J. Med. Internet Res. - Engagement promotes abstinence in a web-based cessation intervention: cohort study.


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CKGROUND: Web-based smoking cessation interventions can have a public health impact because they are both effective in promoting cessation and can reach large numbers of smokers in a cost-efficient manner. Their potential impact, however, has not been realized. It is still unclear how such interventions promote cessation, who benefits most, and how to improve their population impact.OBJECTIVE: To examine the effectiveness of a highly promoted Web-based smoking cessation intervention to promote quit behavior over time, identify the most effective features, and understand who is most likely to use those features by using unweighted and weighted analyses to estimate the impact in the broader pool of registered site users.METHODS: A sample of 1033 new adult registrants was recruited from a Web-based smoking cessation intervention by using an automated study management system. Abstinence was assessed by self-report through a mixed-mode follow-up (online survey with telephone follow-up for nonrespondents) at 1, 3, and 6 months. Software tracked respondents' online activity. Generalized estimating equations (GEE) were used to examine predictors of website utilization and how utilization promoted abstinence using unweighted and weighted data.RESULTS: The 7-day point prevalence abstinence rates at 6 months ranged from 20.68% to 11.13% in the responder and intent-to-treat samples, respectively. Predictors of abstinence in unweighted analyses included number of visits to the website as well as accessing specific interactive or engaging features. In weighted analyses, only number of visits was predictive of abstinence. Motivation to quit was a key predictor of website utilization, whereas negative partner support decreased the likelihood of increasing visits or accessing engaging features.CONCLUSIONS: Engagement is critical to promoting smoking cessation. The next generation of Web-based smoking cessation interventions needs to maximize the initial engagement of all new visitors and work to retain those smokers who proceed to register on the site.

Resumo Limpo

ckground webbas smoke cessat intervent can public health impact effect promot cessat can reach larg number smoker costeffici manner potenti impact howev realiz still unclear intervent promot cessat benefit improv popul impactobject examin effect high promot webbas smoke cessat intervent promot quit behavior time identifi effect featur understand like use featur use unweight weight analys estim impact broader pool regist site usersmethod sampl new adult registr recruit webbas smoke cessat intervent use autom studi manag system abstin assess selfreport mixedmod followup onlin survey telephon followup nonrespond month softwar track respond onlin activ general estim equat gee use examin predictor websit util util promot abstin use unweight weight dataresult day point preval abstin rate month rang respond intenttotreat sampl respect predictor abstin unweight analys includ number visit websit well access specif interact engag featur weight analys number visit predict abstin motiv quit key predictor websit util wherea negat partner support decreas likelihood increas visit access engag featuresconclus engag critic promot smoke cessat next generat webbas smoke cessat intervent need maxim initi engag new visitor work retain smoker proceed regist site

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