Remote Patient Monitoring and Incentives to Support Smoking Cessation Among Pregnant and Postpartum Medicaid Members:...

Area of Science:

• Public Health
• Digital Health
• Maternal Health

Background:

• Smoking rates remain high among low-income populations, particularly pregnant women on Medicaid, leading to adverse birth outcomes and increased healthcare costs.
• Maternal smoking is a key target for improving birth outcomes and reducing healthcare expenditures, yet effective cessation programs are lacking.

Purpose of the Study:

• To assess the feasibility, acceptability, and effectiveness of a smartwatch-enabled, incentive-based smoking cessation program.
• To evaluate a program for Medicaid-eligible pregnant smokers.

Main Methods:

• Three pilot studies were conducted, involving randomized trials of smartwatch remote monitoring and incentive structures (pay-to-wear vs. pay-to-quit).
• The SmokeBeat program was utilized in conjunction with remote monitoring and financial incentives over varying durations (3-12 weeks).

Main Results:

• Decreases in self-reported smoking were observed across all study groups, including controls.
• The SmokeBeat program did not significantly enhance smoking cessation compared to control groups.
• Remote cotinine testing and financial incentives were found to be feasible and acceptable.

Conclusions:

• The smartwatch-enabled program and its components (remote monitoring, cotinine testing, financial incentives) demonstrated feasibility and acceptability among Medicaid-eligible pregnant smokers.
• Despite positive feasibility and acceptability, the program did not significantly improve smoking cessation rates.
• Challenges persist in implementing evidence-based cessation incentives for this vulnerable population.