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  • Explaining why we put forward the fact that it’s offered by CCS (focus groups – it’s human, it’s not governmental, they want our good, they are not making profit, they are professional…) Mentioning that the promotional team was formed of two students in our targeted age range (18-24)

Transcript

  • 1. Montre à La Cigarette C’est Qui Le Boss! :P Using Highly Tailored Text Messages to Help Young Adults Quit Smoking Rachel Fournier, Catherine Lavoie, Trevor van Mierlo, Peter Selby Medicine 2.0 Congress September 18, 2011
  • 2. Before we begin…
    • Rachel Fournier, B.Sc. (Hons) is an employee of Evolution Health Systems Inc.
    • Catherine Lavoie, B.A. is an employee of Canadian Cancer Society
    • Trevor van Mierlo, MScCH, is CEO of Evolution Health Systems Inc.
    • Peter Selby, MBBS, CCFP, MHSc, FASAM, has acted as a consultant to Evolution Health Systems Inc.
  • 3. Canadian Cancer Society – Quebec Division
    • The Canadian Cancer Society (CCS)
    • National community-based organization of volunteers (over 25,000)
    • Mission: eradication of cancer and enhancement of the quality of life of people living with cancer.
  • 4. Evolution Health Systems Inc.
    • Research-based organization founded in 2000
    • Global presence in US, Canada, UK, Japan and Brazil
    • 21 peer-reviewed publications, 70+ presentations
    • Digital Health programs to help people overcome depression, manage anxiety, quit smoking, achieve a healthy weight, overcome problem drinking, etc.
  • 5. Context
    • Tobacco is the leading cause of cancer in Canada.
    • 18-24-year olds have highest smoking prevalence in Quebec
    • and Canada
      • In Quebec: 30%
    • Text Messaging and mHealth applications can reach Young Adults
  • 6. Adapting for Young Adults
  • 7. What is SMAT?
    • Funded by Health Canada
    • Phase I : August 4, 2010 – March 31, 2011 (pilot)
    • Phase II : April 1, 2011 – March 31, 2012
    S ervice de M essagerie texte pour A rrêter le T abac ( S hort M essages A gainst T obacco)
  • 8. Reaching Young Adults
    • Messaging emphasis informed by focus group testing
    • It’s free!
    • Offered by the Canadian Cancer Society
    • Words to avoid: help, commitment, coach
  • 9. Reaching Young Adults
  • 10. Registration Process
    • Smokers complete brief online registration at www.smat.ca
      • Short code preferred but far out of budget
    • Receive first text message from SMAT within an hour
    • Must text back « ok » to confirm registration
      • Users = only those who have confirmed their registration
  • 11. How Does It Work? A. Proactive messages: text schedule B. Reactive messages: reply with a keyword Distraction Envie Pause Oups Party Stress Prep. Week Quit Day Week 1 Weeks 2-4 Weeks 5-12 1 / day 2 2 / day 1 / day 2 / wk
  • 12. The Messages
    • Proactive messages
    • Allez hop! Aux poubelles les cendriers, briquets et clopes! Jette-les tous, sans pitié! Mwahaha :P
    • Reactive messages
    • Trouve qqc à compter autour de toi : les tuiles au plafond, les autos ds la rue, les gommes en dessous de ta chaise, etc.
    • Tone, language and content tested in focus groups and individual interviews
    • Young adults want:
      • Tips and information on physiological changes due to cessation
  • 13. Registrations
    • 71.69% of participants found SMAT via Facebook
    • 269 registrations online resulting in 183 users (68%)
  • 14. Why didn’t you confirm your registration? n = 38 I changed my mind – I don’t want to quit smoking anymore 21 % I never received the first text message asking me to text « ok » to confirm my registration 16 % I forgot to confirm my registration 13 % I didn’t understand i had to text « ok » to confirm my registration and receive the text messages 11 % I didn’t understand that SMAT offered support over my cell phone 5 % I was worried it would cost money 5 % I texted « ok » but nothing happened 3 % I didn’t like the text message i received from SMAT 3 % I don’t remember 8 % Other reasons (lost interest, concerned about fraud, gave a residential number, didn’t know how) 13 %
  • 15. Evaluation
    • n = 74
    Average: 27 Median: 26
  • 16. Keyword Utilization Reasons for not using keywords n=30 I didn’t need them 60% I didn’t remember the keywords 23% I thought it would cost money 5% I don’t like to write text messages 4% I didn’t know there were keywords 4% Other reasons 6%
  • 17. Keyword Utilization
    • 1,196 text messages sent by 183 users
    • Of these, 697 contained a keyword and 398 were conversational
    Keyword Number of times sent Number of users Average per user Distraction 229 56 4 Envie 124 56 2.2 Oups 122 57 2.1 Party 100 50 2 Stress 85 46 1.8 Pause 37 28 1.3
  • 18. What Did Users Think of the Service?
    • High Satisfaction Overall
    • 90% would “definitely” or “probably” recommend to a friend who was quitting smoking
    • 86% were satisfied with the service
    • Most (73%) believed it was useful in their quit attempt
    • 57% would have liked the service to continue for longer than 12 weeks
  • 19. Great, but did it work?
    • At three months:
    • 32% quit smoking
    • 73% plan on quitting
    • 58% would use the service again in their next quit attempt
  • 20. Relapse Relapse Triggers n=54 Stressful situation 62% Alcohol 50% Being around other smokers 42% Withdrawl symptoms (cravings, irritibility, anxiety, difficulty concentrating) 35% Weight gain 3% Other reasons 11%
  • 21. Relapse What would have prevented relapse? n=54 Using pharmaceutical aids while along with the service 45% Ability to text chat with a quit specialist 40% Being buddied up with another quitter 27% Receiving more text messages 21% Receiving more follow-up calls from a specialist 13% Participating in a quit contest 12% Staying home / going out less / less partying 7% Not being around smokers 5% Other reasons 7% Don’t know 7%
  • 22. Conclusions
    • Phase I
    • Evaluation results are very encouraging :-)
    • Attrition rate is acceptable :-)
    • Email follow up rates abysmal :-(
    • Cessation rate is promising :-)
  • 23. What’s Next?
    • Phase II
    • Register 1,000 users, 60% 18-24
    • One-on-one text chat with quitline specialists
    • Extended messages
    • Follow-up surveys via text message and phone only
    ttyl!
  • 24.
    • Thank You!
    • Rachel Fournier
    • Vice President, Business Development
    • Email: [email_address]
    • Toronto: +1-416-644-8476 x222