Features of mHealth Apps for Tobacco Cessation Important to Black Adults: Discrete Choice Experiment

Although mobile health (mHealth) apps for tobacco cessation augment traditional cessation methods and have contributed to increases in cessation rates, Black adults are underrepresented in mHealth app studies for tobacco cessation. As a result, their mHealth app preferences are not well-known.

Our goal was to identify features of mHealth apps for cessation that are important to Black adults who use tobacco products.

We developed an online discrete choice experiment with 12 pairs of hypothetical mHealth apps for tobacco cessation. Inclusion criteria included being 21 years or older, current use of any tobacco product, and identifying as Black or African American. Participants had to be interested in tobacco cessation and have a history of mHealth app use or be willing to use one in the future. From each pair of hypothetical apps within the survey, participants had to choose the app they preferred. Each hypothetical app was made up of 7 features developed from existing mHealth literature and prior qualitative work: graphics, marketing, strategies for quitting, connection with others, personalization, benefits of quitting, and health information. Each feature had up to 4-5 levels (ie, variations of that attribute), and each hypothetical mHealth app was comprised of a random assortment of levels of features. Hierarchical Bayes estimation was used to determine the part-worth utility for each level within each feature for each participant, which was then used to calculate the importance score. Average importance scores across respondents were used to determine overall importance scores for each feature.

We had 901 adult participants. The mean age was 41 (SD 14.02) years, and about a third of participants (377/901, 42%) were female. Two-thirds of participants (549/901, 61%) had used an mHealth app in the past, and the great majority (786/901, 87%) indicated a willingness to use an app for health purposes in the future. The features had the following importance: graphics (16%), marketing (15%), strategies for quitting (15%), connection with others (14%), personalization (13%), benefits of quitting (13%), and health information (13%). Within features, strategies for quitting had the highest and third-highest levels of "making a step-by-step quit plan" and "recommendations to manage relapse or withdrawal," respectively. Marketing had the second-highest level of "Historically Black Colleges and Universities-endorsed app." Graphics had the fourth-highest level of "short video testimonials from people who successfully quit," while connection with others had the fifth-highest level of "quit buddy program for support and accountability."

This study identified features of mHealth apps important to Black adult tobacco users. To enhance the appeal of mHealth apps to such adults, prioritizing inclusion of highly preferred levels in apps may lead to higher use and improved cessation.