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      Effectiveness of a Mobile Phone App for Adults That Uses Physical Activity as a Tool to Manage Cigarette Craving After Smoking Cessation: A Study Protocol for a Randomized Controlled Trial

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          Abstract

          Background

          Results from studies on the effects of exercise on smoking-related variables have provided strong evidence that physical activity acutely reduces cigarette cravings. Mobile technology may provide some valuable tools to move from explanatory randomized controlled trials to pragmatic randomized controlled trials by testing the acute effectiveness of exercise on quitters under real-life conditions. An mHealth app was developed to be used as a support tool for quitters to manage their cigarette cravings.

          Objective

          The primary aim of this paper is to present the protocol of a study examining the effectiveness of the Physical over smoking app (Ph.o.S) by comparing the point prevalence abstinence rate of a group of users to a comparator group during a 6-month follow-up period.

          Methods

          After initial Web-based screening, eligible participants are recruited to attend a smoking cessation program for 3 weeks to set a quit smoking date. Fifty participants who succeed in quitting will be randomly allocated to the comparator and experimental groups. Both groups will separately have 1 more counseling session on how to manage cravings. In this fourth session, the only difference in treatment between the groups is that the experimental group will have an extra 10-15 minutes of guidance on how to use the fully automated Ph.o.S app to manage cravings during the follow-up period. Data will be collected at baseline, as well as before and after the quit day, and follow-up Web-based measures will be collected for a period of 6 months. The primary efficacy outcome is the 7-day point prevalence abstinence rate, and secondary efficacy outcomes are number of relapses and cravings, self-efficacy of being aware of craving experience, self-efficacy in managing cravings, and power of control in managing cravings.

          Results

          Recruitment for this project commenced in December 2014, and proceeded until May 2015. Follow-up data collection has commenced and will be completed by the end of December 2015.

          Conclusions

          If the Ph.o.S app is shown to be effective, the study will provide evidence for the use of the app as a support tool for people who are trying to manage cravings during smoking cessation programs. It is anticipated that the results of the study will provide knowledge of how physical activity affects cigarette craving in real-life situations and inform the development and delivery of relapse prevention in smoking cessation treatment.

          Trial Registration

          International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN55259451; http://www.controlled-trials.com/ISRCTN55259451 (Archived by WebCite at http://www.webcitation.org/6cKF2mzEI)

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          Most cited references43

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          Understanding tailoring in communicating about health.

          'Tailoring' refers to any of a number of methods for creating communications individualized for their receivers, with the expectation that this individualization will lead to larger intended effects of these communications. Results so far have been generally positive but not consistently so, and this paper seeks to explicate tailoring to help focus future research. Tailoring involves either or both of two classes of goals (enhancing cognitive preconditions for message processing and enhancing message impact through modifying behavioral determinants of goal outcomes) and employs strategies of personalization, feedback and content matching. These goals and strategies intersect in a 2 x 3 matrix in which some strategies and their component tactics match better to some goals than to others. The paper illustrates how this framework can be systematically applied in generating research questions and identifying appropriate study designs for tailoring research.
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            Shape of the relapse curve and long-term abstinence among untreated smokers.

            To describe the relapse curve and rate of long-term prolonged abstinence among smokers who try to quit without treatment. Systematic literature review. Cochrane Reviews, Dissertation Abstracts, Excerpt Medica, Medline, Psych Abstracts and US Center for Disease Control databases plus bibliographies of articles and requests of scientists. Prospective studies of self-quitters or studies that included a no-treatment control group. Two reviewers independently extracted data in a non-blind manner. The number of studies was too small and the data too heterogeneous for meta-analysis or other statistical techniques. There is a paucity of studies reporting relapse curves of self-quitters. The existing eight relapse curves from two studies of self-quitters and five no-treatment control groups indicate most relapse occurs in the first 8 days. These relapse curves were heterogeneous even when the final outcome was made similar. In terms of prolonged abstinence rates, a prior summary of 10 self-quitting studies, two other studies of self-quitters and three no-treatment control groups indicate 3-5% of self-quitters achieve prolonged abstinence for 6-12 month after a given quit attempt. More reports of relapse curves of self-quitters are needed. Smoking cessation interventions should focus on the first week of abstinence. Interventions that produce abstinence rates of 5-10% may be effective. Cessation studies should report relapse curves.
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              Control theory: a useful conceptual framework for personality-social, clinical, and health psychology.

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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications Inc. (Toronto, Canada )
                1929-0748
                Oct-Dec 2015
                22 October 2015
                : 4
                : 4
                : e125
                Affiliations
                [1] 1Department of Sport Sciences University of Jyväskylä JyväskyläFinland
                [2] 2Department of Health Sciences University of Jyväskylä JyväskyläFinland
                [3] 3Central Finland Central Hospital JyväskyläFinland
                [4] 4Unit of Family Practice Central Hospital of Central Finland University of Eastern Finland KuopioFinland
                [5] 5Agora Center University of Jyväskylä JyväskyläFinland
                [6] 6Statistical Analysis Services Analyysitoimisto Statisti Oy JyväskyläFinland
                Author notes
                Corresponding Author: Mary Hassandra maria.m.chasandra@ 123456jyu.fi
                Author information
                http://orcid.org/0000-0001-8046-3547
                http://orcid.org/0000-0001-5191-2251
                http://orcid.org/0000-0001-7539-4401
                http://orcid.org/0000-0002-4366-1824
                http://orcid.org/0000-0001-6087-4840
                http://orcid.org/0000-0002-2253-5124
                http://orcid.org/0000-0001-5590-9009
                Article
                v4i4e125
                10.2196/resprot.4600
                4704920
                26494256
                a1430622-d72c-4378-b00d-64dadc841bda
                ©Mary Hassandra, Taru Lintunen, Tarja Kettunen, Mauno Vanhala, Hanna-Mari Toivonen, Kimmo Kinnunen, Risto Heikkinen. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 22.10.2015.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 1 May 2015
                : 16 July 2015
                : 28 August 2015
                : 20 September 2015
                Categories
                Original Paper
                Original Paper

                behavior change,mhealth app,physical activity,randomized controlled trial,relapse prevention,smoking

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