Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study

BackgroundSmartphone mobile apps are frequently used in standalone or multimodal smoking cessation interventions. However, factors that impede or improve app usage are poorly understood. ObjectiveThis study used the supportive accountability model to investigate f...

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Main Authors: Stephen J Lepore, Bradley N Collins, Howard W Killam, Barbara Barry
Format: Article
Language:English
Published: JMIR Publications 2021-07-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2021/7/e28175
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author Stephen J Lepore
Bradley N Collins
Howard W Killam
Barbara Barry
author_facet Stephen J Lepore
Bradley N Collins
Howard W Killam
Barbara Barry
author_sort Stephen J Lepore
collection DOAJ
description BackgroundSmartphone mobile apps are frequently used in standalone or multimodal smoking cessation interventions. However, factors that impede or improve app usage are poorly understood. ObjectiveThis study used the supportive accountability model to investigate factors that influence app usage in the context of a trial designed to reduce maternal smoking in low-income and predominantly minority communities. MethodsWe conducted a secondary analysis of data (N=181) from a randomized controlled trial that included a smoking cessation app (QuitPal-m). Supportive accountability was measured by the number of times a participant was advised by their cessation counselor to use QuitPal-m. Participants reported app use helpfulness and barriers. Investigators tracked reported phone and technical problems that impeded app use. ResultsMost participants rated the app as very helpful (103/155, 66.5%), but daily use declined rapidly over time. App use was positively related to the level of perceived app helpfulness (P=.02) and education (P=.002) and inversely related to perceived barriers (P=.003), phone technical problems (P<.001), and cigarettes smoked per day at the end of treatment (P<.001). Participants used the app a greater proportion of the days following app advice than those preceding app advice (0.45 versus 0.34; P<.001). The positive relation between counselor app advice and app usage 24 hours after receiving advice was stronger among smokers with no plan to quit than in those planning to quit (P=.03), independent of education and phone or app problems. ConclusionsFindings show the utility of supportive accountability for increasing smoking cessation app use in a predominantly low-income, minority population, particularly if quit motivation is low. Results also highlight the importance of addressing personal and phone/technical barriers in addition to adding supportive accountability. Trial RegistrationClinicalTrials.gov NCT02602288; https://clinicaltrials.gov/ct2/show/NCT02602288
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spelling doaj.art-2f6d860daac949d6ad8730a324011d762023-08-28T16:41:58ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222021-07-0197e2817510.2196/28175Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational StudyStephen J Leporehttps://orcid.org/0000-0001-7370-6280Bradley N Collinshttps://orcid.org/0000-0003-3703-9630Howard W Killamhttps://orcid.org/0000-0003-4649-3595Barbara Barryhttps://orcid.org/0000-0003-3097-671X BackgroundSmartphone mobile apps are frequently used in standalone or multimodal smoking cessation interventions. However, factors that impede or improve app usage are poorly understood. ObjectiveThis study used the supportive accountability model to investigate factors that influence app usage in the context of a trial designed to reduce maternal smoking in low-income and predominantly minority communities. MethodsWe conducted a secondary analysis of data (N=181) from a randomized controlled trial that included a smoking cessation app (QuitPal-m). Supportive accountability was measured by the number of times a participant was advised by their cessation counselor to use QuitPal-m. Participants reported app use helpfulness and barriers. Investigators tracked reported phone and technical problems that impeded app use. ResultsMost participants rated the app as very helpful (103/155, 66.5%), but daily use declined rapidly over time. App use was positively related to the level of perceived app helpfulness (P=.02) and education (P=.002) and inversely related to perceived barriers (P=.003), phone technical problems (P<.001), and cigarettes smoked per day at the end of treatment (P<.001). Participants used the app a greater proportion of the days following app advice than those preceding app advice (0.45 versus 0.34; P<.001). The positive relation between counselor app advice and app usage 24 hours after receiving advice was stronger among smokers with no plan to quit than in those planning to quit (P=.03), independent of education and phone or app problems. ConclusionsFindings show the utility of supportive accountability for increasing smoking cessation app use in a predominantly low-income, minority population, particularly if quit motivation is low. Results also highlight the importance of addressing personal and phone/technical barriers in addition to adding supportive accountability. Trial RegistrationClinicalTrials.gov NCT02602288; https://clinicaltrials.gov/ct2/show/NCT02602288https://mhealth.jmir.org/2021/7/e28175
spellingShingle Stephen J Lepore
Bradley N Collins
Howard W Killam
Barbara Barry
Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
JMIR mHealth and uHealth
title Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
title_full Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
title_fullStr Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
title_full_unstemmed Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
title_short Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
title_sort supportive accountability and mobile app use in a tobacco control intervention targeting low income minority mothers who smoke observational study
url https://mhealth.jmir.org/2021/7/e28175
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