The QuitIT coping skills game for promoting tobacco cessation among smokers diagnosed with cancer: Pilot randomized controlled trial Journal Article
| Authors: | Krebs, P.; Burkhalter, J.; Fiske, J.; Snow, H.; Schofield, E.; Iocolano, M.; Borderud, S.; Ostroff, J. S. |
| Article Title: | The QuitIT coping skills game for promoting tobacco cessation among smokers diagnosed with cancer: Pilot randomized controlled trial |
| Abstract: | Background: Although smoking cessation apps have become popular, few have been tested in randomized clinical trials or undergone formative evaluation with target users. Objective: We developed a cessation app targeting tobacco-dependent cancer patients. Game design and behavioral rehearsal principles were incorporated to help smokers identify, model, and practice coping strategies to avoid relapse to smoking. In this randomized pilot trial, we examined feasibility (recruitment and retention rates), acceptability (patient satisfaction), quitting self-confidence, and other cessation-related indices to guide the development of a larger trial. exclusion, and refusal reasons; compare refusal and attrition by key demographic and clinical variables; and report tobacco-related outcomes. Results: Follow-up data were collected from 65% (13/20) patients in the QuitIT and 61% (11/18) in SC arms. Study enrollees were 71% (27/38) females, 92% (35/38) white people, and 95% (36/38) non-Hispanic people. Most had either lung (12/38, 32%) or gastrointestinal (9/38, 24%) cancer. Those dropping out were less likely than completers to have used a tablet (P<.01) and have played the game at all (P=.02) and more likely to be older (P=.05). Of 20 patients in the QuitIT arm, 40% (8/20) played the game (system data). There were no differences between those who played and did not play by demographic, clinical, technology use, and tobacco-related variables. Users completed an average of 2.5 (SD 4.0) episodes out of 10. A nonsignificant trend was found for increased confidence to quit in the QuitIT arm (d=0.25, 95% CI −0.56 to 1.06), and more participants were abstinent in the QuitIT group than in the SC arm (4/13, 30%, vs 2/11, 18%). Satisfaction with gameplay was largely positive, with most respondents enjoying use, relating to the characters, and endorsing that gameplay helped them cope with actual smoking urges. Conclusions: Recruitment and retention difficulties suggest that the perihospitalization period may be a less than ideal time for delivering a smoking cessation app intervention. Framing of the app as a “game” may have decreased receptivity as participants may have been preoccupied with hospitalization demands and illness concerns. Less tablet experience and older age were associated with participant dropout. Although satisfaction with the gameplay was high, 60% (12/20) of QuitIT participants did not play the game. Paying more attention to patient engagement, changing the intervention delivery period, providing additional reward and support for use, and improving cessation app training may bolster feasibility for a larger trial. © Paul Krebs, Jack Burkhalter, Jeffrey Fiske, Herbert Snow, Elizabeth Schofield, Michelle Iocolano, Sarah Borderud, Jamie S Ostroff. |
| Keywords: | tobacco; app; mobile phone; cancer; mhealth |
| Journal Title: | JMIR mHealth and uHealth |
| Volume: | 7 |
| Issue: | 1 |
| ISSN: | 2291-5222 |
| Publisher: | JMIR Publications, Inc |
| Date Published: | 2019-01-01 |
| Start Page: | e10071 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 30632971 |
| PMCID: | PMC6329892 |
| DOI: | 10.2196/10071 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2019 -- Source: Scopus |
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342Ostroff -
72Burkhalter -
11Borderud -
5
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158Schofield
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