Mobile-based Peer Mentoring for Smoking Cessation

Mobile-based Peer Mentoring for Smoking Cessation: A Pilot Study

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.

Study Overview

• Status: Completed
• Conditions: Smoking Cessation; Tobacco Use
• Intervention / Treatment: Behavioral: Control; Behavioral: Peer Mentoring

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94118
      • University of California, San Francisco

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• At least 18 years old
• Current resident of the U.S.
• Smoked 100 or more cigarettes in lifetime
• Current cigarette smoker
• Access to a device that can take pictures to be uploaded to a website
• Willing to complete a salivary cotinine test

Exclusion Criteria:

• Not a current user of nicotine replacement therapy
• Not a current user of electronic cigarettes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Arm; Participants will receive automated text messages drawn from the script used by SmokefreeTXT.	Behavioral: Control; 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.
Experimental: Peer Mentoring Arm; Participants will receive a modified version of the automated text messages sent to the control arm plus random assignment to a peer mentor.	Behavioral: Peer Mentoring; 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	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

Secondary Outcome Measures

Outcome Measure	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	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: assigned to automated messages and self-reports receiving automated messages only,; assigned to automated messages and self-reports receiving at least some messages from a mentor,; assigned to mentor messages and self-reports receiving at least some mentor messages, and; assigned to mentor messages and self-reports receiving automated messages only.	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

Other Outcome Measures

Outcome Measure	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	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

Collaborators and Investigators

• Sponsor: University of California, San Francisco
• Collaborators: George Washington University; American Cancer Society, Inc.; London School of Economics and Political Science
• Investigators: Principal Investigator: Justin S White, PhD, University of California, San Francisco

Publications and helpful links

General Publications

• 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.

Study record dates

Study Major Dates

• Study Start (Actual): February 6, 2017
• Primary Completion (Actual): August 14, 2017
• Study Completion (Actual): August 14, 2017

Study Registration Dates

• First Submitted: February 6, 2017
• First Submitted That Met QC Criteria: February 8, 2017
• First Posted (Estimated): February 9, 2017

Study Record Updates

• Last Update Posted (Actual): September 1, 2023
• Last Update Submitted That Met QC Criteria: August 29, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Keywords: smoking cessation; social support; Peer mentoring; text messaging
• Other Study ID Numbers: 16-18577

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No