Limits...
Comparing two web-based smoking cessation programs: randomized controlled trial.

McKay HG, Danaher BG, Seeley JR, Lichtenstein E, Gau JM - J. Med. Internet Res. (2008)

Bottom Line: Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments.Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits.Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA.

ABSTRACT

Background: Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals.

Objective: We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation.

Methods: The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs.

Results: Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected.

Conclusions: Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

Show MeSH

Related in: MedlinePlus

CONSORT diagram depicting flow of study participants
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC2630830&req=5

figure1: CONSORT diagram depicting flow of study participants

Mentions: We first sought to recruit participants through large worksites in order to reach our recruitment goals and to minimize attrition. This strategy proved unsuccessful. In consultation with an Internet marketing firm, we designed and executed a purely Internet-based recruitment campaign. The campaign involved ad placement on Google and Yahoo search engines (keywords “quit smoking” and “stop smoking”) and links to their relevant affiliated sites. Clicking our ads enabled users to (1) visit our recruitment site (study description, inclusion/exclusion criteria), (2) submit answers to screening items, (3) provide their informed consent, and (4) complete the baseline assessment. This Internet marketing campaign was remarkably successful: we recruited 2318 participants in only 10 weeks at a cost of approximately US $13 per recruit. A total of 69.8% (1169/2318) came from Google, 19.9% (461/2318) from Yahoo, and the remaining 10.3% (238/2318) were recruited from word of mouth or from unknown other sources. The flow of participants across various study milestones is depicted using a CONSORT diagram in Figure 1. Note that 44.3% (1028/2318) of participants completed the 3-month follow-up assessment, 39.2% (909/2318) completed the 6-month assessment, and 631 (27.2%) of the randomized sample completed both the 3- and the 6-month assessments.


Comparing two web-based smoking cessation programs: randomized controlled trial.

McKay HG, Danaher BG, Seeley JR, Lichtenstein E, Gau JM - J. Med. Internet Res. (2008)

CONSORT diagram depicting flow of study participants
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2630830&req=5

figure1: CONSORT diagram depicting flow of study participants
Mentions: We first sought to recruit participants through large worksites in order to reach our recruitment goals and to minimize attrition. This strategy proved unsuccessful. In consultation with an Internet marketing firm, we designed and executed a purely Internet-based recruitment campaign. The campaign involved ad placement on Google and Yahoo search engines (keywords “quit smoking” and “stop smoking”) and links to their relevant affiliated sites. Clicking our ads enabled users to (1) visit our recruitment site (study description, inclusion/exclusion criteria), (2) submit answers to screening items, (3) provide their informed consent, and (4) complete the baseline assessment. This Internet marketing campaign was remarkably successful: we recruited 2318 participants in only 10 weeks at a cost of approximately US $13 per recruit. A total of 69.8% (1169/2318) came from Google, 19.9% (461/2318) from Yahoo, and the remaining 10.3% (238/2318) were recruited from word of mouth or from unknown other sources. The flow of participants across various study milestones is depicted using a CONSORT diagram in Figure 1. Note that 44.3% (1028/2318) of participants completed the 3-month follow-up assessment, 39.2% (909/2318) completed the 6-month assessment, and 631 (27.2%) of the randomized sample completed both the 3- and the 6-month assessments.

Bottom Line: Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments.Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits.Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA.

ABSTRACT

Background: Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals.

Objective: We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation.

Methods: The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs.

Results: Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected.

Conclusions: Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

Show MeSH
Related in: MedlinePlus