Optimizing Text Messaging to Improve Adherence to Web-Based Cessation Treatment

Truth Initiative

Status: Completed

Conditions: Smoking Cessation

Treatments: Behavioral: Personalization; Behavioral: Dynamic Tailoring; Behavioral: Integration; Behavioral: Message Intensity; Behavioral: Optimal-Adherence Text

Study type: Interventional

Funder types: Other

Identifiers

NCT02585206

1R01DA038139

Details and patient eligibility

About

This study is comprised of 2 phases to study the impact of a text message system on overall adherence to a web-based smoking cessation program. Phase I uses a full factorial design to identify the most optimal text message intervention to maximize adherence to the BecomeAnEX.org smoking cessation program. Phase II is a randomized controlled trial that compares regular BecomeAnEX users to those who will receive the optimized text message intervention (from Phase I) in conjunction with BecomeAnEX for impact on long-term abstinence.

Full description

This study is comprised of 2 active phases, all conducted with registered users on BecomeAnEX.org, a well-established smoking cessation website.

Phase I involves the initial development and optimization of the text message intervention. The investigators will examine the impact of 4 experimental text message intervention features on smokers' adherence to a web-based cessation intervention during the first 3 months of program enrollment. The investigators will utilize a full factorial design where participants will be randomized to 1 of 2 levels of each of the following features: 1) personalization (yes/no), 2) integration (yes/no), 3) dynamic tailoring (yes/no), and 4) message intensity (standard vs. decreasing). The primary outcome in Phase I will be a composite metric of utilization.

Phase II involves a 2-arm randomized trial that compares WEB alone to WEB plus the text message intervention from Phase I that yields optimal adherence (WEB+OA_TXT). The randomized trial will use a repeated measures design, with assessments at baseline, 3, 9, and 15 months. Follow-ups at 3, 9, and 15 months correspond to 0, 6, and 12 months post-treatment. The primary outcome is 30-day point prevalence abstinence (ppa) at 9-months. The investigators will assess and validate smoking status at all follow-ups. Other outcomes include motivation to quit, quit attempts, and continuous abstinence.

Enrollment: 1,485 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• US residency
• Current smoker
• Access to and willingness to receive text messages on a mobile phone
• Access to Internet
• Access to and willingness to receive email communication from study personnel

Exclusion criteria

• None

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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1,485 participants in 18 patient groups

Arm 1

No Intervention group

Description:

All 4 factors off - standard text message program Personalization OFF Integration OFF Dynamic Tailoring OFF Message Intensity OFF

Arm 2

Active Comparator group

Description:

Personalization OFF Integration OFF Dynamic Tailoring OFF Message Intensity ON

Treatment:

Behavioral: Message Intensity

Arm 3

Active Comparator group

Description:

Personalization OFF Integration OFF Dynamic Tailoring ON Message Intensity OFF

Treatment:

Behavioral: Dynamic Tailoring

Arm 4

Active Comparator group

Description:

Personalization OFF Integration OFF Dynamic Tailoring ON Message Intensity ON

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Message Intensity

Arm 5

Active Comparator group

Description:

Personalization OFF Integration ON Dynamic Tailoring OFF Message Intensity OFF

Treatment:

Behavioral: Integration

Arm 6

Active Comparator group

Description:

Personalization OFF Integration ON Dynamic Tailoring OFF Message Intensity ON

Treatment:

Behavioral: Integration

Behavioral: Message Intensity

Arm 7

Active Comparator group

Description:

Personalization OFF Integration ON Dynamic Tailoring ON Message Intensity OFF

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Integration

Arm 8

Active Comparator group

Description:

Personalization OFF Integration ON Dynamic Tailoring ON Message Intensity ON

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Integration

Behavioral: Message Intensity

Arm 9

Active Comparator group

Description:

Personalization ON Integration OFF Dynamic Tailoring OFF Message Intensity OFF

Treatment:

Behavioral: Personalization

Arm 10

Active Comparator group

Description:

Personalization ON Integration OFF Dynamic Tailoring OFF Message Intensity ON

Treatment:

Behavioral: Message Intensity

Behavioral: Personalization

Arm 11

Active Comparator group

Description:

Personalization ON Integration OFF Dynamic Tailoring ON Message Intensity OFF

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Personalization

Arm 12

Active Comparator group

Description:

Personalization ON Integration OFF Dynamic Tailoring ON Message Intensity ON

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Message Intensity

Behavioral: Personalization

Arm 13

Active Comparator group

Description:

Personalization ON Integration ON Dynamic Tailoring OFF Message Intensity OFF

Treatment:

Behavioral: Integration

Behavioral: Personalization

Arm 14

Active Comparator group

Description:

Personalization ON Integration ON Dynamic Tailoring OFF Message Intensity ON

Treatment:

Behavioral: Integration

Behavioral: Message Intensity

Behavioral: Personalization

Arm 15

Active Comparator group

Description:

Personalization ON Integration ON Dynamic Tailoring ON Message Intensity OFF

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Integration

Behavioral: Personalization

Arm 16

Active Comparator group

Description:

Personalization ON Integration ON Dynamic Tailoring ON Message Intensity ON

Treatment:

Behavioral: Dynamic Tailoring

Behavioral: Integration

Behavioral: Message Intensity

Behavioral: Personalization

WEB

No Intervention group

Description:

Phase II arm. Full access to standard BecomeAnEX.org web-based smoking cessation program.

WEB+OA_TXT

Active Comparator group

Description:

Phase II arm. Full access to standard BecomeAnEX.org web-based smoking cessation program PLUS optimal-adherence text message program from Phase I.

Treatment:

Behavioral: Optimal-Adherence Text