title: Crowdsourced peer- versus expert-written smoking-cessation messages.
abstract: BACKGROUND
  Tailored, web-assisted interventions can reach many smokers. Content from other smokers (peers) through crowdsourcing could enhance relevance.
  
  
  OBJECTIVE
  To evaluate whether peers can generate tailored messages encouraging other smokers to use a web-assisted tobacco intervention (Decide2Quit.org).
  
  
  METHODS
  Phase 1: In 2009, smokers wrote messages in response to scenarios for peer advice. These smoker-to-smoker (S2S) messages were coded to identify themes. Phase 2: resulting S2S messages, and comparison expert messages, were then e-mailed to newly registered smokers. In 2012, subsequent Decide2Quit.org visits following S2S or expert-written e-mails were compared.
  
  
  RESULTS
  Phase 1: a total of 39 smokers produced 2886 messages (message themes: attitudes and expectations, improvements in quality of life, seeking help, and behavioral strategies). For not-ready-to-quit scenarios, S2S messages focused more on expectations around a quit attempt and how quitting would change an individual's quality of life. In contrast, for ready-to-quit scenarios, S2S messages focused on behavioral strategies for quitting. Phase 2: In multivariable analysis, S2S messages were more likely to generate a return visit (OR=2.03, 95% CI=1.74, 2.35), compared to expert messages. A significant effect modification of this association was found, by time-from-registration and message codes (both interaction terms p<0.01). In stratified analyses, S2S codes that were related more to "social" and "real-life" aspects of smoking were driving the main association of S2S and increased return visits.
  
  
  CONCLUSIONS
  S2S peer messages that increased longitudinal engagement in a web-assisted tobacco intervention were successfully collected and delivered. S2S messages expanded beyond the biomedical model to enhance relevance of messages.
  
  
  BACKGROUND
  This study is registered at www.clinicaltrials.gov NCT00797628 (web-delivered provider intervention for tobacco control [QUIT-PRIMO]) and NCT01108432 (DPBRN Hygienists Internet Quality Improvement in Tobacco Cessation [HiQuit]).
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Coley
authors.forename: Rajani S
authors.initials: RS
authors.lastname: Sadasivam
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Williams
authors.forename: Julie E
authors.initials: JE
authors.lastname: Volkman
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Schoenberger
authors.forename: Connie L
authors.initials: CL
authors.lastname: Kohler
authors.forename: Heather
authors.initials: H
authors.lastname: Sobko
authors.forename: Midge N
authors.initials: MN
authors.lastname: Ray
authors.forename: Jeroan J
authors.initials: JJ
authors.lastname: Allison
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ford
authors.forename: Gregg H
authors.initials: GH
authors.lastname: Gilbert
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Houston
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D063045:Crowdsourcing / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D010379:Peer Group; D011788:Quality of Life; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D013997:Time Factors; D055815:Young Adult