Mobile-health intervention for smoking cessation among Cambodian people living with HIV: A mixed-methods pilot study

ABSTRACT

This mixed methods study aimed to evaluate the feasibility and preliminary efficacy of a fully automated, interactive smartphone-delivered intervention for smoking cessation among people living with HIV in Cambodia. We used the explanatory sequential design, with a pilot two-group single-blind randomized controlled trial (N = 50) followed by in-depth interviews with all trial participants. In the trial, participants were randomized to Standard Care (SC) or Automated Messaging (AM) group. SC comprised brief advice to quit and self-help materials. AM consisted of the SC components plus a fully automated smartphone-based treatment program that involved interactive and tailored proactive messaging for 2 months. Results showed that the AM approach was highly feasible and efficacious. Feasibility was supported by high rates of treatment engagement (e.g., 81% of delivered messages and assessments were read or completed) and high retention (96%) through the 2-month follow-up. Biochemically verified point prevalence abstinence at follow-up was 40% for the AM group and 8% for the SC group (relative risk: 5.0, 95% confidence interval: 1.2, 20.5). Being able to avoid other smokers, having coping skills, and having social/familial support contributed to successful abstinence. The AM program has the potential for wide-scale implementation in Cambodia and other low-income countries.

KEYWORDS:

• Smoking cessation
• mhealth
• people living with HIV
• Cambodia

Acknowledgement

We would like to thank all staff at the National Institute of Public Health of Cambodia and at the Social Health Clinic of the National Center for HIV/AIDS, Dermatology, and STDs for their support in data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported in part by the US National Cancer Institute Cancer Center Support Grant [grant number P30CA225520] awarded to the University of Oklahoma Stephenson Cancer Center and used the mHealth Technology Shared Resource. This work was also supported in part by a grant from the Oklahoma Tobacco Settlement Endowment Trust [grant number 092-016-00021]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.