title: Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study.
abstract: BACKGROUND
  Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques.
  
  
  OBJECTIVE
  The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use.
  
  
  METHODS
  20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion.
  
  
  RESULTS
  720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use.
  
  
  CONCLUSIONS
  The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.
authors.affiliation: School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States. James.Pike@cgu.edu.
authors.forename: James Russell
authors.identifier: http://orcid.org/0000-0002-6858-620X
authors.initials: JR
authors.lastname: Pike
authors.forename: Bin
authors.identifier: http://orcid.org/0000-0002-7075-5113
authors.initials: B
authors.lastname: Xie
authors.forename: Nasya
authors.identifier: http://orcid.org/0000-0003-1483-5423
authors.initials: N
authors.lastname: Tan
authors.forename: Melanie Dee
authors.identifier: http://orcid.org/0000-0001-8026-7212
authors.initials: MD
authors.lastname: Sabado-Liwag
authors.forename: Annette
authors.identifier: http://orcid.org/0000-0001-9984-442X
authors.initials: A
authors.lastname: Orne
authors.forename: Tupou
authors.identifier: http://orcid.org/0000-0001-9133-8477
authors.initials: T
authors.lastname: Toilolo
authors.forename: Steven
authors.identifier: http://orcid.org/0000-0002-7859-8909
authors.initials: S
authors.lastname: Cen
authors.forename: Vanessa
authors.identifier: http://orcid.org/0000-0001-9096-285X
authors.initials: V
authors.lastname: May
authors.forename: Cevadne
authors.identifier: http://orcid.org/0000-0002-9381-5078
authors.initials: C
authors.lastname: Lee
authors.forename: Victor Kaiwi
authors.identifier: http://orcid.org/0000-0002-6555-0244
authors.initials: VK
authors.lastname: Pang
authors.forename: Michelle A
authors.identifier: http://orcid.org/0000-0003-1401-6807
authors.initials: MA
authors.lastname: Rainer
authors.forename: Dorothy Etimani S
authors.identifier: http://orcid.org/0000-0002-9846-2726
authors.initials: DE
authors.lastname: Vaivao
authors.forename: Jonathan Tana
authors.identifier: http://orcid.org/0000-0002-6022-4298
authors.initials: JT
authors.lastname: Lepule
authors.forename: Sora Park
authors.identifier: http://orcid.org/0000-0002-8829-9363
authors.initials: SP
authors.lastname: Tanjasiri
authors.forename: Paula Healani
authors.identifier: http://orcid.org/0000-0003-0353-7893
authors.initials: PH
authors.lastname: Palmer
keywords: Pacific Islander; cigarette use; ecological momentary assessment; mobile phone; text message; tobacco use