A text message intervention for quitting cigarette smoking among young adults experiencing homelessness: study protocol for a pilot randomized controlled trial

Tucker, Joan S.; Pedersen, Eric R.; Linnemayr, Sebastian; Shadel, William G.; DeYoreo, Maria; Zutshi, Rushil

doi:10.1186/s13722-020-00187-6

Cited by 8 publications

(7 citation statements)

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“…The intervention was carried out in a cluster cross-over randomized controlled design such that each drop-in center alternated between serving as an intervention or control site by phase across the field period. After formative work with 26 participants [ 18 ], we settled on a study design that provided a brief group counseling session based on the 5 As (ask, advise, assess, assist, and arrange) [ 19 ] and nicotine patches to all participants, and those in the TMI condition were then sent automated text messages. The study flow is shown in Figure 1 , and a detailed description of the intervention design has been published elsewhere [ 20 ]; here we focus on aspects related to the text messaging component.…”

Section: Methodsmentioning

confidence: 99%

“…Given that TMIs have not been previously implemented for behavior change among young homeless smokers, there is little guidance from the existing literature regarding the frequency and timing of text messages for this population. Therefore, we conducted several focus groups with a total of 18 homeless smokers and elicited usability testing feedback with a separate sample of 10 homeless smokers recruited from the drop-in centers [ 18 ]. During these groups we also reviewed the content of texts with participants and made sure that receiving texts would be feasible for this population to inform decisions about the optimal content (eg, what types of messages would likely be most effective in dealing with cravings) and wording (eg, how to word the text message so that it motivates homeless youth to stay quit).…”

Section: Methodsmentioning

confidence: 99%

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Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial

Linnemayr¹,

Zutshi²,

Shadel³

et al. 2021

JMIR Mhealth Uhealth

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Background Smoking rates are significantly higher among young people experiencing homelessness than in the general population. Despite a willingness to quit, homeless youth have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. Homeless youth generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. Objective This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI) as an adjunct to group-based cessation counseling and provision of nicotine patches to help homeless youth quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. Methods Homeless youth smokers aged 18 to 25 years who were interested in quitting (n=77) were recruited from drop-in centers serving homeless youth in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches, with 52% (40/77) randomly assigned to receive 6 weeks of text messages to provide additional support for their quit attempt. Participants received text messages on their own phone rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow-up survey data as well as back-end data from the messaging platform to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. Results Participants had widespread (smart)phone ownership—16.4% (36/219) were ineligible for study participation because they did not have a phone that could receive text messages. Participants experienced interruptions in their phone use (eg, 44% [16/36] changed phone numbers during the follow-up period) but reported being able to receive the majority of messages. These survey results were corroborated by back-end data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Qualitative feedback indicated that participants enjoyed the group counseling session that preceded the TMI and suggested including more such group elements into the intervention. Conclusions The TMI was well accepted and feasible to support smoking cessation among homeless youth. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support homeless youth, a population urgently in need of effective smoking cessation interventions. Trial Registration ClinicalTrials.gov NCT03874585; https://clinicaltrials.gov/ct2/show/NCT03874585 International Registered Report Identifier (IRRID) RR2-10.1186/s13722-020-00187-6

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial

Linnemayr¹,

Zutshi²,

Shadel³

et al. 2021

JMIR Mhealth Uhealth

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show abstract

“…The intervention was carried out in a cluster cross-over randomized controlled design such that each drop-in center alternated between serving as an intervention or control site by phase across the field period. After formative work with 26 participants [18], we settled on a study design that provided a brief group counseling session based on the 5 As (ask, advise, assess, assist, and arrange) [19] and nicotine patches to all participants, and those in the TMI condition were then sent automated text messages. The study flow is shown in Figure 1, and a detailed description of the intervention design has been published elsewhere [20]; here we focus on aspects related to the text messaging component.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…The project team generated 174 text messages to send to all TMI participants (see previous work [20] for example texts by the 5 main foci of the TMI program as well as TMI time point [ie, pre-quit day texts, quit day texts, early post-quit texts, later post-quit texts]). Text message content was informed by our prior work with homeless smokers to identify key factors associated with motivation to quit, consultation with the text messaging literature, and review of text messages included in other public domain smoking cessation programs (eg, Text2Quit [21] and SmokefreeTXT [22]).…”

