"If I Were Nick": Men's Responses to an Interactive Video Drama Series to Support Smoking Cessation.
BACKGROUND
Men continue to smoke in greater numbers than women; however, few interventions have been developed and tested to support men's cessation. Men tend to rely on quitting strategies associated with stereotypical manliness, such as willpower, stoicism, and independence, but they may lack the self-efficacy skills required to sustain a quit. In this paper, we describe the development of and reception to an interactive video drama (IVD) series, composed of 7 brief scenarios, to support and strengthen men's smoking cessation efforts. The value of IVD in health promotion is predicated on the evidence that viewers engage with the material when they are presented characters with whom they can personally identify. The video dramatizes the challenges unfolding in the life of the main character, Nick, on the first day of his quit and models the skills necessary to embark upon a sustainable quit.


OBJECTIVE
The objective was to describe men's responses to the If I were Nick IVD series as part of a study of QuitNow Men, an innovative smoking cessation website designed for men. Specific objectives were to explore the resonance of the main character of the IVD series with end-users and explore men's perceptions of the effectiveness of the IVD series for supporting their quit self-management.


METHODS
Seven brief IVD scenarios were developed, filmed with a professional actor, and uploaded to a new online smoking cessation website, QuitNow Men. A sample of 117 men who smoked were recruited into the study and provided baseline data prior to access to the QuitNow Men website for a 6-month period. During this time, 47 men chose to view the IVDs. Their responses to questions about the IVDs were collected in online surveys at 3-month and 6-month time points and analyzed using descriptive statistics.


RESULTS
The majority of participants indicated they related to the main character, Nick. Participants who "strongly agreed" they could relate to Nick perceived significantly higher levels of support from the IVDs than the "neutral" and "disagree" groups (P<.001, d=2.0, P<.001, d=3.1). The "agree" and "neutral" groups were significantly higher on rated support from the videos than the "disagree" (P<.001, d=2.2, P=.01, d=1.5). Participants' perception of the main character was independent of participant age, education attainment, or previous quit attempts.


CONCLUSIONS
The findings suggest that IVD interventions may be an important addition to men's smoking cessation programs. Given that the use of IVD scenarios in health promotion is in its infancy, the positive outcomes from this study signal the potential for IVD and warrant ongoing evaluation in smoking cessation and, more generally, men's health promotion.
School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada. joan.bottorff@ubc.ca.
Joan L
http://orcid.org/0000-0001-9724-5351
JL
Bottorff
Gayl
http://orcid.org/0000-0001-5517-1032
G
Sarbit
John L
http://orcid.org/0000-0001-9029-4003
JL
Oliffe
Mary T
http://orcid.org/0000-0002-8666-8567
MT
Kelly
Maria
http://orcid.org/0000-0003-3525-1283
M
Lohan
Sean
http://orcid.org/0000-0003-2771-9149
S
Stolp
Paul
http://orcid.org/0000-0001-5616-3181
P
Sharp
D000328:Adult; D019034:CD-I; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D012648:Self Care; D016540:Smoking Cessation / Q000379:methods*
interactive video drama; self-efficacy; smoking cessation; technology; tobacco use