Recruitment Messages for Current Smokers Recently Diagnosed With Cancer

Study Overview
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Brief Summary
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The objective of this study was to conduct a pilot factorial randomized trial to identify the message frames that are most effective in promoting participation in a tobacco treatment trial for current smokers recently diagnosed with cancer. To do so, we used a multimethod approach to evaluate 3 different message frames across evaluation, effectiveness, and outcome measures. We combine findings from a message design experiment with textual analytic software to provide a holistic understanding of how message frames may or may not differentially affect tobacco treatment trial participation within the context of a cancer diagnosis.

Detailed Description
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Background: A cancer diagnosis can catalyze motivation to quit smoking. Tobacco treatment trials offer cessation resources but have low accrual rates. Digital outreach may improve accrual, but knowledge of how best to recruit smokers with recent diagnoses is limited. Objective: This study aims to identify the message frames that were most effective in promoting intent to talk to a physician about participating in a tobacco treatment trial for smokers recently diagnosed with cancer. Methods: From February to April 2019, current smokers diagnosed within the past 24 months were recruited from a national web-based panel for a multimethod pilot randomized trial (N=99). Participants were randomized to a 2×3 plus control factorial design that tested 3 unique message frames: proximal versus distal threats of smoking, costs of continued smoking versus benefits of quitting, and gains of participating versus losses of not participating in a tobacco treatment trial.

Official Title
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A Multimethod Evaluation of Tobacco Treatment Trial Recruitment Messages for Current Smokers Recently Diagnosed With Cancer: Pilot Factorial Randomized Controlled Trial

Conditions
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Tobacco Smoking, Health Behavior

Intervention / Treatment
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* Behavioral: Proximal
* Behavioral: Distal
* Behavioral: Cost
* Behavioral: Benefit
* Behavioral: Loss
* Behavioral: Gain
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Speak and understand English A recent cancer diagnosis (within the past 24 months) 18 years or older Report any cigarette use within the past 30 days Exclusion Criteria: Do not speak or understand English Have not been diagnosed with cancer within the past 24 months Below the age of 18 Does not report any cigarette use within the past 30 days

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Control<br>The control condition was a kernel message that included study information present in all conditions but did not include any of the message factors. | Behavioral: Control<br>* Does not include any of the three message factors.<br>|
| Experimental: Proximal x Cost x Loss<br>Message frame: proximal threats of smoking, cost of continued smoking, and loss of not participating in a tobacco treatment trial. | Behavioral: Proximal<br>* The first factor tested framing of the near, proximal threat of continued smoking.<br>Behavioral: Cost<br>* Cost framework measures the response efficacy to quitting smoking by displaying costs of continued smoking.<br>Behavioral: Loss<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing loss of not participating in a smoking cessation.<br>|
| Experimental: Proximal x Cost x Gain<br>Message frame: proximal threats of smoking, cost of continued smoking, and gain of participating in a tobacco treatment trial. | Behavioral: Proximal<br>* The first factor tested framing of the near, proximal threat of continued smoking.<br>Behavioral: Cost<br>* Cost framework measures the response efficacy to quitting smoking by displaying costs of continued smoking.<br>Behavioral: Gain<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing gain of participating in a smoking cessation.<br>|
| Experimental: Proximal x Benefit x Gain<br>Message frame: proximal threats of smoking, benefits of quitting, and gain of participating in a tobacco treatment trial. | Behavioral: Proximal<br>* The first factor tested framing of the near, proximal threat of continued smoking.<br>Behavioral: Benefit<br>* Benefit framework measures the response efficacy to quitting smoking by displaying benefits of quitting.<br>Behavioral: Gain<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing gain of participating in a smoking cessation.<br>|
| Experimental: Proximal x Benefit x Loss<br>Message frame: proximal threats of smoking, benefits of quitting, and loss of not participating in a tobacco treatment trial. | Behavioral: Proximal<br>* The first factor tested framing of the near, proximal threat of continued smoking.<br>Behavioral: Benefit<br>* Benefit framework measures the response efficacy to quitting smoking by displaying benefits of quitting.<br>Behavioral: Loss<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing loss of not participating in a smoking cessation.<br>|
| Experimental: Distal x Cost x Gain<br>Message frame: distal threats of smoking, cost of continued smoking, and gain of participating in a tobacco treatment trial. | Behavioral: Distal<br>* The first factor tested framing of the long-term, distal threat of continued smoking.<br>Behavioral: Cost<br>* Cost framework measures the response efficacy to quitting smoking by displaying costs of continued smoking.<br>Behavioral: Gain<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing gain of participating in a smoking cessation.<br>|
| Experimental: Distal x Cost x Loss<br>Message frame: distal threats of smoking, cost of continued smoking, and loss of not participating in a tobacco treatment trial. | Behavioral: Distal<br>* The first factor tested framing of the long-term, distal threat of continued smoking.<br>Behavioral: Cost<br>* Cost framework measures the response efficacy to quitting smoking by displaying costs of continued smoking.<br>Behavioral: Loss<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing loss of not participating in a smoking cessation.<br>|
| Experimental: Distal x Benefit x Loss<br>Message frame: distal threats of smoking, benefits of quitting, and loss of not participating in a tobacco treatment trial. | Behavioral: Distal<br>* The first factor tested framing of the long-term, distal threat of continued smoking.<br>Behavioral: Benefit<br>* Benefit framework measures the response efficacy to quitting smoking by displaying benefits of quitting.<br>Behavioral: Loss<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing loss of not participating in a smoking cessation.<br>|
| Experimental: Distal x Benefit x Gain<br>Message frame: distal threats of smoking, benefits of quitting, and gain of participating in a tobacco treatment trial. | Behavioral: Distal<br>* The first factor tested framing of the long-term, distal threat of continued smoking.<br>Behavioral: Benefit<br>* Benefit framework measures the response efficacy to quitting smoking by displaying benefits of quitting.<br>Behavioral: Gain<br>* The third factor tested framing of the response efficacy of participating in a cessation study by utilizing gain of participating in a smoking cessation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference in intent to talk to a physician about participating in a smoking cessation study between factors. | The main effect within each message factor level was examined using ANOVA and compared with the control condition. | Within 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Predictors of intent to talk to a physician about participating in a smoking cessation study. | Other message evaluation and effectiveness measures were collected and explored in a multivariable model predicting intent to talk to a physician. | Within 30 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cancer, Digital outreach, Multimethod randomized trial, Factorial Design, Message Frames, Tobacco use, Smoker enrollment rates