Mobile EMA-based Peer Counselling for Youth Smokers

Study Overview
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Brief Summary
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This pilot trial aims to examine the feasibility, acceptability, and preliminary effectiveness of EMA-based peer counseling for youth smokers.

Detailed Description
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Most smokers begin smoking during adolescence and early adulthood, a crucial period to prevent initiation and continuation of smoking. However, many proven smoking cessation interventions for adult smokers were not found effective in youth smokers, which may be partly explained by the vast differences in the pattern of tobacco use and determinants of quitting between adult and youth smokers. This calls for more research on novel intervention models to help young smokers quit. The HKU Youth Quitline provides free smoking cessation support for smokers aged below 25 years since August 2005 in Hong Kong. The service provides multisession peer-led telephone counselling with an individualised quit plan devised for each young smoker according to their responses. Since the counselling model depends on the information retrospectively recalled by the smokers, it may be prone to recall and social desirability biases and fail to capture the variability of youth smoking patterns and momentary changes in personal (e.g., mood) and situational (e.g., peer smoking) antecedents of smoking episodes. Recent advances in mobile technologies have enabled the use of more advanced and robust data collection approaches like ecological momentary assessment (EMA), which may benefit the counselling model by providing more ecologically valid data than traditional surveys. Previous studies have demonstrated the feasibility of using EMA to collect data on psychosocial processes and smoking behaviours in adolescent smokers. Therefore, we propose to develop and test a mobile EMA-based counselling intervention for youth smokers by conducting a pilot RCT.

Official Title
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Mobile Ecological Momentary Assessment-based Peer Counselling for Youth Smokers: a Pilot Randomised Controlled Trial

Conditions
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Smoking Cessation

Intervention / Treatment
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* Behavioral: EMA assessment
* Behavioral: EMA-based cessation counselling
* Behavioral: Usual peer counselling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 15 to 25 years Have smoked in the past 30 days Own a smartphone with an mobile instant messaging app installed Can communicate in Chinese Exclusion Criteria: Youth smokers who are participating in other smoking cessation studies or program other than the HKU Youth Quitline

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 25 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EMA+ group<br>EMA assessment + EMA-based cessation counselling | Behavioral: EMA assessment<br>* Subjects will be asked to complete 3 waves of ecological momentary assessment (EMA) about smoking cues and smoking consumption via mobile phone at the first, second and third month after baseline (total 6 weeks)<br>Behavioral: EMA-based cessation counselling<br>* Subjects will receive tailored peer counselling based on the participants' EMA responses at 1-month and 3-month telephone follow-ups.<br>|
| Active Comparator: EMA group<br>EMA assessment only + Usual peer counselling | Behavioral: EMA assessment<br>* Subjects will be asked to complete 3 waves of ecological momentary assessment (EMA) about smoking cues and smoking consumption via mobile phone at the first, second and third month after baseline (total 6 weeks)<br>Behavioral: Usual peer counselling<br>* Subjects will receive peer counselling through telephone during follow-ups (usual care), in which the counsellor will apply the 5As model and motivational interviewing techniques.<br>|
| Active Comparator: Control<br>Usual peer counselling | Behavioral: Usual peer counselling<br>* Subjects will receive peer counselling through telephone during follow-ups (usual care), in which the counsellor will apply the 5As model and motivational interviewing techniques.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biochemically-validated tobacco abstinence | Defined as a negative result of the iScreen OFD test for measuring salivary cotinine (with a cut-off of lower than 30ng/mL) | 6 months after randomisation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported 7-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 7 days | 3 months after randomisation | 
| Self-reported 7-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 7 days | 6 months after randomisation | 
| Self-reported 30-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 30 days | 3 months after randomisation | 
| Self-reported 30-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 30 days | 6 months after randomisation | 
| Smoking reduction by at least 50% | Smoking reduction by at least half of the baseline daily number of cigarettes | 3 months after randomisation | 
| Smoking reduction by at least 50% | Smoking reduction by at least half of the baseline daily number of cigarettes | 6 months after randomisation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chinese, counselling, ecological momentary assessment, young smoker, mobile health, adolescsent, quitline