Recruiting pregnant smokers from Text4baby for a randomized controlled trial of Quit4baby

Abstract

Recruiting pregnant smokers into clinical trials is challenging since this population tends to be disadvantaged, the behavior is stigmatized, and the intervention window is limited. The purpose of this study is to test the feasibility and effectiveness of recruiting pregnant smokers into a smoking cessation trial by sending recruitment text messages to an existing subscriber list. Recruitment messages were sent to subscribers flagged as pregnant in Text4baby, a national text messaging program for pregnant women and mothers. Four recruitment messages were rotated to test the effectiveness of different emotional frames and a financial incentive. Study staff called subscribers who expressed interest to screen for eligibility and enroll eligible women. Between October 6, 2015 and February 2, 2016, 10,194 recruitment messages were sent to Text4baby subscribers flagged as pregnant, and 10.18% (1038) responded indicating interest. No significant increase in cancellation was observed compared to subscribers who received other ad hoc messages. Of respondents, 54.05% (561) were reached by phone for follow-up, and 21.97% (228) were found to be eligible. Among the eligible, 87% (199) pregnant smokers enrolled. The recruitment message with a pride emotional appeal had a significantly higher response (p = 0.02) compared to the recruitment message with no emotional appeal, but enrollment did not significantly differ between recruitment messages with different emotional appeals. The recruitment messages with a reference to financial incentive yielded higher response (p < 0.01) and enrollment (p = 0.03) compared to a recruitment message without. This study demonstrates success recruiting pregnant smokers using text message. Future studies should consider building on this approach for recruiting high-risk populations.

E-cigarettes and smoking cessation: a prospective study of a national sample of pregnant smokers

“…The sample for this analysis comes from the Quit4baby trial, a randomized controlled trial of text messaging for smoking cessation in pregnant women in the U.S. Recruitment for the study occurred between August, 2015 and February, 2016 [28, 29]. Participants ( N = 508) were recruited from enrollees in Text4baby, the largest text messaging service for pregnant women and mothers in the United States.…”

“…Some participants were randomized to also receive Quit4baby [29]. A detailed recruitment process is published elsewhere [28]. This study was approved by the George Washington University Institutional Review Board.…”

A Randomized Trial of Text Messaging for Smoking Cessation in Pregnant Women

“…23–28 Existing studies consist of pilot studies that are underpowered for efficacy, have short-term follow-up, 24–27 lack a control group, 24 or lack biochemical verification of self-reported smoking status. 24 Studies indicate that text messaging programs are acceptable for smoking cessation in pregnant women, 24,25,28 can result in favorable outcomes across a number of psychosocial mechanisms, 25 but have mixed efficacy. 26–28 …”

“…24 Studies indicate that text messaging programs are acceptable for smoking cessation in pregnant women, 24,25,28 can result in favorable outcomes across a number of psychosocial mechanisms, 25 but have mixed efficacy. 26–28 …”

Pregnant Smokers’ Experiences and Opinions of Techniques Aimed to Address Barriers and Facilitators to Smoking Cessation: A Qualitative Study

“…There were some limitations to this study. Smoking in pregnancy is a sensitive and often stigmatized topic and, as such, pregnant women tend to be reluctant to fully disclose their smoking behaviors [21], especially as there is increasing pressure on women to quit both from health care professionals and society in general [22]. It is possible that the responses given may not have been a true reflection of smoking patterns for reasons such as fear of being judged negatively or being put under further pressure to quit.…”