Text messaging promoting physician-led brief intervention tobacco cessation: A before-and-after study among physicians in three tertiary hospitals in Nigeria

Abstract

Background: Physician-led smoking cessation services are suboptimal in Nigeria. Objectives: This study evaluated a text messaging intervention designed to increase the knowledge and practices of physicians in Nigeria to help smokers quit. Methods: Using a pre-post study design, all physicians (N = 946) in 3 tertiary care hospitals located in 3 geopolitical zones in Nigeria were sent 2–3 text messages weekly over a 13-week period to create awareness and improve cessation practices using the “Ask, Advise and Refer” (AAR) model. The primary outcomes were the awareness of AAR and the proportion of physicians who offered each of the components of the brief intervention (AAR) to at least half of eligible patients. Secondary outcomes included the attitudes and self-reported effects of the messages on motivation to offer AAR to patients who smoke. Results: Of the 946 eligible respondents, only 165 responded to both the before and after intervention surveys (17.4% participation rate). Participants were more likely to indicate awareness of the AAR approach after the intervention (60%) than before (21.2%). Overall, physicians’ practice of each component of the AAR changed significantly after the intervention (P < .001; McNemar test). Of the participants, 71.5% reported reading the messages most/all of the time and 84.8% reported that the frequency of the messages was just adequate. Conclusions: A brief and low-cost text messaging intervention to physicians increased the awareness and practice of AAR in those who participated in the study. However, the relatively low participation rate highlights the importance of new research to improve and expand text messaging as an intervention among physicians to help them foster tobacco treatment among their patients.

Keywords:

• AAR
• physicians
• text messages
• tobacco cessation

Additional information

Funding

Research reported in this publication was funded by the Pfizer Independent Grants for Learning and Change (grant ID: 13503941). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.” The study was also supported by the Global Bridges Network and the Fogarty International Center of the National Institutes of Health under award number K43TW010704. O.O. received support (protected time) for drafting the manuscript from the National Institutes of Health under award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes on contributors

Oluwakemi Odukoya

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Babalola Faseru

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Nkolika Uguru

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Mustapha Jamda

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Olanrewaju Onigbogi

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Oluwafunmilola James

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Scott Leischow

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.

Olalekan Ayo-Yusuf

All the authors conceived the research idea. O.O., B.F., N.U., and O.A. refined the research idea and drafted the manuscript. All authors reviewed the final version of the manuscript.