Internet-Based Nonsmoking Program for Postpartum Women
Condition: Cigarette Smoking; Smoking, Tobacco
Study type: Interventional
Phase: Phase 2

Summary: 
      This project developed and evaluated an Internet-based interactive program with digital
      coaching designed to assist two groups of smokers in quitting smoking: (1) pregnant smokers
      and (2) general-population smokers (i.e., men and non-pregnant women). Program content was
      based on the U.S. Department of Health and Human Services Clinical Practice Guidelines,
      "Treating Tobacco Use and Dependence: 2008 Update" (Fiore et al., 2008) and input from
      project consultants.
    

Detailed description: 
      The "Break the Chain" program is an online smoking cessation intervention that incorporated
      strategic message construction based on behavior change constructs, interactive exercises,
      and digitial coaching support to engage the user in their smoking behavior change. The
      Expanded Theory of Reasoned Action (ETRA) (Fishbein, 1999, 2000) provides the theoretical
      foundation for the content. Intervention components include: (1) interactive check-ins, (2)
      content modules and interactive smoking cessation tools, (3) digital coaching, and (4) online
      social media (i.e., article feed).

      Content modules included: Benefits of quitting, Making a plan for quitting, Boosting your
      support system, Planning for cravings and tempting situations, Managing stress and mood,
      Managing your weight, and Becoming an ex-smoker. Tailored information within each module was
      presented to the user based on responses to initial assessment questions and interactive
      check-ins (e.g., readiness to quit, pregnancy status, previous quit attempts, self-efficacy
      for quitting, worry about weight gain). Interactive tools presented within the logical flow
      of the modules included a Reasons for Quitting questionnaire, Pros and Cons of Quitting tool
      (decisional balance), Nicotine Dependence quiz, a Pharmacological Aid Decision tool, and a
      Quit Meter. Content was entirely text-based.

      Within-program coach-generated and program-generated messages provided cessation tips and
      information. Digital coaching contacts were timed and tailored to the user's smoking status,
      health history, pregnancy status (if appropriate), and timing of quit day. The coaching
      messages prompted the user to engage more fully with the website by presenting hyperlinks to
      pertinent smoking cessation information or strategies in the program. A computer algorithm
      controlled the timing of the messages to each user. Users were invited to contact their coach
      via in-program message at any time with questions or concerns about smoking cessation
      strategies. A coaching interface allowed a health coach to view user information as the user
      progressed through the program and developed his/her quit plan. The coaching interface was
      also the platform through which the coach managed communication with each user.
    

Intervention name(s): Break the Chain; Clearing the Air
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Internet-based smoking cessation intervention designed for general population smokers with targeted materials for pregnant women. The program included a digital coaching component delivered via email at specific points as the user progresses through his/her quit process. Program content is based on Department of Health and Human Services Clinical Practice Guidelines for Treating Tobacco Use and Dependence.; PDF version of smoking cessation booklet from National Cancer Institute.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: Cigarette smoking; Smoking, Tobacco; postpartum; internet; interactive; coach