Mobile Delivery of Mindfulness-based Smoking Cessation among Low-income Adults During the COVID-19 P
Saturday, June 19, 2021
Posted by: Natalia Gromov
Mhende
J, Bell SA, Cottrell-Daniels C, Luong J, Streiff M, Dannenfelser M, Hayat MJ,
Spears CA.
Mobile Delivery of
Mindfulness-based Smoking Cessation among Low-income Adults During the COVID-19
Pandemic: Pilot Randomized Controlled Trial.
JMIR Form Res. 2021 May 19. doi: 10.2196/25926. Epub ahead of print. PMID:
34033580.
Background.
Smoking is the leading cause of premature death, and low-income adults suffer
disproportionate burden from tobacco. Mindfulness interventions show promise
for improving smoking cessation. A text messaging program, iQuit Mindfully, was
created to deliver just-in-time support for quitting smoking among low-income
adults. A pilot study of iQuit Mindfully was conducted in spring 2020, right in
the midst of the COVID-19 pandemic among low-income and predominantly African
American smokers.
Objective.
This pilot study examined the acceptability and feasibility of delivering Mindfulness-Based
Addiction Treatment via mHealth during the COVID-19 pandemic.
Methods.
Participants were adult cigarette smokers (N=23, 35% [8 of 23] female, 83%
African American, 78% [18 of 23] annual income <$24,000). They were randomly
assigned to either 8 weeks of iQuit Mindfully as a fully automated standalone
intervention or iQuit Mindfully in combination with therapist-led in-person
group treatment. For participant safety, in-person mindfulness groups were
transitioned online and assessments took place online. Survey questions asked
participants about changes in their stress, smoking habits and quit attempts,
as well as their perceptions of the mindfulness and text messaging intervention
in the context of the pandemic.
Results.
Most participants (71%, 15 of 21) indicated a change in stress due to the
pandemic, with 93% (14 of 15) of those indicating higher stress. Participants
shared concerns about finances, homelessness, health and social isolation. Most
(81%, 17 of 21) believed that smoking increases risk for contracting COVID-19,
and although that was motivating for some, others expressed lower motivation to
quit because of higher stress. Most (86%, 18 of 21) said that practicing
mindfulness was helpful during the pandemic. Mean ratings of the helpfulness of
text messages and the extent they would recommend the program to others were
7.1 (median 8 on 10-point scale, SD=2.9) and 8.2 (median 9, SD=2.5),
respectively. Through open-ended program evaluations, participants shared
details about how mindfulness practice and the text messages helped them to
manage stress and feel a sense of social support during the pandemic. Moreover,
53% (10 of 19) of participants achieved 7-day abstinence from smoking, with no
differences between conditions.
Conclusions.
This study supports the promise of text messaging and use of teleconferencing
to provide mindfulness and smoking cessation services to underserved
populations during a global pandemic.
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