Implementation of a WeChat-Based Smoking Cessation Program for Chinese Smokers

Introduction: Although smoking prevalence has recently declined, the smoking prevalence in China remains high. Extensive research has demonstrated ways that social media can assist in quitting smoking. WeChat is the most commonly used social media platform in China but has not been used for smoking cessation. A process evaluation of a novel WeChat-based smoking cessation intervention was conducted to measure its efficacy of content delivery, participant satisfaction, engagement, and likelihood of recommendation to others. Methods: A three-week, three-arm, single-blind randomized control trial was established. WeChat was used to recruit 403 participants and to deliver intervention messages and process evaluation surveys to them. Recruitment advertisements were posted on an official WeChat account and were forwarded to WeChat Moments. Intervention messages were delivered once a day during weekdays, using the WeChat broadcasting messages function, with two messages being sent each time. Process evaluation surveys were organized using Wenjuanwang and were delivered via WeChat. Process assessments were conducted every Friday to assess intervention message receipt, satisfaction level, engagement level, and recommendation to others. The receipt of intervention messages was measured by a self-reported question indicating which messages were read each week. Satisfaction was measured by a five-item Likert scale survey. Engagement was measured by a one-item Likert scale survey. Recommendation to others was measured by one self-reported question. Results: Participants read an average of 4.76 (out of 10), 5.80 (out of 10), and 4.25 (out of 6) messages at week 1, week 2, and week 3, respectively. The second messages were less likely to be read compared to the first messages (52.3% vs. 61.6%, respectively). Moreover, within each single week, the number of participants who read the intervention messages gradually decreases over time. Picture-based intervention messages tended to be less likely to be read than video-based intervention messages. Total program satisfaction scores ranged between 5 and 25, and the overall scores for satisfaction for each week were 21.55, 22.27, and 22.76, respectively. No significant differences were found in all the satisfaction indicators between groups. More than 60% of participants reported being either highly engaged or somewhat engaged each week. In addition, most participants (93.0% at week 1, 95.8% at week 2, and 96.2% at week 3) reported that they were willing to recommend our program to others. Discussion: A WeChat-based smoking cessation intervention for Chinese smokers was implemented and evaluated. For future studies, one should consider sending messages of a higher importance as the first message of a given day. Smokers had a higher rate of reading intervention messages at the beginning part of each week, during which, relatively important messages should be prioritized. One might also consider alternating the topics and formats of the messages for a better engagement of the users in future studies.

Evidence-Based Behaviour Change Intervention on Saiga Horn Medicine in Singapore: Research Brief

Key Points: 1. A rare example of a wildlife trade initiative that covers all stages of an evidence-based behaviour change intervention. 2. Intervention development involved combining extensive consumer research with human behaviour theory and past research. 3. Intervention used a cutting-edge, powerful combination of online news coverage and targeted advertising. 4. Post-intervention, 4% of the target audience changed their behaviour (vs 1% of non-target) and the intervention message was shown as the key cause; but high-level users did not decrease significantly pre-to post-intervention.

Evaluating a large-scale online behaviour change intervention aimed at wildlife product consumers in Singapore

Interventions to shift the behaviour of consumers using unsustainable wildlife products are key to threatened species conservation. Whether these interventions are effective is largely unknown due to a dearth of detailed evaluations. We previously conducted a country-level online behaviour change intervention targeting consumers of the Critically Endangered saiga antelope (Saiga tatarica) horn in Singapore. To evaluate intervention impact, we carried out in-person consumer surveys with >2,000 individuals pre- and post-intervention (2017 and 2019), and 93 in-person post-intervention surveys with traditional Chinese medicine (TCM) shopkeepers (2019). The proportion of self-reported high-usage saiga horn consumers in the target audience (Chinese Singaporean women aged 35–59) did not change significantly from pre- to post-intervention (24.4% versus 22.6%). However, post-intervention the target audience was significantly more likely than the non-target audience to accurately recall the intervention message and to report a decrease in saiga horn usage (4% versus 1% reported a behaviour change). Within the target audience, high-usage consumers were significantly more likely than lower-usage consumers to recall the message and report a behaviour change. Across respondents who reported a decrease in saiga horn usage, they cited the intervention message as a specific reason for their behaviour change significantly more than other reasons. Additionally, across all respondents, the belief that saiga is a common species in the wild decreased significantly from pre- to post-intervention. TCM shopkeepers, however, cited factors such as price and availability as the strongest influences on saiga horn sales. In sum, the intervention did significantly influence some consumers but the reduction of high-usage consumer frequency was not significant at the population level. We explore reasons for these findings, including competing consumer influences, characteristics of the intervention, and evaluation timing. This work suggests our intervention approach has potential, and exemplifies a multi-pronged in-person evaluation of an online wildlife trade consumer intervention.

Process evaluation of the development and remote recruitment for Essential Coaching for Every Mother during COVID-19