Section: Description Of Tmimentioning

confidence: 99%

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial (Preprint)

Linnemayr¹,

Zutshi²,

Shadel³

et al. 2020

Preprint

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BACKGROUND Smoking rates are significantly higher among youth experiencing homelessness (YEH) than in the general population. Despite a willingness to quit, YEH have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. YEH generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. OBJECTIVE This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI), as an adjunct to group-based cessation counseling and provision of nicotine patches, to help YEH quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. METHODS YEH smokers who were interested in quitting (n = 77) were recruited from drop-in centers serving YEH in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches; with n = 40 randomly assigned to receive six weeks of text messages to provide additional support for their quit attempt. Participants were sent the text messages to their own phone, rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow up survey data, as well as backend data from the messaging platform, to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. RESULTS Participants had widespread (smart)phone ownership – only 14% were ineligible for study participation because they either did not have a phone that could receive text messages or did not want to receive messages. Participants experienced interruptions in their phone use but reported being able to receive the majority of messages. These survey results were corroborated by backend data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Participants reported enjoying the group counseling session that preceded the TMI, and suggested to include more such group elements into the intervention. CONCLUSIONS The TMI was well accepted and feasible to support smoking cessation among YEH. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages, and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support YEH, a population urgently in need of effective smoking cessation interventions. CLINICALTRIAL We report on implementation lessons, i.e. do not make use of the randomized controlled trial aspect of the underlying parent study that is registered with the ClinicalTrials.gov Identifier: NCT03874585

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“…Furthermore, how adolescents and young adults experience smoking cessation makes it crucial to understand how the smoking cessation process affects their lives. Given the early stages of smoking cessation interventions geared towards young people, studies suggest that young people are more likely to prefer to take on the smoking cessation process without seeking the support of health professionals or cessation programs [15]. Therefore, an understanding of the lived experiences and coping mechanisms of such young people who become successful in their solitary cessation journey can serve as useful information for health promotion interventions towards new strategies for smoking cessation programs.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study Exploring Smoking Cessation Experiences of People around London South Bank University Who have Stopped Smoking

Edet

Caplan

2020

AJARR

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Aim: To explore, understand and interpret the lived experiences of the smoking cessation process and the meaning participants attach to their experiences of the cessation process. A qualitative exploratory study of the lived experiences of people who have stopped smoking can generate useful information that specifies the supportive factors that can be taken into consideration when planning smoking cessation interventions. Study Design: A qualitative study design using an interpretive phenomenological approach was adopted in this study to explore the smoking cessation experiences of the participants. Place and Duration of Study: School of Health and Social Care, London South Bank University, London, UK. Methodology: An exploratory phenomenological study was conducted with seven participants. A qualitative semi-structured interview guide was developed by the researcher after a preliminary review of significant literatures and in line with other standardised schedules. All face-to-face semi-structured interviews with participants were audio recorded and transcribed verbatim. All interview transcripts were analyzed using the interpretive phenomenological analysis (IPA) method. Results: Based on IPA method, ten themes emerged and these were put together into two groups. The first group of themes are the participant’s experiences of the smoking cessation process. All the participants narrated experiences of symptoms due to Nicotine withdrawal. Also, experiences of their social environment, relapse as well as loneliness and boredom, emerged as themes. The second group of themes explored how participants made sense of their smoking cessation experiences. All the participants expressed how they made sense of their feelings, understood their situation and coped with their cessation experiences which they termed a difficult process. Also, confidence, self-regulation, motivation, feelings of fear and the importance of time, emerged as themes. Conclusion and Recommendation: According to participants, the smoking cessation process is a difficult process due to the many challenges and barriers associated with it. Therefore, the importance of self-confidence, motivation and social support cannot be overemphasized for a successful cessation. However, further research is recommended with respect to gender and the smoking cessation process.

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A text message intervention for quitting cigarette smoking among young adults experiencing homelessness: study protocol for a pilot randomized controlled trial

Cited by 8 publications

References 53 publications

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial

Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial (Preprint)

A Qualitative Study Exploring Smoking Cessation Experiences of People around London South Bank University Who have Stopped Smoking

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