title: Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults.
abstract: OBJECTIVE
  Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth smoking cessation program for young adult smokers.
  
  
  METHODS
  164 18-24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day.
  
  
  RESULTS
  (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of program messages was the most commonly noted program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it.
  
  
  CONCLUSIONS
  Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and program features to be even more salient.
  
  
  CONCLUSIONS
  Future young adult mHealth interventions could: Integrate models that are flexible to different "paths" of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys.
authors.affiliation: Center for Innovative Public Health Research, San Clemente, USA. Electronic address: Michele@InnovativePublicHealth.org.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Ybarra
authors.affiliation: Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora, USA.
authors.forename: Jodi Summers
authors.initials: JS
authors.lastname: Holtrop
authors.affiliation: Center for Innovative Public Health Research, San Clemente, USA.
authors.forename: Tonya L
authors.initials: TL
authors.lastname: Prescott
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, San Diego, USA.
authors.forename: David
authors.initials: D
authors.lastname: Strong
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D017216:Telemedicine; D060145:Text Messaging; D014481:United States; D055815:Young Adult
keywords: Hard-to-reach populations; Intervention features; Smoking cessation; Text messaging; Young adults; mHealth
references.citation: Curr HIV/AIDS Rep. 2007 Dec;4(4):201-7
references.pmid: 18366952
references.citation: Nicotine Tob Res. 2013 Aug;15(8):1388-99
references.pmid: 23348969
references.citation: J Telemed Telecare. 2011;17(1):41-8
references.pmid: 21097565
references.citation: Lancet. 2011 Jul 2;378(9785):49-55
references.pmid: 21722952
references.citation: Tob Control. 2005 Aug;14(4):255-61
references.pmid: 16046689
references.citation: J Health Commun. 2014 Dec;19(12):1393-407
references.pmid: 24766267
references.citation: Tob Control. 2005 Jun;14(3):181-5
references.pmid: 15923468
references.citation: Am J Public Health. 2008 Feb;98(2):317-22
references.pmid: 18172143
references.citation: J Med Internet Res. 2012 Jul 24;14(4):e103
references.pmid: 22832182
references.citation: Cochrane Database Syst Rev. 2012 Nov 14;11:CD006611
references.pmid: 23152238
references.citation: Am J Public Health. 2002 Jun;92(6):908-16
references.pmid: 12036776
references.citation: Epidemiol Rev. 2010;32:56-69
references.pmid: 20354039
references.citation: Nicotine Tob Res. 2013 Nov;15(11):1948-51
references.pmid: 23811010