Instant Messaging Reinforcement for Smoking Cessation Counseling Training

April 22, 2025 updated by: Dr. Derek Yee-Tak Cheung, The University of Hong Kong

Efficacy of Instant Messaging Reinforcement on the Learning Outcomes of Smoking Cessation Counseling Training in Nursing Students: A Randomized Controlled Trial

This research aims to assess the impact of instant messaging reinforcement on the learning outcomes of smoking cessation counseling (SCC) training among master of nursing (MN) students at the University of Hong Kong. The hypotheses suggest that this reinforcement can enhance students' SCC knowledge and techniques, improve their perception of SCC, and increase their application of SCC in clinical work.

The study is a pragmatic randomized controlled trial (RCT) with a 1:1 allocation ratio, using WhatsApp Messenger (WhatsApp) messages for intervention and control groups. The intervention group receives messages related to SCC, while the control group receives generic mental health information. The subjects are MN students enrolled in the "Tobacco Dependency Nursing Intervention and Management" course.

The study uses various tools for measurement, including Ecological momentary assessment (EMA) and Providers Smoking Cessation Training Evaluation (ProSCiTE). The main outcome measures include SCC practice frequency, SCC knowledge score, SCC attitude score, and SCC practice score.

Data analysis will be performed in Statistical Package for the Social Sciences (SPSS), using descriptive statistics, intention-to-treat analysis, Chi-square and t-tests, Cohen's d for effect size, and linear mixed models. The expected results suggest that instant messaging reinforcement will enhance SCC knowledge, attitude, and practice among MN students.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study aims to evaluate the efficacy of instant messaging reinforcement on the learning outcomes of smoking cessation counseling (SCC) training among master of nursing (MN) students at the University of Hong Kong.

Hypotheses to be tested: (1) Instant messaging reinforcement can increase MN students' mastery of SCC knowledge and techniques. (2) Instant messaging reinforcement can increase MN students' positive perception towards SCC and their willingness to provide SCC in their clinical work. (3) Instant messaging reinforcement can increase MN students' SCC practice, i.e. the frequency at which they perform Ask, Advise, Assess, Assist, and Arrange (5As), during their clinical work.

Design and subjects: This proposed study is a 2-arm, placebo-control, pragmatic randomized controlled trial (RCT) with a 1:1 allocation ratio. The intervention involves sending reinforcement WhatsApp messages to participants. To ensure that the subjects do not know their assigned group, the investigators also sent WhatsApp messages to the control group, but these messages are unrelated to smoking cessation counseling. The targeted subjects are MN students who are taking the course "Tobacco Dependency Nursing Intervention and Management (NURS8205)" in the spring semester of 2024. The course mentioned would be attended by all students regardless of their participation in this study.

Intervention group: 3 WhatsApp messages per week for six weeks after course training. These messages are about the core content of the course developed based on the Knowledge-Attitude-Practice (KAP) model.

Control group: WhatsApp messages about generic mental health information with the same frequency and schedule as the intervention group.

Instruments: Ecological momentary assessment (EMA) measurement of SCC practice frequency; Providers Smoking Cessation Training Evaluation (ProSCiTE); Self-compiled questionnaire on SCC knowledge; Self-compiled baseline questionnaire.

Main outcome measures: (1) MN students' SCC practice frequency, measured by EMA; (2) MN students' SCC knowledge score, measured by self-compiled questionnaire; (3) MN students' SCC attitude score, measured by attitude subscale of Providers Smoking Cessation Training Evaluation (ProSCiTE); (4) MN students' SCC practice score, measured by behavior subscale of Providers Smoking Cessation Training Evaluation (ProSCiTE).

Data analysis: Data analysis will be conducted in SPSS for Windows (version 20), using descriptive statistics (frequency, percentage, mean) to summarize outcomes and variables. Intention-to-treat analysis will handle participants lost to follow-up as no change. Outcome comparisons between groups will utilize Chi-square and t-tests, calculating Cohen's d for effect size. Linear mixed models will evaluate intervention effects on KAP, considering multiple observations and data clustering within subjects. SCC practice frequency, as measured by EMA, will be analyzed at between- and within-person levels using the "xtcenter" module, exploring associations with outcomes simultaneously.

