Technology Assisted Motivational Interviewing (TAMI)

University of California San Francisco (UCSF)

Status: Enrolling

Conditions: Smoking; Smoking Cessation

Treatments: Behavioral: TAMI Coach

Study type: Interventional

Funder types: Other

Identifiers

NCT06713603

T34IR7967 (Other Grant/Funding Number)

24-41634

Details and patient eligibility

About

Building on our successful pilot work to develop a Motivational Interviewing (MI)-capable chatbot and cessation coach, the investigators propose to address the problems of intrinsic motivation and social barriers to smoking cessation by evaluating a highly scalable and easily accessible digital-coaching intervention that 1) promotes readiness to change using a technology-assisted MI (TAMI) chatbot, 2) provides compelling and accessible multilingual education about smoking cessation tools, and 3) develops a tailored quit plan addressing social barriers to treatment initiation and sustainment.

Enrollment: 440 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• A current Primary Care Provider patient
• Age 18 or older
• Smoke at least 1 cigarette per day for the past 7 consecutive days (and at least 100 lifetime)
• Have a digital device (phone, laptop, tablet)
• Moderately proficient in English
• Able to participate for 6-month trial

Exclusion criteria

• Current participation in a smoking cessation program
• Current use of Nicotine Replacement Therapy or smoking cessation pharmacotherapy
• Cognitive impairment that would preclude informed consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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440 participants in 2 patient groups

Technology Assisted Motivational Interviewing (TAMI)

Experimental group

Description:

Individuals randomized to TAMI will interact with the fully automated, web-based MI-chatbot for the 6-month study period. Patients who continue to smoke will receive up to two text messages per week with the chatbot URL link to initiate additional conversations always beginning with an assessment of readiness to change but "remembering" prior conversations much like a clinician. Individuals in the preparation stage will move directly to EBP education, tailoring a quit plan and boosting both self-efficacy and outcome expectancies. Patients with sufficient confidence will be encouraged to set a quit date. Patients will be encouraged to include their PCP and/or state quitline. TAMI will provide support proximal to the quit date including guidance through common obstacles. TAMI will check back to assess treatment initiation, treatment sustainment (and/or cessation), or relapse. Patients who are unable to quit (or who relapse) will be encouraged to restart conversations with TAMI.

Treatment:

Behavioral: TAMI Coach

Usual Care

No Intervention group

Description:

Individuals randomized to the Usual Care (UC) condition will receive a detailed educational handout on the health risks associated with smoking and information on Evidence Based Practice's (EBP) for cessation using the standard "Kick-It California" materials. Additional materials and referral resources regarding depression, stress, and other common barriers will be provided to all UC participants. Any UC individual can choose to quit at any time but they will not have access to TAMI. While this is not an "active" treatment condition, the handout and recurring assessments (at 3 and 6mo) may serve as reminders about the importance of quitting and may assist with finding support for co-occurring conditions or social needs.