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Cited by 117Smoking Behavior and CessationDigital Mental Health InterventionsMobile Health and mHealth Applications

Get with the program: Adherence to a smartphone app for smoking cessation

Open access
Zeng, Emily Y., Heffner, Jaimee L., Copeland, Wade K., Mull, Kristin E., Bricker, Jonathan B.·2016·Addictive Behaviors
DOI 10.1016/j.addbeh.2016.07.007PMC PMC5501958
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Abstract

Introduction Although engagement is generally predictive of positive outcomes in technology-based behavioral change interventions, engagement measures remain largely atheoretical and lack treatment-specificity. This study examines the extent to which adherence measures based on the underlying behavioral change theory of an Acceptance and Commitment Therapy (ACT) app for smoking cessation predict smoking outcomes, and user characteristics associated with adherence.Methods Study sample was adult daily smokers in a single arm pilot study (n=84). Using the app's log file data, we examined measures of adherence to four key components of the ACT behavior change model as predictors of smoking cessation and reduction. We also examined baseline user characteristics associated with adherence measures that predict smoking cessation.Results Fully adherent users (24%) were over four times more likely to quit smoking (OR=4.45; 95% CI=1.13, 17.45; p=0.032). Both an increase in tracking the number of urges passed (OR=1.02; 95% CI=1.00, 1.03; p=0.043) and ACT modules completed (OR=1.27; 95% CI=1.01, 1.60; p=0.042) predicted cessation. Lower baseline acceptance of cravings was associated with over four times higher odds of full adherence (OR=4.59; 95% CI=1.35, 15.54; p=0.014).Conclusions Full adherence and use of specific ACT theory-based components of the app predicted quitting. Consistent with ACT theory, users with low acceptance were most likely to adhere to the app. Further research is needed on ways to promote app engagement.

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  • In the study by Zeng et al, the technology consisted of different elements that were all evaluated as effective in other studies, and users were considered adherent if they used all elements.

    “In the study by Zeng et al, the technology consisted of different elements that were all evaluated as effective in other studies [75]. Users were considered adherent if they used all elements.”

    From Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence (2017) · cites this paper as [75]

  • The intended use or therapeutic dose can be justified using existing guidelines for healthy living and medication use or using previous research regarding other technologies.

    “the intended use or the “therapeutic dose” can be justified just as well using existing guidelines for healthy living and medication use [74,77] or using previous research regarding other technologies [75,76].”

    From Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence (2017) · cites this paper as [75]

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2 of the 45 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [34]Dube S Asman K Malarcher A Carabollo R Cigarette smoking among adults and trends in smoking cessation – United States, 2008 Morb Mortal Wkly Rep 2009 58 44 1227 1232 http://www.cdc.gov/mmwr/PDF/wk/mm5844.pdf 19910909

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Authors
Zeng, E. Y., Heffner, J. L., Copeland, W. K., Mull, K. E., & Bricker, J. B.
Affiliations
  • University of Washington (US)
  • Fred Hutch Cancer Center (US)
Corresponding author
Bricker, Jonathan B.
ORCID
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2016-12
Volume
63
Pages
120-124
ISSN
0306-4603 (ISSN-L)
DOI
10.1016/j.addbeh.2016.07.007
PMC
PMC5501958
OpenAlex
W2465833870
Cited by
117
References
45
Citations by year
2026: 2 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 16 · 2021: 4 · 2020: 52 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 1
FWCI
5.90
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Addictive Behaviors (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (R01CA192849, R01CA166646)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
smoking cessation, acceptance and commitment therapy, app engagement, daily smokers, smoking reduction
MeSH terms
Smartphone, Adult, Female, Humans, Male, Patient Compliance, Pilot Projects, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Mobile Applications, Acceptance and Commitment Therapy

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