Engagement Promotes Abstinence in a Web-based Cessation Intervention: Cohort Study
Engagement Promotes Abstinence in a Web-based Cessation Intervention: Cohort Study
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DOI：
10.2196/jmir.2277
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发表时间：
2013-01-01
影响因子：
7.4
通讯作者：
Vallone, Donna
中科院分区：
文献类型：
--
作者：
Richardson, Amanda;Graham, Amanda L.;Vallone, Donna
背景：基于网络的戒烟干预措施可以对公共卫生产生影响，因为它们既能有效促进戒烟，又能以经济高效的方式惠及大量吸烟者。然而，它们的潜在影响尚未实现。目前尚不清楚此类干预措施如何促进戒烟，谁受益最大，以及如何提高其人群影响。 目的： 检验高度推广的基于网络的戒烟干预措施在一段时间内促进戒烟行为的有效性，确定最有效的功能，并通过使用未加权和加权分析来估计更广泛的注册网站用户的影响，了解谁最有可能使用这些功能。 方法： 从基于网络的吸烟者中招募了 1033 名新成人注册者作为样本。使用自动化研究管理系统进行戒烟干预。在 1、3 和 6 个月时，通过混合模式随访（在线调查，对未答复者进行电话随访）的自我报告来评估戒酒情况。软件跟踪受访者的在线活动。广义估计方程 (GEE) 用于使用未加权和加权数据来检查网站使用率的预测因素以及使用率如何促进戒烟。结果：在响应者和意向治疗样本中，6 个月时的 7 天点戒烟率范围分别为 20.68% 至 11.13%。未加权分析中的禁欲预测因素包括网站的访问次数以及访问特定互动或引人入胜的功能的次数。在加权分析中，只有就诊次数才能预测禁欲。戒烟动机是网站使用率的一个关键预测因素，而合作伙伴的负面支持会降低增加访问量或访问吸引人的功能的可能性。结论：参与对于促进戒烟至关重要。下一代基于网络的戒烟干预措施需要最大限度地提高所有新访问者的初始参与度，并努力留住那些继续在网站上注册的吸烟者。 (J Med Internet Res 2013;15(1):e14) doi:10.2196/jmir.2277
Background: Web-based smoking cessation interventions can have a public health impact because they are both effective in promoting cessation and can reach large numbers of smokers in a cost-efficient manner. Their potential impact, however, has not been realized. It is still unclear how such interventions promote cessation, who benefits most, and how to improve their population impact.Objective: To examine the effectiveness of a highly promoted Web-based smoking cessation intervention to promote quit behavior over time, identify the most effective features, and understand who is most likely to use those features by using unweighted and weighted analyses to estimate the impact in the broader pool of registered site users.Methods: A sample of 1033 new adult registrants was recruited from a Web-based smoking cessation intervention by using an automated study management system. Abstinence was assessed by self-report through a mixed-mode follow-up (online survey with telephone follow-up for nonrespondents) at 1, 3, and 6 months. Software tracked respondents' online activity. Generalized estimating equations (GEE) were used to examine predictors of website utilization and how utilization promoted abstinence using unweighted and weighted data.Results: The 7-day point prevalence abstinence rates at 6 months ranged from 20.68% to 11.13% in the responder and intent-to-treat samples, respectively. Predictors of abstinence in unweighted analyses included number of visits to the website as well as accessing specific interactive or engaging features. In weighted analyses, only number of visits was predictive of abstinence. Motivation to quit was a key predictor of website utilization, whereas negative partner support decreased the likelihood of increasing visits or accessing engaging features.Conclusions: Engagement is critical to promoting smoking cessation. The next generation of Web-based smoking cessation interventions needs to maximize the initial engagement of all new visitors and work to retain those smokers who proceed to register on the site. (J Med Internet Res 2013;15(1):e14) doi:10.2196/jmir.2277