Using New Communication Technologies to Enhance Services at Smoking Quitlines

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Using New Communication Technologies to Enhance
Services at Smoking Quitlines

• Lorien Abroms, ScD.
• Dept. of Prevention Community Health
• GW School of Public Health Health Services
• Lorien_at_gwu.edu

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I . Why integrate new technology into Quitline
services
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Who Uses the Internet How?

• 147 million people (73) on the Internet
• 91 read email
• 48 video sharing
• 39 read blogs
• 35 have profile on social networking site (2008)
• Source Pew 2007/2008

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Who Uses Cell Phones How?

• Over 75 of adults have cell phones
• 40 use SMS/text messaging
• Age 65 of 18-29
• Ethnicity Hispanics (54) Af-Am (42), Whites
  (31)
• 44 of people use their mobile as their main
  camera

Source Pew 2005
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Where people search for health information
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(No Transcript)
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Quitlines New Media

• Quitlines collect user information in
  computerized databases at intake

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II. How make use of technology opportunities
Existing Technology for smoking cessation
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Following from U.S. Public Health Clinical
Practice Guideline, tobacco treatment programs
should

• Be intense
• Offer social support
• Teach problem solving and coping skills
• Promote use of pharacotherapy
• Combine delivery modes

Fiore et al. 2000
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Technology opportunity 1 Email for smoking
cessation

• Efficacy of tailored and time emails (Lenert et
  al. 2004)
• Utility of emails for reducing smoking among NRT
  users (Etter et al. 2003)
• Efficacy of email for smoking cessation in a
  college population (Abroms et al. 2007)

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Technology opportunity 2 Mobile Phones for
smoking cessation

• STOMP
• Colorado Dept. of Public Health

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Technology opportunity 3 Social Networking/Web
sites for smoking cessation

• Quitnet
• BecomeAnEx.org
• Facebook???

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III. How make use of technology opportunities at
quitlines Examples from My Research
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Email

• Example 1

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• Efficacy study of email Phone Counseling at the
  ACS Quitline

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Aims

• 1. To develop a computer generated, tailored
  email message service, which will be used as an
  adjunct to phone counseling
• 2. To pilot test the service
• 3. To conduct an efficacy study within the
  context of the ACS Quitline (NE)

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Quit Smoking E-Messenger

• Hello Mary!
•  Today is the day! Youve been preparing for
  your Quit Day and now its here. Remind your
  friends and family that todays your Quit Day.
  Youll need their support.
•  
• Here are some tips to help you get through the
  day
•  Stay busy. Its important to distract yourself
  so you wont have time to think about smoking. If
  you spend time at the computer, you might like to
  download the ACS Craving Stopper.
• Avoid being in places you associate with smoking.
• Recognize your triggers and try to avoid them.
• Dont forget the urge to smoke usually only
  lasts 3-5 minutes. Distract yourself and youll
  make it through the urge.
•  
•  
•  

Marys Quitting Information Top 2 reasons for
quitting 1. Family or friends 2. To feel more
in control of your life Social Support Your
husband QuitDay January 16, 2007
Email a quit smoking counselor your question
Talk to a quit smoking counselor at
1-800-QUIT-NOW
Send an e-card to get support from someone you
know
Visit the Great American Smokeout
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Hypotheses

• Phone counseling enhanced with email messages
  will result in
• Higher quit rates
• Better quitting outcomes (e.g. more quit
  attempts, more consecutive days quit, and higher
  levels of quitting than phone counseling alone).
• Higher levels of client satisfaction
• Additional use of Quitline services (more
  contact hours)

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Design and Evaluation

• Design Prototype
• PilotCallers (N25),
• Large trial N1070

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Phases II III Develop prototype and test,
Figure 3. Study Design
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Why Innovative?

• Makes use of existing technology which is widely
  used, but which has not been applied for smoking
  cessation
• Makes use of existing quitline data
  infrastructure
• Good potential for improving quit rates
• Email can increase the intensity and contact
  time, enhance problem solving skills, serve as an
  additional treatment modality
• Builds on existing platform, the
  Quitline--potential for dissemination is high.

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Text messaging

• Example 2

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• Formative evaluation of text messaging and email
  at Smokefree.gov

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Formative evaluation of text messaging and email
at Smokefree.gov
Figure 3. Study Design
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Smartphones

• Example 3

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iPhone App called My Quitline
Rationale connect users with proven therapy
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Content Analysis of iPhone Apps for smoking
cessation (n62)

• Adherence to best practice guidelines
• US Public Health Service 2008 Clinical Practice
  Guidelines
• Approach to smoking cessation
• Popularity of use

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Results

• Most used a calendar approach followedby a
  rationing, hypnosis and calculator approach.
• Few apps included the following practices
• communicate the risks of smoking,
• provide social support for cessation,
• connect a smoker to proven treatments

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Conclusions

• Use of new communication technologies is
  widespread
• Quitline callers are using it
• Quitlines have computerized intake which can
  integrate with technology
• Technology opportunities abound
• 1 Email
• 2. Mobile
• 3. Social networking

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Questions?

• Contact Lorien Abroms, ScD
• Lorien_at_gwu.edu