Smoking Cessation Amartphone App Use Over Time: Predicting 12-month Cessation Outcomes in a 2-Arm Ra
Thursday, September 15, 2022
Posted by: Natalia Gromov
Bricker
JB, Mull KE, Santiago-Torres M, Miao Z, Perski O, Di C.
Smoking Cessation
Amartphone App Use Over Time: Predicting 12-month Cessation Outcomes in a 2-Arm
Randomized Trial.
J Med Internet Res. 2022;24(8):e39208. Published 2022 Aug 18. doi:10.2196/39208
Background. Little
is known about how individuals engage over time with smartphone app
interventions and whether this engagement predicts health outcomes.
Objective. In
the context of a randomized trial comparing 2 smartphone apps for smoking
cessation, this study aimed to determine distinct groups of smartphone app
log-in trajectories over a 6-month period, their association with smoking
cessation outcomes at 12 months, and baseline user characteristics that predict
data-driven trajectory group membership.
Methods. Functional
clustering of 182 consecutive days of smoothed log-in data from both arms of a
large (N=2415) randomized trial of 2 smartphone apps for smoking cessation
(iCanQuit and QuitGuide) was used to identify distinct trajectory groups.
Logistic regression was used to determine the association of group membership
with the primary outcome of 30-day point prevalence of smoking abstinence at 12
months. Finally, the baseline characteristics associated with group membership
were examined using logistic and multinomial logistic regression. The analyses
were conducted separately for each app.
Results. For
iCanQuit, participants were clustered into 3 groups: "1-week users"
(610/1069, 57.06%), "4-week users" (303/1069, 28.34%), and
"26-week users" (156/1069, 14.59%). For smoking cessation rates at
the 12-month follow-up, compared with 1-week users, 4-week users had 50% higher
odds of cessation (30% vs 23%; odds ratio [OR] 1.50, 95% CI 1.05-2.14; P=.03),
whereas 26-week users had 397% higher odds (56% vs 23%; OR 4.97, 95% CI
3.31-7.52; P<.001). For QuitGuide, participants were clustered into 2
groups: "1-week users" (695/1064, 65.32%) and "3-week
users" (369/1064, 34.68%). The difference in the odds of being abstinent
at 12 months for 3-week users versus 1-week users was minimal (23% vs 21%; OR
1.16, 95% CI 0.84-1.62; P=.37). Different baseline characteristics predicted
the trajectory group membership for each app.
Conclusions. Patterns
of 1-, 3-, and 4-week smartphone app use for smoking cessation may be common in
how people engage in digital health interventions. There were significantly
higher odds of quitting smoking among 4-week users and especially among 26-week
users of the iCanQuit app. To improve study outcomes, strategies for detecting
users who disengage early from these interventions (1-week users) and proactively
offering them a more intensive intervention could be fruitful.
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