Cell Phone-Based Expert Systems for Smoking Cessation.

摘要

This project examined the effectiveness of tailored text messages as an enhancement to a computerized tailored intervention (CTI) for smoking cessation with Veterans. CTIs have shown increasing promise as useful behavior change programs for improved health behaviors; however, the ubiquity and sophistication of today s wireless mobile technologies represent new modes of delivery for evidence-based smoking cessation and other behavioral health interventions. The CTI is based on the Transtheoretical Model of Behavior Change (TTM) and developed by Pro-Change Behavior Systems, Inc. A randomized clinical pilot study tested the effectiveness of the CTI alone and CTI plus individualized text messaging enhancements in reducing smoking behavior in Veterans. In addition to smoking cessation, readiness to change other negative health behaviors such as alcohol use, health eating, and exercise was also assessed. Four-hundred and forty-six Veterans were recruited at baseline. All participants were active smokers, distributed across the stages of change as 11.9% in Precontemplation (n=53; not intending to change in the next 6 months); 63% in Contemplation (n=281; intending to change in the next 6 months), and 25.1% in Preparation (n=112; intending to change in the next 30 days). Two- hundred and thirty-five individuals (52.7%) completed the one-month and three- month follow-ups: n=116 in the treatment group (CTI only; Tx) and n=119 in the treatment-plus group (CTI plus text messages; Tx-plus). Results indicated that the CTI-plus-text-messaging intervention outperformed the CTI-only intervention at an unprecedented quit rate. For those participants in the Tx group 32.8% had quit smoking at three-month follow-up; however, those in the Tx-plus group had quit rates of 43.2%. These findings are highly encouraging, and exceed those quit rates found for other CTI interventions for both groups by almost 15% (Krebs, Prochaska & Rossi, 2010).