Challenges in the Development of e-Quit worRx: An iPad App for Smoking Cessation Counseling and Shared Decision Making in Primary Care

Doarn, Charles R.; Meulen, Mary Beth Vonder; Pallerla, Harini; Acquavita, Shauna P.; Regan, Saundra; Elder, Nancy C.; Tubb, Matthew R.

doi:10.2196/11300

Cited by 2 publications

(7 citation statements)

References 34 publications

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“…To address these opportunities and challenges, we developed and tested a tablet-based m-Health application (e-Quit worRx™) to assist PCPs in disseminating patient-centered outcomes research evidence to support SDM about smoking cessation (18,19). Literacy level of our app was assessed and optimized during the development of the app, reported previously (19). The primary outcome of this pilot study was app feasibility in primary care from the patient and PCP perspective.…”

Section: Original Articlementioning

confidence: 99%

“…This project was guided by a novel conceptual framework described previously (19). This framework includes grouping of factors called Antecedents, Mediators, and Proximal and Distal Outcomes.…”

Section: Approachmentioning

confidence: 99%

“…The first aim of this project, previously published, was to develop the app, incorporating feedback from multiple stakeholder groups (19). The second aim, described in this manuscript, involved a pilot study and clinical evaluation of the final mobile app, e-Quit worRx™, at three different For this practice-based pragmatic study, we chose a single crossover control design wherein each practice begins the study in a control period (Booklet group), followed by an intervention period (iPad group).…”

Section: Approachmentioning

confidence: 99%

“…These included the Fagerstrom Nicotine Tolerance Questionnaire (FTQ) ( 21), Smoking: Stage of Change-Short Form (SOC-SF) (22,23), and Smoking: Decisional Balance-Short Form (DBSF) (24). The user interface was designed through an iterative process of qualitative feedback and integration of design principles from the literature and was described previously (19).…”

Section: E-quit Worrxmentioning

confidence: 99%

“…This study had a few predicted and unforeseen limitations. The design process described in detail separately (19) presented several challenges including navigating requests to our coders for repeated changes to both content and design, resolving conflicting feedback from our diverse group of stakeholders and even within our study group, realizing the time-intensity of editing content and code, and integration into a clinical setting.…”

Section: Limitationsmentioning

confidence: 99%

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Clinical evaluation of e-Quit worRx: a mobile app to enhance smoking cessation shared decision making in primary care

Tubb

Meulen

Pallerla

et al. 2019

mHealth

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Background: Smoking is the leading preventable cause of morbidity and mortality in the United States.Primary care providers (PCPs) have a unique opportunity to engage patients to quit smoking, but to be effective, clinicians must be able to personalize evidence-based interventions that are useful and appealing to patients in a time efficient manner. We pilot tested a novel iPad application (app), called e-Quit worRx™, designed to enhance patient-centered shared-decision making (SDM) about smoking cessation, with the primary goal of determining feasibility in primary care offices.Methods: A total of 73 patients from three offices within a local diverse primary care network were enrolled in a pragmatic single crossover-controlled trial. The decision aid app was incorporated into current smokers' waiting time for their PCP in the exam room, and their PCP reviewed their personal responses and selections to finalize treatment choices. Mixed methods were used in the evaluation and the primary outcomes were app feasibility in primary care and enhanced SDM.Results: Our app was determined to be feasible for use in primary care for both patients and PCPs. It significantly increased time spent discussing smoking cessation with their PCP and the likelihood that a decision was made at the time of the visit. While not significant, mean differences were observed in other study measures including SDM, decisional conflict, quality of patient-provider communication, and stage of change progression at 12 weeks post-trial. Conclusions:We created a usable and acceptable iPad app-based decision aid for use in primary care offices. The design process presented several challenges including integration into a clinical setting. Despite these challenges, we successfully ran a pragmatic pilot trial in three primary care offices using a technology novel to many of the users.

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Section: Original Articlementioning

confidence: 99%

Section: Approachmentioning

confidence: 99%

Section: Approachmentioning

confidence: 99%

Section: E-quit Worrxmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Clinical evaluation of e-Quit worRx: a mobile app to enhance smoking cessation shared decision making in primary care

Tubb

Meulen

Pallerla

et al. 2019

mHealth

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A Comprehensive Literature Review of Digital Health Interventions in the Treatment of Substance Use Disorder With Special Focus on Mobile Applications

Jordan,

Sahni,

Ahmed

et al. 2023

Cureus

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COVID-19 quarantine showed an increase in opioid-related deaths partially due to the limited capacity of clinics and treatment centers. Digital health interventions (DHIs) such as telehealth have improved access to treatment, reduced psychosocial barriers, and helped patients with substance use disorder (SUD). An indepth literature review was conducted to gauge the efficacy and usefulness of DHIs on substance use disorder. PubMed was used with string search terms to identify studies analyzing telehealth for substance use disorders. Studies were eligible and selected if they used health interventions (HIs) and reported outcomes on the efficacy of DHIs, benefits of DHIs, and limitations of DHIs. The Agency of Healthcare Research and Quality (AHRQ) was used to analyze the impact of DHIs on SUD. Lastly, Apple's App Store was used to identify the current DHI available. The analysis indicated that mobile phone apps were the most appropriate sources to use for patients with substance use disorders. The search also found 36 mobile applications available on the market for patients, containing mainly pain medication diaries and trackers. The study did not find any apps for clinical usage that met the standards necessary for adequate healthcare in the opioid crisis, largely due to a lack of clinician involvement in using applications. Developing adequate DHIs has the potential to improve outcomes in patients with SUD and aid in recovery time. The research concluded that physicians looking to develop DHIs should take into consideration the mode of delivery of DHI, the aim to produce specific health outcomes as opposed to multiple outcomes, and clinician involvement in DHI development. DHIs can become a vital tool for medical professionals, especially during the COVID-19 crisis, as the use of healthcare technology has limited in-person contact, maintained current doctor-patient relationships, and allowed for contact tracing of the disease.

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Challenges in the Development of e-Quit worRx: An iPad App for Smoking Cessation Counseling and Shared Decision Making in Primary Care

Cited by 2 publications

References 34 publications

Clinical evaluation of e-Quit worRx: a mobile app to enhance smoking cessation shared decision making in primary care

Clinical evaluation of e-Quit worRx: a mobile app to enhance smoking cessation shared decision making in primary care

A Comprehensive Literature Review of Digital Health Interventions in the Treatment of Substance Use Disorder With Special Focus on Mobile Applications

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