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Background The smoking relapse rate during the first 12 months after pregnancy is around 80% in the United States. Delivering remote smoking cessation interventions to women in the postpartum period can reduce the burden associated with frequent office visits and can enable remote communication and support. Developing reliable, remote, smoking measuring instruments is a crucial step in achieving this vision. Objective The study presents the evaluation of the MoMba Live Long system, a smartphone-based breath carbon monoxide (CO) meter and a custom iOS smartphone app. We report on how our smoking detection system worked in a controlled office environment and in an out-of-office environment to examine its potential to deliver a remote contingency management intervention. Methods In-office breath tests were completed using both the MoMba Live Long system and a commercial monitor, the piCO+ Smokerlyzer. In addition, each participant provided a urine test for smoking status validation through cotinine. We used in-office test data to verify the validity of the MoMba Live Long smoking detection system. We also collected out-of-office tests to assess how the system worked remotely and enabled user verification. Pregnant adult women in their second or third trimester participated in the study for a period of 12 weeks. This study was carried out in the United States. Results Analyses of in-office tests included 143 breath tests contributed from 10 participants. CO readings between the MoMba Live Long system and the piCO+ were highly correlated (r=.94). In addition, the MoMba Live Long system accurately distinguished smokers from nonsmokers with a sensitivity of 0.91 and a specificity of 0.94 when the piCO+ was used as a gold standard, and a sensitivity of 0.81 and specificity of 1.0 when cotinine in urine was used to confirm smoking status. All participants indicated that the system was easy to use. Conclusions Relatively inexpensive portable and internet-connected CO monitors can enable remote smoking status detection in a wide variety of nonclinical settings with reliable and valid measures comparable to a commercially available CO monitor. Trial Registration ClinicalTrials.gov NCT02237898; https://clinicaltrials.gov/ct2/show/NCT02237898

Maker culture is on the rise in healthcare with the adoption of consumer-grade fabrication technologies. However, little is known about the activities and resources involved in prototyping medical devices to improve patient care. In this paper, we refer to such activity asmedical making to report findings based on a qualitative study of stakeholder engagement in physical prototyping (making) experiences. We examine perspectives from diverse stakeholders including clinicians, engineers, administrators, and medical researchers. Through 18 semi-structured interviews with medical-makers in the US and Canada, we analyze making activity in medical settings. We find that medical makers share strategies to address risks, adopt labor roles, and acquire resources within traditional medical practice. Our findings outline how medical-makers mitigate risks for patient safety, collaborate with local and global stakeholder networks, and overcome constraints of co-location and material practices. We recommend a clinician-aided software system, partially-open repositories, and a collaborative skill-sharing social network to extend their strategies in support of medical making.