J. Med. Internet Res. - From online randomized controlled trials to participant preference studies: morphing the San Francisco Stop Smoking site into a worldwide smoking cessation resource.

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Resumo

CKGROUND: Internet interventions have the potential to address many of the health problems that produce the greatest global burden of disease. We present a study illustrating this potential. The Spanish/English San Francisco Stop Smoking Internet site, which yielded quit rates of 20% or more at 12 months in published randomized controlled trials (RCTs), was modified to make it accessible to Spanish- and English-speaking smokers 18 years of age or older anywhere in the world.OBJECTIVE: To illustrate that Internet interventions designed to conduct RCTs can be adapted to serve as universal health care resources. We also examine quit rates obtained in the current participant preference study (in which users could choose from all elements tested in previous RCTs) to determine whether they differ from the quit rates found in the RCTs.METHODS: We modified the San Francisco Stop Smoking Internet site so that, instead of being randomly assigned to a specific intervention, participants could personalize the site by choosing among nine site elements (eg, stop smoking guide, reminder emails, journal, mood management intervention, or virtual group). Participants completed a baseline assessment, and reported smoking and mood data at 1-, 3-, 6-, and 12-month follow-ups. We assessed the modified website's reach and outcomes (quit rates), and compared the quit rates of the current participant preference study with those of the previous RCTs.RESULTS: In the first year of recruitment, 94,158 individuals from 152 countries and territories visited the site; 13,488 participants left some data; 9173 signed consent; 7763 completed the baseline survey; and 1955, 1362, 1106, and 1096 left 1-, 3-, 6-, and 12-month data, respectively. Observed quit rates were 38.1% (n = 668), 44.9% (n = 546), 43.6% (n = 431), and 45.4% (n = 449), respectively. The current participant preference study yielded higher observed quit rates (odds ratio 1.30) than the previous RCT when controlling for individuals' demographic and smoking characteristics.CONCLUSIONS: After strict RCTs are completed, Internet intervention sites can be made into worldwide health intervention resources without reducing their effectiveness.TRIAL REGISTRATION: Clinicaltrials.gov NCT00721786; http://clinicaltrials.gov/ct2/show/NCT00721786 (Archived by WebCite at http://www.webcitation.org/66npiZF4y).

Resumo Limpo

ckground internet intervent potenti address mani health problem produc greatest global burden diseas present studi illustr potenti spanishenglish san francisco stop smoke internet site yield quit rate month publish random control trial rcts modifi make access spanish englishspeak smoker year age older anywher worldobject illustr internet intervent design conduct rcts can adapt serv univers health care resourc also examin quit rate obtain current particip prefer studi user choos element test previous rcts determin whether differ quit rate found rctsmethod modifi san francisco stop smoke internet site instead random assign specif intervent particip person site choos among nine site element eg stop smoke guid remind email journal mood manag intervent virtual group particip complet baselin assess report smoke mood data month followup assess modifi websit reach outcom quit rate compar quit rate current particip prefer studi previous rctsresult first year recruit individu countri territori visit site particip left data sign consent complet baselin survey left month data respect observ quit rate n n n n respect current particip prefer studi yield higher observ quit rate odd ratio previous rct control individu demograph smoke characteristicsconclus strict rcts complet internet intervent site can made worldwid health intervent resourc without reduc effectivenesstri registr clinicaltrialsgov nct httpclinicaltrialsgovctshownct archiv webcit httpwwwwebcitationorgnpizfi

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