title: A multimedia mobile phone-based youth smoking cessation intervention: findings from content development and piloting studies.
abstract: BACKGROUND
  While most young people who smoke want to quit, few access cessation support services. Mobile phone-based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention.
  
  
  OBJECTIVE
  The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone.
  
  
  METHODS
  Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention.
  
  
  RESULTS
  Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting "real" and "honest" role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study.
  
  
  CONCLUSIONS
  A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people.
authors.affiliation: University of Auckland, Leader Health Technology Research, Clinical Trials Research Unit, Private Bag, Auckland, New Zealand. r.whittaker@ctru.auckland.ac.nz
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.forename: Hayden
authors.initials: H
authors.lastname: McRobbie
authors.forename: Chris
authors.initials: C
authors.lastname: Bullen
authors.forename: Simon
authors.initials: S
authors.lastname: Denny
authors.forename: Enid
authors.initials: E
authors.lastname: Dorey
authors.forename: Mary
authors.initials: M
authors.lastname: Ellis-Pegler
authors.forename: Jaco
authors.initials: J
authors.lastname: van Rooyen
authors.forename: Anthony
authors.initials: A
authors.lastname: Rodgers
mesh_terms: D000293:Adolescent; D006801:Humans; D040421:Cell Phone; D003219:Confidentiality; D004282:Documentation; D007398:Interpersonal Relations; D007407:Interviews as Topic; D040541:Marketing; D009146:Music; D010865:Pilot Projects; D012064:Relaxation Therapy; D012380:Role; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D012944:Social Support; D013690:Television