An Avatar-Led Web-Based and SMS Text Message Smoking Cessation Program for Socioeconomically Disadvantaged Veterans:
Jaimee L Heffner1, Megan M Kelly2,3, Erin D Reilly2,3
1Fred Hutchinson Cancer Center, Seattle, WA, United States.
JMIR Formative Research
|April 14, 2023
Summary
This pilot study found that Vet Flexiquit and SmokefreeVET, two digital smoking cessation programs for veterans, had similar acceptability and efficacy. Enhancing these programs with provider support may improve engagement and outcomes.
Area of Science:
- Digital health interventions
- Behavioral science
- Public health
Background:
- High smoking prevalence among socioeconomically disadvantaged veterans receiving care from the Veterans Health Administration.
- Existing smoking cessation treatments have limited reach, focusing only on those ready to quit.
- Need for accessible, effective interventions for veterans at all stages of smoking cessation readiness.
Purpose of the Study:
- To develop and evaluate Vet Flexiquit, a web-based Acceptance and Commitment Therapy (ACT) program for veterans.
- To assess the acceptability, efficacy, and impact on ACT-based change processes of Vet Flexiquit compared to SmokefreeVET.
- To conduct a pilot randomized controlled trial (RCT) to compare these digital interventions.
Main Methods:
- Pilot RCT with 49 veterans randomized 1:1 to Vet Flexiquit or SmokefreeVET.
- Both fully automated, self-guided web programs with 6 weeks of SMS text messaging.
- Primary outcome data collected at 3 months; smoking abstinence biochemically verified via saliva cotinine.
Main Results:
- High acceptability (treatment satisfaction) for both programs (100% Vet Flexiquit, 95% SmokefreeVET).
- Modest utilization (log-ins) for both programs (M=3.7 Vet Flexiquit, M=3.2 SmokefreeVET).
- No significant differences between arms in acceptability, smoking cessation, or ACT process changes.
Conclusions:
- Both digital programs demonstrate high acceptability but limited utilization among veterans.
- Preliminary findings suggest similar outcomes for Vet Flexiquit and SmokefreeVET in this pilot study.
- Integrating provider/peer support and enhancing SMS messaging may boost engagement and improve cessation outcomes.
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