A Randomized Trial of an Avatar-Hosted Multiple Behavior Change Intervention for Young Adult Smokers

An, Lawrence C.; Demers, Michele; Kirch, Matthias; Considine-Dunn, Shannon E.; Nair, Vijayan N.; Dasgupta, Kohinoor; Narisetty, Naveen N.; Resnicow, Ken; Ahluwalia, Jasjit S.

doi:10.1093/jncimonographs/lgt021

Cited by 58 publications

(87 citation statements)

References 37 publications

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“… 22 , 74 Several trials recruited through listservs, health plans, or survey panels. 40 , 41 , 47 , 54 , 61 , 65 , 73 , 75 – 77 Other proactive recruitment sources included health facilities or clinics, 44 – 48 , 51 , 58 , 60 , 74 quitlines, 47 , 75 and worksites. 57 Several studies used a combination of recruitment strategies.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

Graham¹,

Carpenter²,

Cha³

et al. 2016

SAR

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BackgroundThe aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines.MethodsThis review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of “Internet,” “web-based,” and “smoking cessation intervention” and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.ResultsForty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15–2.21, I2=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63–1.10, I2=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25–3.52, I2=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97–1.87, I2=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79–1.13, I2=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03–1.31, I2=76.7%).ConclusionInternet interventions are superior to other broad reach cessation interventions (ie, print materials), equivalent to other currently recommended treatment modes (telephone and in-person counseling), and they have an important role to play in the arsenal of tobacco-dependence treatments.

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Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

Graham¹,

Carpenter²,

Cha³

et al. 2016

SAR

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“…Several recent trials have included such measures (11-14), while others that have relied on self-report have noted the lack of biochemical verification as a limitation of their findings (15-23). The emphasis on biochemical verification during peer review may be because digital interventions are newer than traditional face-to-face or telephonic approaches, and the perception that such studies should include more conservative metrics of abstinence to demonstrate their effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of biochemical verification in a web-based smoking cessation study

Cha

Ganz

Cohn

et al. 2017

Addictive Behaviors

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Background and Aims Cogent arguments have been made against the need for biochemical verification in population-based studies with low-demand characteristics. Despite this fact, studies involving digital interventions (low-demand) are often required in peer review to report biochemically verified abstinence. To address this discrepancy, we examined the feasibility and costs of biochemical verification in a web-based study conducted with a national sample. Methods Participants were 600 U.S. adult current smokers who registered on a web-based smoking cessation program and completed surveys at baseline and 3 months. Saliva sampling kits were sent to participants who reported 7-day abstinence at 3 months, and analyzed for cotinine. Results The response rate at 3-months was 41.2% (n=247): 93 participants reported 7-day abstinence (38%) and were mailed a saliva kit (71% returned). The discordance rate was 36.4%. Participants with discordant responses were more likely to report 3-month use of nicotine replacement therapy or e-cigarettes than those with concordant responses (79.2% vs. 45.2%, p=.007). The total cost of saliva sampling was $8280 ($125/sample). Conclusions Biochemical verification was both time- and cost-intensive, and yielded a relatively small number of samples due to low response rates and use of other nicotine products during the follow-up period. There was a high rate of discordance of self-reported abstinence and saliva testing. Costs for data collection may be prohibitive for studies with large sample sizes or limited budgets. Our findings echo previous statements that biochemical verification is not necessary in population-based studies, and add evidence specific to technology-based studies.

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“…With the current level and variety of technology in use among all demographics of U.S. adults, using technology to promote health is increasingly appropriate and indicated. In this review, Internet intervention platforms and mobile phone apps were the most frequently used technologies, but interesting work is also being conducted with newer technologies including the following: virtual reality , which is being used, for example, to examine cue reactivity in tobacco use [15-18], improve mobility in stroke patients [19, 20], and promote PA [21]; gaming to increase engagement and the dose-response of interventions designed to increase PA and reduce weight [22-26]; alternate world reality gaming to increase PA and reduce weight [27, 28]; avatars to promote PA [29, 30]; Embodied Conversational Agents (virtual coaches) to promote PA and increase fruit and vegetable intake [31, 32]; and social media for increasing engagement and social support [33-37]. …”

Section: Discussionmentioning

confidence: 99%

The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

Winter

Sheats

King

2016

Progress in Cardiovascular Diseases

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This review examined the use of health behavior change techniques and theory in technology-enabled interventions targeting risk factors and indicators for cardiovascular disease (CVD) prevention and treatment. Articles targeting physical activity, weight loss, smoking cessation and management of hypertension, lipids and blood glucose were sourced from PubMed (November 2010-2015) and coded for use of 1) technology, 2) health behavior change techniques (using the CALO-RE taxonomy), and 3) health behavior theories. Of the 984 articles reviewed, 304 were relevant (240=intervention, 64=review). Twenty-two different technologies were used (M=1.45, SD=+/−0.719). The most frequently used behavior change techniques were self-monitoring and feedback on performance (M=5.4, SD=+/−2.9). Half (52%) of the intervention studies named a theory/model - most frequently Social Cognitive Theory, the Trans-theoretical Model, and the Theory of Planned Behavior/Reasoned Action. To optimize technology-enabled interventions targeting CVD risk factors, integrated behavior change theories that incorporate a variety of evidence-based health behavior change techniques are needed.

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A Randomized Trial of an Avatar-Hosted Multiple Behavior Change Intervention for Young Adult Smokers

Abstract: This online avatar-hosted personal health makeover "show" increased smoking abstinence and induced positive changes in multiple related health behaviors. Addition of the online video-based peer coaching further improved behavioral outcomes.

Cited by 58 publications

References 37 publications

Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

Feasibility of biochemical verification in a web-based smoking cessation study

The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

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