See Me Smoke-Free: Protocol for a Research Study to Develop and Test the Feasibility of an mHealth App for Women to Address Smoking, Diet, and Physical Activity.
See Me Smoke-Free: Protocol for a Research Study to Develop and Test the Feasibility of an mHealth App for Women to Address Smoking, Diet, and Physical Activity.
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DOI：
10.2196/resprot.5126
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发表时间：
2016-01-21
影响因子：
1.7
通讯作者：
Gordon JS
中科院分区：
文献类型：
--
作者：
Giacobbi P Jr;Hingle M;Johnson T;Cunningham JK;Armin J;Gordon JS
本文提出了一项正在进行的研究方案，以开发和测试多行为移动健康应用程序的可行性。在美国，大约有2700万女性吸烟，每年有超过18万女性死于与吸烟有关的疾病。女性戒烟的困难更大。对体重增加、负面身体形象和低自我效能感的担忧可能是影响女性戒烟的关键因素。最近的研究表明，包括饮食和体育活动在内的多行为方法可能更有效地帮助女性戒烟。在我们的三个目标行为——运动、饮食和戒烟——中，引导意象已经成功地用于解决身体形象问题和自我效能。然而，它还没有在一次干预中同时用于吸烟、饮食和运动行为。虽然图像是一种有效的行为改变治疗工具，但交付方式通常是面对面的，这限制了范围。通过智能手机提供的移动健康应用程序提供了一个独特的渠道，通过该渠道分发基于图像的干预措施。我们研究的目的是评估为女性设计一款同时解决吸烟、饮食和体育活动行为的移动健康应用程序的可行性。这些目标有三个具体目标支持：(1)开发引导图像内容、用户界面和资源，以减轻女性吸烟者对体重的担忧，提高身体形象和自我效能感，以改变女性吸烟者的行为；(2)编写一个包含所有必要元素的应用程序原型，包括文本、图形、多媒体和交互功能；(3)评估应用程序在女性吸烟者中的可行性、可接受性和初步效果。我们在多个焦点小组和深度访谈中与9名参与者合作，创建了节目内容并设计了用于Android平台的原型应用程序。我们与6名参与者一起编程并测试了应用程序的可用性，为开放，测试前和测试后的试用做准备。目前，我们正在测试该应用程序的可行性和可接受性，评估程序使用与戒烟、饮食行为和身体活动的关系，并评估使用android智能手机的约70名女性吸烟者的消费者满意度。该研究于2014年1月1日开始。该应用于2015年4月1日上线，并开始进行可行性测试。参与者于2015年4月1日至6月30日注册。在此期间，这款应用在没有付费广告的情况下被下载了350多次。参与者被要求在30天内“大部分时间”使用该应用程序，否则他们将被排除在研究之外。我们招募了151名参与者。其中，78人被放弃或退出研究，剩下73名参与者。我们已经完成了为期30天的评估，响应率为92%。为期90天的评估仍在进行中。在研究的最后阶段，我们将进行数据分析，并通过演讲和出版物传播研究结果。可行性将通过成功的参与者留存率和高水平的应用程序使用来证明。我们将检查个人指标（例如，使用时间，浏览屏幕的数量，使用模式随时间的变化）和互动活动的参与度（例如，活动跟踪）。我们将这些数据汇总成综合曝光分数，结合访问次数和总持续时间来计算结果与项目曝光和参与度之间的相关性。最后，我们将使用谷歌Analytics比较参与者和非参与者之间的应用程序使用情况。
This paper presents the protocol for an ongoing research study to develop and test the feasibility of a multi-behavioral mHealth app. Approximately 27 million women smoke in the US, and more than 180,000 women die of illnesses linked to smoking annually. Women report greater difficulties quitting smoking. Concerns about weight gain, negative body image, and low self-efficacy may be key factors affecting smoking cessation among women. Recent studies suggest that a multi-behavioral approach, including diet and physical activity, may be more effective at helping women quit. Guided imagery has been successfully used to address body image concerns and self-efficacy in our 3 target behaviors—exercise, diet and smoking cessation. However, it has not been used simultaneously for smoking, diet, and exercise behavior in a single intervention. While imagery is an effective therapeutic tool for behavior change, the mode of delivery has generally been in person, which limits reach. mHealth apps delivered via smart phones offer a unique channel through which to distribute imagery-based interventions. The objective of our study is to evaluate the feasibility of an mHealth app for women designed to simultaneously address smoking, diet, and physical activity behaviors. The objectives are supported by three specific aims: (1) develop guided imagery content, user interface, and resources to reduce weight concern, and increase body image and self-efficacy for behavior change among women smokers, (2) program a prototype of the app that contains all the necessary elements of text, graphics, multimedia and interactive features, and (3) evaluate the feasibility, acceptability, and preliminary efficacy of the app with women smokers. We created the program content and designed the prototype application for use on the Android platform in collaboration with 9 participants in multiple focus groups and in-depth interviews. We programmed and tested the application’s usability with 6 participants in preparation for an open, pre- and posttest trial. Currently, we are testing the feasibility and acceptability of the application, evaluating the relationship of program use to tobacco cessation, dietary behaviors, and physical activity, and assessing consumer satisfaction with approximately 70 women smokers with Android-based smart phones. The study was started January 1, 2014. The app was launched and feasibility testing began in April 1, 2015. Participants were enrolled from April 1-June 30, 2015. During that time, the app was downloaded over 350 times using no paid advertising. Participants were required to use the app “most days” for 30 days or they would be dropped from the study. We enrolled 151 participants. Of those, 78 were dropped or withdrew from the study, leaving 73 participants. We have completed the 30-day assessment, with a 92% response rate. The 90-day assessment is ongoing. During the final phase of the study, we will be conducting data analyses and disseminating study findings via presentations and publications. Feasibility will be demonstrated by successful participant retention and a high level of app use. We will examine individual metrics (eg, duration of use, number of screens viewed, change in usage patterns over time) and engagement with interactive activities (eg, activity tracking). We will aggregate these data into composite exposure scores that combine number of visits and overall duration to calculate correlations between outcome and measures of program exposure and engagement. Finally, we will compare app use between participants and non-participants using Google Analytics.