The Measurement of Dose and Response for Smoking Behavior Change Interventions in the Digital Age: Systematic Review

Abstract

Background There is little consensus regarding effective digital health interventions for diverse populations, which is due in part to the difficulty of quantifying the impact of various media and content and the lack of consensus on evaluating dosage and outcomes. In particular, digital smoking behavior change intervention is an area where consistency of measurement has been a challenge because of emerging products and rapid policy changes. This study reviewed the contents and outcomes of digital smoking interventions and the consistency of reporting to inform future research. Objective This study aims to systematically review digital smoking behavior change interventions and evaluate the consistency in measuring and reporting intervention contents, channels, and dose and response outcomes. Methods PubMed, Embase, Scopus, PsycINFO, and PAIS databases were used to search the literature between January and May 2021. General and journal-based searches were combined. All records were imported into Covidence systematic review software (Veritas Health Innovation) and duplicates were removed. Titles and abstracts were screened by 4 trained reviewers to identify eligible full-text literature. The data synthesis scheme was designed based on the concept that exposure to digital interventions can be divided into intended doses that were planned by the intervention and enacted doses that were completed by participants. The intended dose comprised the frequency and length of the interventions, and the enacted dose was assessed as the engagement. Response measures were assessed for behaviors, intentions, and psychosocial outcomes. Measurements of the dose-response relationship were reviewed for all studies. Results A total of 2916 articles were identified through a database search. Of these 2916 articles, the title and abstract review yielded 324 (11.11%) articles for possible eligibility, and 19 (0.65%) articles on digital smoking behavior change interventions were ultimately included for data extraction and synthesis. The analysis revealed a lack of prevention studies (0/19, 0%) and dose-response studies (3/19, 16%). Of the 19 studies, 6 (32%) reported multiple behavioral measures, and 5 (23%) reported multiple psychosocial measures as outcomes. For dosage measures, 37% (7/19) of studies used frequency of exposure, and 21% (4/19) of studies mentioned the length of exposure. The assessment of clarity of reporting revealed that the duration of intervention and data collection tended to be reported vaguely in the literature. Conclusions This review revealed a lack of studies assessing the effects of digital media interventions on smoking outcomes. Data synthesis showed that measurement and reporting were inconsistent across studies, illustrating current challenges in this field. Although most studies focused on reporting outcomes, the measurement of exposure, including intended and enacted doses, was unclear in a large proportion of studies. Clear and consistent reporting of both outcomes and exposures is needed to develop further evidence in intervention research on digital smoking behavior change.

Digital Media for Behavior Change: Review of an Emerging Field of Study

“…There is a dearth of published research on the effectiveness of social media interventions for behavior change in tobacco control [ 19 ]. The objective of a study led by Evans and colleagues was to determine the feasibility of the Virtual Lab platform to recruit participants and assess awareness of an anti-e-cigarette health campaign on Facebook.…”

“…A kind of bandwagon effect may result, leading to behavior change. Theoretically, the effect of such social media campaigns may be to promote a social norm in support of specific health behaviors, such as COVID-19 vaccination, healthy eating and physical activity, or avoidance of nicotine consumption [ 19 ]. The following case studies illustrate interventions and research that investigate this hypothesized effect of social media campaigns.…”

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Impact of Digital Learning Platforms on Behaviour Change Communication in Public Health Education

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Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis

“…Smoking cessation is one of the core topics in public health globally. Practitioners and scholars in this field are concerned about how to better design and implement smoking cessation intervention projects [1][2][3]. With the increasing public awareness of the harm of smoking and the popularization of social networking services, online smoking cessation communities (OSCCs) are developing rapidly.…”