title: Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol.
abstract: BACKGROUND
  Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components.
  
  
  METHODS
  We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome.
  
  
  BACKGROUND
  This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses.
  
  
  BACKGROUND
  NCT02585206.
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington DC, USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Graham
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Jacobs
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington DC, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Cohn
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cha
authors.affiliation: Department of Prevention and Community Health, The George Washington University, Washington DC, USA.
authors.forename: Lorien C
authors.initials: LC
authors.lastname: Abroms
authors.affiliation: Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA.
authors.forename: George D
authors.initials: GD
authors.lastname: Papandonatos
authors.affiliation: National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000379:methods*; D060145:Text Messaging; D014481:United States; D055815:Young Adult
keywords: Internet; adherence; smoking cessation; text messaging