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      Adaptation and uptake evaluation of an SMS text message smoking cessation programme (MiQuit) for use in antenatal care

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          Abstract

          Objectives

          To adapt a tailored short message service (SMS) text message smoking cessation intervention (MiQuit) for use without active health professional endorsement in routine antenatal care settings, to estimate ‘real-world’ uptake and test the feasibility of its use.

          Design

          Single-site service evaluation.

          Setting

          A Nottinghamshire (UK) antenatal clinic.

          Participants

          Pregnant women accessing the antenatal clinic (N=1750) over 6 months.

          Intervention

          A single-sheet A5 leaflet provided in the women's maternity notes folder describing the MiQuit text service. Similar materials were left on clinic desks and noticeboards.

          Outcome measures

          MiQuit activation requests and system interactions were logged for two time frames: 6 months (strict) and 8 months (extended). Local hospital data were used to estimate the denominator of pregnant smokers exposed to the materials.

          Results

          During the strict and extended time frames, 13 and 25 activation requests were received, representing 3% (95% CI 2% to 5%) and 4% (95% CI 3% to 6%) of estimated smokers, respectively. Only 11 (44%) of the 25 requesting activation sent a correctly formatted initiation text. Of those activating MiQuit, and invited to complete tailoring questions (used to tailor support), 6 (67%) completed all 12 questions by text or website and 5 (56%) texted a quit date to the system. Of the 11 activating MiQuit, 5 (45%, 95% CI 21% to 72%) stopped the programme prematurely.

          Conclusions

          A low-intensity, cheap cessation intervention promoted at very low cost, resulted in a small but potentially impactful uptake rate by pregnant smokers.

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          Most cited references10

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          Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day.

          Two simple self-report measures have been used to assess the heaviness of smoking, 'number of cigarettes per day' (CPD) and 'time to the first cigarette of the day' (TTF). Little attention, however, has been given to the precise method of scoring this information. Using biochemical indicators of heaviness of smoking (alveolar carbon monoxide and cotinine), we explore the optimum data transformations for regression analysis and categorical analysis. We suggest a four category scoring scheme for both time to the first cigarette of the day (less than or equal to 5, 6-30, 31-60 and 61+ min) and average daily consumption of cigarettes (1-10, 11-20, 21-30, 31+ cigarettes) as the most powerful and practical categorical scoring of these variables. Due to possible ceiling effects on biochemical measures, we suggest using logarithmic transformations of CPD or TTF for regression or correlation analyses.
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            Parental smoking and lung function in children: an international study.

            Both prenatal and postnatal passive smoking have been linked with respiratory symptoms and asthma in childhood. Their differential contributions to lung function growth in the general children's population are less clear. To study the relative impact of pre- and postnatal exposure on respiratory functions of primary school children in a wide range of geographic settings, we analyzed flow and volume data of more than 20,000 children (aged 6-12 yr) from nine countries in Europe and North America. Exposure information had been obtained by comparable questionnaires, and spirometry followed a protocol of the American Thoracic Society/European Respiratory Society. Linear and logistic regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results and mean effects were estimated using meta-analytic tools. Smoking during pregnancy was associated with decreases in lung function parameters between -1% (FEV1) and -6% maximal expiratory flow at 25% of vital capacity left (MEF25). A 4% lower maximal midexpiratory flow (MMEF) corresponded to a 40% increase in the risk of poor lung function (MMEF < 75% of expected). Associations with current passive smoking were weaker though still measurable, with effects ranging from -0.5% (FEV1) to -2% maximal expiratory flow (MEF50). Considering the high number of children exposed to maternal smoking in utero and the even higher number exposed to passive smoking after birth, this risk factor for reduced lung function growth remains a serious pediatric and public health issue.
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              Attitudes towards SMS text message smoking cessation support: a qualitative study of pregnant smokers.

              SMS text messaging shows promise for delivering smoking cessation support. However, little is known about smokers' feelings towards receiving behavioural advice and support on their mobile phones. This article explores the attitudes of women with experience of prenatal smoking towards receiving pregnancy-related smoking cessation support by text message. Data collected by semi-structured interviews and focus group from women who received either tailored smoking cessation texts or no text support (N = 33) were analysed using thematic analysis. Three themes emerged: convenience, high expectations and perceived source. Texting was regarded as a highly convenient mode of support delivery leading to high levels of attention to messages, although high convenience sometimes resulted in the value of a text being short-lived. Many who did not receive texts had high expectations for text support to intervene with routine smoking behaviour in real time. Those who received texts (with no real-time intervention element), however, felt they were helpful and supportive. Participants discussed how factors relating to perceived source, including personalization, personal relevance and salience of text automatization, could affect message attention and impact. Our findings provide insight into how maximizing personalization and personal relevance can increase the value of text message support and reduce the risk of disengagement.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2015
                22 October 2015
                : 5
                : 10
                : e008871
                Affiliations
                [1 ]Behavioural Science Group, Institute of Public Health, University of Cambridge , Cambridge, UK
                [2 ]Division of Primary Care, U.K. Centre for Tobacco and Alcohol Studies and National Institute for Health Research School for Primary Care Research, University of Nottingham , Nottingham, UK
                Author notes
                [Correspondence to ] Dr Felix Naughton; fmen2@ 123456medschl.cam.ac.uk
                Article
                bmjopen-2015-008871
                10.1136/bmjopen-2015-008871
                4620162
                26493459
                e6289a99-c0b0-4732-a228-662b34c57724
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 22 May 2015
                : 28 July 2015
                : 25 August 2015
                Categories
                Smoking and Tobacco
                Research
                1506
                1734
                1724

                Medicine
                smoking cessation,pregnancy,text message,service evaluation
                Medicine
                smoking cessation, pregnancy, text message, service evaluation

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