Expected results: Instant messaging will improve MN students' SCC knowledge and skills, positive attitude toward providing SCC, and eventually increase their SCC practice frequency in their clinical practice.

Study Type

Interventional

Enrollment (Actual)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong, 00
        • Hong KongLKS Faculty of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • MN students (1 or 2 years)
  • Able to access WhatsApp and receive messages

Exclusion Criteria:

• Currently attending any other SCC training program other than this course

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention group
WhatsApp messages based on smoking cessation counseling Knowledge-Attitude-Practice (KAP)
Other: WhatsApp message

Participants in the intervention group will receive 3 WhatsApp messages per week for six weeks after attending the standardized course training "Tobacco Dependency Nursing Intervention and Management (NURS8205)". These messages are about the core content of the course, including (1) Knowledge Themes: harmfulness of smoking and benefits of quitting, the fundamentals of nicotine addiction, smoking cessation counselling with the 5A model, and pharmacotherapy for smoking cessation; (2) Attitude Themes: nurses' role in smoking cessation and the importance of smoking cessation; and (3) Practice Themes: practical advice on counseling techniques, communication skills by motivational interviewing, local smoking cessation resources for referral.

Participants in the control group will receive 3 WhatsApp messages about generic mental health information per week for six weeks after attending the standardized course training "Tobacco Dependency Nursing Intervention and Management (NURS8205)".
Placebo Comparator: Control group
WhatsApp messages about generic mental health information
Other: WhatsApp message

Participants in the intervention group will receive 3 WhatsApp messages per week for six weeks after attending the standardized course training "Tobacco Dependency Nursing Intervention and Management (NURS8205)". These messages are about the core content of the course, including (1) Knowledge Themes: harmfulness of smoking and benefits of quitting, the fundamentals of nicotine addiction, smoking cessation counselling with the 5A model, and pharmacotherapy for smoking cessation; (2) Attitude Themes: nurses' role in smoking cessation and the importance of smoking cessation; and (3) Practice Themes: practical advice on counseling techniques, communication skills by motivational interviewing, local smoking cessation resources for referral.

Participants in the control group will receive 3 WhatsApp messages about generic mental health information per week for six weeks after attending the standardized course training "Tobacco Dependency Nursing Intervention and Management (NURS8205)".

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
SCC practice measurement
Time Frame: The EMA will be conducted every night for two weeks after 6 weeks of instant messaging reinforcement
Participants' SCC practice would be measured through ecological momentary assessment (EMA) by asking how many times they have performed Ask, Advise, Assess, Assist, and Arrange (5As) on each working day
The EMA will be conducted every night for two weeks after 6 weeks of instant messaging reinforcement

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
SCC knowledge score
Time Frame: through study completion, an average of 6 months
Measured by self-compiled questionnaire on knowledge about SCC, the score ranges from 0 to 14, with higher score indicating better outcome
through study completion, an average of 6 months
SCC attitude score
Time Frame: through study completion, an average of 6 months
Measured by attitude subscale of Providers Smoking Cessation Training Evaluation (ProSCiTE), the score ranges from 8 to 40, with higher score indicating better outcome
through study completion, an average of 6 months
SCC practice score
Time Frame: through study completion, an average of 6 months
Measured by behavior subscale of Providers Smoking Cessation Training Evaluation (ProSCiTE), the score ranges from 19 to 95, with higher score indicating better outcome
through study completion, an average of 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The University of Hong Kong

Investigators

  • Principal Investigator: Derek Yee Tak CHEUNG, PhD, The University of Hong Kong

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 26, 2024

Primary Completion (Actual)

August 26, 2024

Study Completion (Actual)

November 26, 2024

Study Registration Dates

First Submitted

April 11, 2024

First Submitted That Met QC Criteria

April 15, 2024

First Posted (Actual)

April 18, 2024

Study Record Updates

Last Update Posted (Actual)

April 25, 2025

Last Update Submitted That Met QC Criteria

April 22, 2025

Last Verified

April 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • HKWC-2024-179

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Research data and documentation will be available upon request.

IPD Sharing Time Frame

Data will be available for 10 years.

IPD Sharing Access Criteria

Research data and documentation will be available upon request.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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