BackgroundWith the sudden decrease in in-person support and increase in perinatal mental health concerns during the coronavirus pandemic, innovative strategies, such as mHealth, are more important than ever. This study has two objectives: (1) to describe the modification of Essential Coaching for Every Mother during the coronavirus pandemic, and (2) to describe the process evaluation of recruitment and retention of pregnant and postpartum women for a pre-post intervention study.MethodsFor objective 1, modified messages were piloted with mothers and postpartum healthcare providers simultaneously. Semi-structured interviews were conducted with a subset of 10 participants from the original development study. For objective 2, three methods were used for recruitment: social media, posters in hospital, and media outreach. First time mothers were eligible for enrollment antenatally (37+ weeks) and postnatally (<3 weeks). Eligibility screening occurred remotely via text message with participants initiating contact. Data were collected via TextIt and REDCap. Outcomes were days to recruit 75 participants, eligibility vs. ineligibility rates, dropout and exclusion reasons, survey completion rates, perinatal timing of enrollment, and recruitment sources.ResultsFor objective 1, three mothers (M age=30.67 years) and seven healthcare providers (M age = 46.0 years) participated in the modification of the messages. Participants felt the messages were appropriate and relevant related to changes in postpartum care during the coronavirus pandemic. Nine messages were modified related to coronavirus and five messages were added to the program. For objective 2, recruitment ran July 15th-September 19th (67 days) with 200 screened and 88 enrolled, 70% antenatally. It took 50 days to enroll 75 participants. Mothers recruited antenatally (n=53) were more likely to receive all intervention message (68% vs. 19%). Mothers recruited postnatally (n=35) missed more messages on average (13.8 vs. 6.4). Participants heard about the study through family/friends (31%), news (20%), Facebook groups (16%), Facebook ads (14%), posters (12%), or other ways (7%).ConclusionAntenatal recruitment resulted in participants enrolling earlier and receiving more of the study messages. Word of mouth and media outreach were successful, followed by advertisement on Facebook. Remote recruitment was a feasible way to recruit for Essential Coaching for Every Mother.

Developing an Intervention to Reduce Sedentary Behavior: Assisted Living Resident Feedback

Older adults in assisted living (AL) tend to be highly sedentary, which increases their risk of functional decline and frailty. Reducing sedentary behavior (SB) and replacing it with light physical activity (LPA) could have important implications for maintenance of functional abilities. The purpose of this qualitative study was to gather feedback from AL residents on a proposed exercise-specific self-efficacy enhancing intervention designed to promote LPA and reduce SB. We conducted one-on-one semi-structured interviews at four AL facilities with 20 residents ages 65-99 (mean age 83.1; 60% women). They were presented with the proposed intervention and were asked questions to inform the development and modification of the intervention. Data were analyzed with a thematic analysis approach. Specific recommendations included short intervention sessions of one hour and scheduled in the morning. Many residents thought a 16 week intervention was too long. We identified broader themes, including concerns about how the intervention would work for residents with a wide range of abilities and concerns about safety. They suggested that exercises will need to be highly modifiable. Most residents recommended framing the intervention message as increasing LPA rather than decreasing SB, because it would be more positive. All except one said they would want to participate in the intervention, but they were unsure how many other residents would want to be more active. The resident feedback and suggestions will guide development of the intervention and are important for increasing the probability that a future feasibility and acceptability trial of the intervention will be successful.

Warming up Cooling Cooperators

The warm-glow of giving is one mechanism proposed to account for high levels of human cooperation. However, little is known about how warm-glow can be harnessed to sustain long-term cooperation to benefit wider society (vaccinations, blood donation). We argue that the power of warm-glow to sustain long-term cooperation cools offs over time but can be warmed-up with a simple intervention message. We test, and confirm this prediction, in a field-based experiment (n = 5,821) comparing warm-glow versus positive affect messages to predict long-term cooperation (blood donation) and confirm our findings in a subsequent implementation study comparing donation attendance in a 3 year pre-implementation period, prior to the warm-glow message being sent to all 1st time donors in Australia (Ns = 90,317, 93,430 & 89,606) to a 2 year post-implementation period (Ns = 81,766 & 88,551). Exogenously manipulated warm-glow can encourage long-term cooperation that benefits society. Wider societal implications are discussed.

Increasing Information Seeking About Antibiotic Risks: Testing a Clinical Intervention Message Using the Risk Information Seeking and Processing Model

We employed the risk information seeking and processing (RISP) model to inform the design of antibiotic stewardship messages aiming at influencing intentions to seek or avoid antibiotic risk information. College-age respondents ( N = 400) from a national sample viewed one of three versions of a RISP-informed message or no message (control group). Relative to the control group, all RISP-informed messages increased perceptions of information insufficiency. The most complete version of the RISP-informed message increased severity perceptions and information seeking intention and decreased information avoidance intention. Approaches to designing antibiotic stewardship messages are recommended accordingly.

Can a Social Norms Appeal Reduce Indoor Tanning? Preliminary Findings From a Tailored Messaging Intervention

Perceived social norms are routinely observed as positive predictors of indoor tanning. Past research has suggested that messaging interventions target normative perceptions to reduce indoor tanning behavior. Despite this call, little empirical research has investigated the utility of taking a social norms approach in behavioral interventions. The present study addresses this gap by conducting a quasi-experiment ( N = 206) assessing the effect of an intervention message correcting normative misperceptions on indoor tanning intentions at different levels of tanning frequency. Results suggest that tailored normative intervention messages can successfully reduce tanning intentions among high-frequency tanners, those who scored at the 75th and 90th percentile of tanning frequency ( f2 for interaction = .015). These results provide preliminary empirical evidence to support previous theorizing on the efficacy of social norms interventions among high-frequency indoor tanners.

Congenital lobar emphysema: a rare cause of respiratory distress in a neonate

Congenital lobar emphysema (CLE) is a congenital condition characterized by distension and air trapping of the affected lobe of the lung. It is one of the causes of infantile respiratory distress, which may require surgical resection of affected lobe. Case characteristics: 3-day-old neonate with ventilation refractory respiratory distress. Imaging was suggestive of decreased lung tissue on the right side with ipsilateral mediastinal shift. Intervention/ outcome: Early surgical lobectomy was done to improve lung functions and the child improved dur to early intervention. Message: An early diagnosis with high index of suspicion helps patients with this rare congenital anomaly. Early intervention is the key to good long-term outcome. More awareness about the entity and treatment options available would greatly help improving the outcome and disease burden.