarely been used to maximum effect by smoking cessation programs. The text-messaging platform serves as the basis for a randomized controlled trial to test the effectiveness of peer mentoring for smoking cessation.
This pilot will include approximately 200 U.S. adult smokers who will be randomly assigned to a peer mentor or not. Participants in the control group will receive automated text messages used in SmokefreeTXT, a nationwide text-messaging service sponsored by the National Cancer Institute (NCI) in which users receive one to five automated messages per day for up to eight weeks. Smokers in the intervention group will receive a modified version of the same automated messages from SmokefreeTXT, but with additional personalized messages from an assigned peer mentor. Mentors will provide responses to specific questions or comments a smoker may have after receiving the automated messages.
The intervention will last 8 weeks. The study includes primary outcomes to measure the acceptability, engagement, user experience, and early efficacy of the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Arm | Active Comparator | Participants will receive automated text messages drawn from the script used by SmokefreeTXT. |
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| Peer Mentoring Arm | Experimental | Participants will receive a modified version of the automated text messages sent to the control arm plus random assignment to a peer mentor. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Control | Behavioral | Participants will receive automated text messages used by SmokefreeTXT. The messages are designed to provide encouragement, support, and information about quitting smoking. Participants will receive 1-5 automated messages per day for 6-8 weeks depending on choice of quit date. |
| Measure | Description | Time Frame |
|---|---|---|
| Saliva test for cotinine | The primary measure of early efficacy is the 7-day point prevalence of abstinence measured 3 months after the quit day, using a saliva cotinine test. The saliva test results will be recorded through a series of photographs and shared with the study team via email or online upload. Participants who self-report having smoked in the last 7 days, as part of the follow-up survey, will be considered to be continuing smokers. | 3 months after quit day |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported smoking status | Participants will self-report 7-day point prevalence of abstinence in the follow-up survey, measured 3 months after the quit day. | 3 months after quit day |
| Duration of engagement |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported smoking status during the intervention | This is self-reported 7-day point prevalence based on text message replies to a status message. The status messages were sent at days 7, 14, 21, 28, 35, 42, 60, and 90, relative to the person's quit date. | From quit day to day 90 |
| Recommends the program |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Justin S White, PhD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, San Francisco | San Francisco | California | 94118 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30892616 | Result | White JS, Toussaert S, Thrul J, Bontemps-Jones J, Abroms L, Westmaas JL. Peer Mentoring and Automated Text Messages for Smoking Cessation: A Randomized Pilot Trial. Nicotine Tob Res. 2020 Mar 16;22(3):371-380. doi: 10.1093/ntr/ntz047. |
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| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| D064424 | Tobacco Use |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
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| Peer Mentoring | Behavioral | Participants will receive a modified version of the automated text messages sent to the control arm plus random assignment to a peer mentor. The modified messages include automated "conversation starters," designed to stimulate conversation with the peer mentor. The peer mentor will then send personalized, tailored responses. The peer mentor is a former smoker who has completed a training program developed by the investigator team. Participants will receive 1-5 automated messages per day for 6-8 weeks depending on choice of quit date. |
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The primary measure of participant engagement is the number of days from enrollment since the participant last replied to a message asking about the person's status (e.g., mood and cravings). The status messages are common to the scripts sent to participants in the control and peer mentoring arms.
| Up to 8 weeks |
| Satisfaction with the program | The primary measure of acceptability of the intervention is the self-reported rating of participants to the statement, "I liked participating in the iQuit Project." Responses will be on a 5-point Likert scale from "completely disagree" to "completely agree." | 3 months after quit day |
| Proportion of participants who correctly self-report their message type | The primary measure of user experience in the intervention is whether participants correctly identify the type of messages they received: automated or personal from a mentor. The measure has four categories:
| 3 months after quit day |
| Change in average cigarettes per day | This measures the difference in self-reported average number of cigarettes smoked per day from the baseline survey to the follow-up survey 3 months after quit day | 3 months after quit day |
| Number of participant messages sent | This measure of engagement is the number of resp days from enrollment since the participant last replied to a message asking about the person's status (e.g., mood and cravings). The status messages are common to the scripts sent to participants in the control and peer mentoring arms. | Throughout the 6-8 week intervention |
| Proportion who unsubscribe | This measure of engagement is the proportion of participants who unsubscribe from the text-messaging intervention prior to the end of the intervention period. | Throughout the 6-8 week intervention |
| Accuracy of beliefs about personal content | This is the difference between the percentage of messages reported to be from a mentor (as opposed to being automated) and the actual percentage. | Throughout the 6-8 week intervention |
This is a 5-point Likert scale response to "I would recommend the iQuit Project to a friend," assessed in the follow-up survey. |
| 3 months after quit day |
| Helpfulness of information | This is a 5-point Likert scale response to "Text messages contained helpful information on quitting," assessed in the follow-up survey. | 3 months after quit day |
| Helpfulness in trying to quit | This is a 5-point Likert scale response to "Text messages helped me try to quit smoking," assessed in the follow-up survey. | 3 months after quit day |
| Timeliness of messages | This is a 5-point Likert scale response to "Text messages arrived at the right time," assessed in the follow-up survey. | 3 months after quit day |
| Personalized content of messages | This is a 5-point Likert scale response to "Text messages were created for me personally," assessed in the follow-up survey. | 3 months after quit day |
| Frequency of messages too low | This is a 5-point Likert scale response to "Text messages should have been sent more frequently," assessed in the follow-up survey. | 3 months after quit day |
| Frequency of messages too high | This is a 5-point Likert scale response to "Text messages should have been sent less frequently," assessed in the follow-up survey. | 3 months after quit day |
| Tailoring of messages | This is a 5-point Likert scale response to "Text messages applied to me specifically," assessed in the follow-up survey. | 3 months after quit day |
| Messages were caring | This is a 5-point Likert scale response to "Text messages made me feel someone cared if I quit," assessed in the follow-up survey. | 3 months after quit day |
| Messages gave feeling of worth | This is a 5-point Likert scale response to "Text messages made me think that it was worthwhile for me to quit," assessed in the follow-up survey. | 3 months after quit day |
| Messages gave feeling of competence | This is a 5-point Likert scale response to "Text messages made me feel that I knew the right steps to take to quit," assessed in the follow-up survey. | 3 months after quit day |
| Messages gave feeling of confidence | This is a 5-point Likert scale response to "Text messages gave me confidence that I can quit," assessed in the follow-up survey. | 3 months after quit day |
| Days to unsubscribe | This is the number of days since enrollment that it took the participant to unsubscribe. | Throughout the 6-8 week intervention |
| Proportion of replies that provide informational vs. emotional support | This is the proportion of a participant's replies that are in response to a message coded with information support, as opposed to emotional support. | Throughout the 6-8 week intervention |
| Percentage of personalized messages | This is the percentage of messages that the participant believes came from a mentor, as opposed to the automated script. | 3 months after enrollment |
| Preference for personalized messages | This is the percentage of participants who prefer personal messages from mentors, compared to automated messages. | 3 months after enrollment |
| Integration of messages | This is a 5-point Likert scale response to "The automated and personal messages worked well together," assessed in the follow-up survey. | 3 months after enrollment |
| Satisfaction with mentor | This is a 5-point Likert scale response to "I am satisfied with my mentor," assessed in the follow-up survey. | 3 months after enrollment |
| Knowledge of mentor | This is a 5-point Likert scale response to "I think my mentor was knowledgable," assessed in the follow-up survey. | 3 months after enrollment |