A Web-Based Intervention to Increase Smokers’ Intentions to Participate in a Cessation Study Offered at the Point of Lung Screening: Factorial Randomized Trial

Background Screen ASSIST is a cessation trial offered to current smokers at the point of lung cancer screening. Because of the unique position of promoting a prevention behavior (smoking cessation) within the context of a detection behavior (lung cancer screening), this study employed prospect theory to design and formatively evaluate a targeted recruitment video prior to trial launch. Objective The aim of this study was to identify which message frames were most effective at promoting intent to participate in a smoking cessation study. Methods Participants were recruited from a proprietary opt-in online panel company and randomized to a 2 (benefits of quitting vs risks of continuing to smoke at the time of lung screening; BvR) × 2 (gains of participating vs losses of not participating in a cessation study; GvL) message design experiment (N=314). The primary outcome was self-assessed intent to participate in a smoking cessation study. Message effectiveness and lung cancer risk perception measures were also collected. Analysis of variance examined the main effect of the 2 message factors and a least absolute shrinkage and selection operator (LASSO) approach identified predictors of intent to participate in a multivariable model. A mediation analysis was conducted to determine the direct and indirect effects of message factors on intent to participate in a cessation study. Results A total of 296 participants completed the intervention. There were no significant differences in intent to participate in a smoking cessation study between message frames (P=.12 and P=.61). In the multivariable model, quit importance (P<.001), perceived message relevance (P<.001), and affective risk response (ie, worry about developing lung cancer; P<.001) were significant predictors of intent to participate. The benefits of quitting frame significantly increased affective risk response (Meanbenefits 2.60 vs Meanrisk 2.40; P=.03), which mediated the relationship between message frame and intent to participate (b=0.24; 95% CI 0.01-0.47; P=.03). Conclusions This study provides theoretical and practical guidance on how to design and evaluate proactive recruitment messages for a cessation trial. Based on our findings, we conclude that heavy smokers are more responsive to recruitment messages that frame the benefits of quitting as it increased affective risk response, which predicted greater intention to participate in a smoking cessation study.

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A Web-Based Intervention to Increase Smokers’ Intentions to Participate in a Cessation Study Offered at the Point of Lung Screening: Factorial Randomized Trial (Preprint)

10.2196/preprints.28952 ◽

2021 ◽

Author(s):

Jordan M Neil ◽

Yuchiao Chang ◽

Brett Goshe ◽

Nancy Rigotti ◽

Irina Gonzalez ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Multivariable Model ◽

Message Effectiveness ◽

Risk Response ◽

Message Frames ◽

Intentions To Participate ◽

Lung Screening

BACKGROUND Screen ASSIST is a cessation trial offered to current smokers at the point of lung cancer screening. Because of the unique position of promoting a prevention behavior (smoking cessation) within the context of a detection behavior (lung cancer screening), this study employed prospect theory to design and formatively evaluate a targeted recruitment video prior to trial launch. OBJECTIVE The aim of this study was to identify which message frames were most effective at promoting intent to participate in a smoking cessation study. METHODS Participants were recruited from a proprietary opt-in online panel company and randomized to a 2 (benefits of quitting vs risks of continuing to smoke at the time of lung screening; BvR) × 2 (gains of participating vs losses of not participating in a cessation study; GvL) message design experiment (N=314). The primary outcome was self-assessed intent to participate in a smoking cessation study. Message effectiveness and lung cancer risk perception measures were also collected. Analysis of variance examined the main effect of the 2 message factors and a least absolute shrinkage and selection operator (LASSO) approach identified predictors of intent to participate in a multivariable model. A mediation analysis was conducted to determine the direct and indirect effects of message factors on intent to participate in a cessation study. RESULTS A total of 296 participants completed the intervention. There were no significant differences in intent to participate in a smoking cessation study between message frames (P=.12 and P=.61). In the multivariable model, quit importance (P<.001), perceived message relevance (P<.001), and affective risk response (ie, worry about developing lung cancer; P<.001) were significant predictors of intent to participate. The benefits of quitting frame significantly increased affective risk response (Meanbenefits 2.60 vs Meanrisk 2.40; P=.03), which mediated the relationship between message frame and intent to participate (b=0.24; 95% CI 0.01-0.47; P=.03). CONCLUSIONS This study provides theoretical and practical guidance on how to design and evaluate proactive recruitment messages for a cessation trial. Based on our findings, we conclude that heavy smokers are more responsive to recruitment messages that frame the benefits of quitting as it increased affective risk response, which predicted greater intention to participate in a smoking cessation study.

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Study protocol for a telephone-based smoking cessation randomized controlled trial in the lung cancer screening setting: The lung screening, tobacco, and health trial

Contemporary Clinical Trials ◽

10.1016/j.cct.2019.05.006 ◽

2019 ◽

Vol 82 ◽

pp. 25-35 ◽

Cited By ~ 2

Author(s):

Kathryn L. Taylor ◽

Danielle E. Deros ◽

Shelby Fallon ◽

Jennifer Stephens ◽

Emily Kim ◽

...

Keyword(s):

Lung Cancer ◽

Randomized Controlled Trial ◽

Smoking Cessation ◽

Cancer Screening ◽

Study Protocol ◽

Controlled Trial ◽

Lung Cancer Screening ◽

Randomized Controlled ◽

Lung Screening

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CONNECT: Smoking Cessation and Lung Cancer Screening

Case Medical Research ◽

10.31525/ct1-nct04149249 ◽

2019 ◽

Author(s):

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Screening ◽

Lung Cancer Screening

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Receipt of Tobacco Treatment and One-Year Smoking Cessation Rates Following Lung Cancer Screening in the Veterans Health Administration

Journal of General Internal Medicine ◽

10.1007/s11606-021-07011-0 ◽

2021 ◽

Author(s):

Jaimee L. Heffner ◽

Scott Coggeshall ◽

Chelle L. Wheat ◽

Paul Krebs ◽

Laura C. Feemster ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Veterans Health Administration ◽

Veterans Health ◽

Health Administration ◽

Tobacco Treatment ◽

One Year

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Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djab002 ◽

2021 ◽

Cited By ~ 1

Author(s):

Christopher J Cadham ◽

Pianpian Cao ◽

Jinani Jayasekera ◽

Kathryn L Taylor ◽

David T Levy ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cost Effectiveness ◽

Cancer Screening ◽

Task Force ◽

Lung Cancer Screening ◽

Cancer Registries ◽

Web Based ◽

Screening Programs ◽

Life Years

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.

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