J. Med. Internet Res. - Effectiveness of a Web-based multiple tailored smoking cessation program: a randomized controlled trial among Dutch adult smokers.

Tópicos

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Resumo

CKGROUND: Distributing a multiple computer-tailored smoking cessation intervention through the Internet has several advantages for both provider and receiver. Most important, a large audience of smokers can be reached while a highly individualized and personal form of feedback can be maintained. However, such a smoking cessation program has yet to be developed and implemented in The Netherlands.OBJECTIVE: To investigate the effects of a Web-based multiple computer-tailored smoking cessation program on smoking cessation outcomes in a sample of Dutch adult smokers.METHODS: Smokers were recruited from December 2009 to June 2010 by advertising our study in the mass media and on the Internet. Those interested and motivated to quit smoking within 6 months (N = 1123) were randomly assigned to either the experimental (n = 552) or control group (n = 571). Respondents in the experimental group received the fully automated Web-based smoking cessation program, while respondents in the control group received no intervention. After 6 weeks and after 6 months, we assessed the effect of the intervention on self-reported 24-hour point prevalence abstinence, 7-day point prevalence abstinence, and prolonged abstinence using logistic regression analyses.RESULTS: Of the 1123 respondents, 449 (40.0%) completed the 6-week follow-up questionnaire and 291 (25.9%) completed the 6-month follow-up questionnaire. We used a negative scenario to replace missing values. That is, we considered respondents lost to follow-up to still be smoking. The computer-tailored program appeared to have significantly increased 24-hour point prevalence abstinence (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.30-2.65), 7-day point prevalence abstinence (OR 2.17, 95% CI 1.44-3.27), and prolonged abstinence (OR 1.99, 95% CI 1.28-3.09) rates reported after 6 weeks. After 6 months, however, no intervention effects could be identified. Results from complete-case analyses were similar.CONCLUSIONS: The results presented suggest that the Web-based computer-tailored smoking cessation program had a significant effect on abstinence reported after a 6-week period. At the 6-month follow-up, however, no intervention effects could be identified. This might be explained by the replacement of missing values on the primary outcome measures due to attrition using a negative scenario. While results were similar when using a less conservative scenario (ie, complete-case analyses), the results should still be interpreted with caution. Further research should aim at identifying strategies that will prevent high attrition in the first place and, subsequently, to identify the best strategies for dealing with missing data when studies have high attrition rates.TRIAL REGISTRATION: Dutch Trial Register NTR1351; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1351 (Archived by WebCite at http://www.webcitation.org/67egSTWrz).

Resumo Limpo

ckground distribut multipl computertailor smoke cessat intervent internet sever advantag provid receiv import larg audienc smoker can reach high individu person form feedback can maintain howev smoke cessat program yet develop implement netherlandsobject investig effect webbas multipl computertailor smoke cessat program smoke cessat outcom sampl dutch adult smokersmethod smoker recruit decemb june advertis studi mass media internet interest motiv quit smoke within month n random assign either experiment n control group n respond experiment group receiv fulli autom webbas smoke cessat program respond control group receiv intervent week month assess effect intervent selfreport hour point preval abstin day point preval abstin prolong abstin use logist regress analysesresult respond complet week followup questionnair complet month followup questionnair use negat scenario replac miss valu consid respond lost followup still smoke computertailor program appear signific increas hour point preval abstin odd ratio confid interv ci day point preval abstin ci prolong abstin ci rate report week month howev intervent effect identifi result completecas analys similarconclus result present suggest webbas computertailor smoke cessat program signific effect abstin report week period month followup howev intervent effect identifi might explain replac miss valu primari outcom measur due attrit use negat scenario result similar use less conserv scenario ie completecas analys result still interpret caution research aim identifi strategi will prevent high attrit first place subsequ identifi best strategi deal miss data studi high attrit ratestri registr dutch trial regist ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgegstwrz

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