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Abstract
Background and objectives: The aim of this study was to examine the efficacy of a web-assisted computer-tailored smoking cessation intervention, an action planning (AP) intervention in which potential quitters were encouraged to form action plans (e.g., plan a quit date) and execute them (e.g., remove ashtrays). We also investigated whether the AP intervention resulted in more AP and plan execution than a similar, control intervention without the supplementary AP component. Methods: In a randomized controlled trial, the AP intervention (N = 977) was compared with the control intervention (N = 1,005) in terms of self-reported continued abstinence (CA) and point prevalence abstinence (PPA) six months after baseline. AP, plan execution, and opinion of the intervention were measured one month after baseline. Results: Complete-case logistic regression analysis showed that the AP intervention had a significant effect on CA (OR = 2.01; CI 1.08–3.84, p = .02), whereas intention-to-treat analysis showed a borderline significant effect (OR = 1.68; CI .96–2.92, p = .07). Sixteen percent of the experimental group achieved CA compared to 10% of the control group. The AP intervention had no effect on PPA. The experimental group also showed significantly more AP and plan execution at one month. Execution of plans was associated with smoking cessation. Conclusions: The effects of the AP intervention on CA, AP, and execution of plans were encouraging. The potential for widespread use of web-based interventions means that even small behavioral effects may have an impact on public health. We recommend that the intervention be intensified and improved.
THE AUTHORS
Catherine Bolman, Ph.D., is Associate Professor in Health Psychology at the Open University of the Netherlands (Faculty of Psychology and Educational Sciences). She participates in CAPHRI School for Primary Care in the Netherlands. Her research focusses on psychosocial determinants of health-related behaviors and the (cost) effectiveness and dissemination of behavioral health-related (eHealth) interventions. She supervises Ph.D. projects on smoking, physical activity promotion, wellbeing, and lifestyle change in the general population and in (ex) cancer patients. Together with colleagues she published over 100 peer-reviewed articles and a book on patient-related health psychology
Sander Matthijs Eggers, MSc., is a Ph.D. student at the Department of Health Promotion at Maastricht University/CAPHRI School for Primary Care in the Netherlands. He holds a Master's degree in Health and Social Psychology and is doing a Ph.D. on the application of socio-cognitive theories in sub-Saharan Africa. His main interest is in methodology and statistics
Liesbeth van Osch, Ph.D., is Assistant Professor in Health Communication and Social Oncology at the Department of Health Promotion at Maastricht University/CAPHRI School for Primary Care in the Netherlands. She conducted her Ph.D. research on postmotivational determinants of health behavior and obtained her Ph.D. in 2009. Her research interests further pertain to self-regulation of lifestyle behaviors, health communication, and decision making in behavioral and clinical settings
Fam Te Poel, M.Sc., is a Researcher and Lecturer at the Department of Communication Science at VU University Amsterdam. Her current research focusses on online health information search and health anxiety. She studied Psychology with a specialization in cognitive ergonomics at Maastricht University, where she subsequently worked as a Researcher and Lecturer at the Department of Health Education and Promotion at Maastricht University. Her research there focused on the efficacy of computer-tailored web-based smoking cessation interventions aimed at the Dutch adult smoking population. Her current interests pertain to health communication, health psychology, and eHealth
Math Candel, Ph.D., is Associate Professor in Statistics at the Department of Methodology and Statistics at Maastricht University/CAPHRI School in the Netherlands. He obtained his Ph.D. in mathematical psychology at the Radboud University Nijmegen in 1991. His main research interests concern optimal designs and sample size calculation for cluster randomized and multicenter trials, and mixed model analysis of data obtained with nested and longitudinal designs. His research and consultancy activities have led to over 100 articles in peer-reviewed journals and books
Hein de Vries, Ph.D., is a Professor in Health Communication at the Department of Health Promotion at the Department of Health Promotion at Maastricht University/CAPHRI School for Primary Care in the Netherlands. He obtained his Ph.D. from Maastricht University in 1989. His research concerns the fields of cancer prevention and cardiovascular diseases (e.g., tobacco control, physical activity, lifestyles, screening) and Aids prevention. He has published over 100 peer-reviewed articles and chapters in books and is the developer of the I-Change Model. His interests further pertain to computer tailoring and eHealth programs and concepts such as social influences, self-efficacy, and action planning
GLOSSARY
Action planning: strategies that an individual makes to reach and maintain a certain behavioral change goal.
Computer-tailored feedback: intervention strategy that refers to the provision of automatized personalized feedback on issues that are related to the behavior that the receiver wants to change. Computer-based data-driven decision rules form the base to automatically adapt feedback to the personal characteristics of the receiver.
Coping planning: draft of actions that a person plans in terms of coping strategies when coming into a difficult situation that may endanger the maintenance of the newly acquired health behavior.
Plan enactment: actual implementation, application of plans.
Preparatory planning: draft of actions that a person plans to undertake to prepare the behavioral change attempt.