Personalized prevention: mobile application for smokers

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Personalized prevention: mobile application for smokers Pr Jean-François ETTER, PhD Institute of Global Health Personalized Health in the Digital Age Geneva, September 22, 2016

Stop-tabac mobile app, since 2012, iOS and Android

Stop-tabac app for smartphones Currently 22’000 users per month Expensive to develop, but marginal cost per user = 0 Supported by Tobacco Prevention Fund, Canton GE Available to users at no charge Content: Timely feedback if relapse, craving episode Interactive ‘coach’ with individually-tailored messages Discussion forum, moderated by psychologist and 15 voluntary moderators Randomized trial ongoing, real vs ‘placebo’ app

Timely feedback if craving episode, withdrawal symptoms, or relapse Ecological momentary assessment Craving episode Withdrawal symptoms: mood disturbance Relapse Timely, situational feedback (fact sheets) Encouragement from “The Tribe”

Interactive ‘Coach’, individually-tailored feedback Questionnaire: personal profile - current / former smoker - Quit date (planned or past) - Level of dependence (cigarettes per day) - Use of nicotine medications Individually-tailored feedback report Individually-tailored follow-up messages over several months

Discussion forum: “The Tribe” Every month: - 5’400 messages are published - 51’000 responses to messages - 540’000 accesses to “The Tribe” Response from other users usually in the next 2-3 minutes Support, encouragement - from other users - from the psychologist Moderation: - psychologist (University diploma in tobacco dependence treatment) - team of 15 moderators (volunteers), - from 7 am to 11 pm, daily

Efficacy: randomized controlled trial Random assignment to app versus ‘placebo’ app Follow-up by e-mail after 3 and 6 months Outcome: self-report of smoking cessation and relapse University of Bern Funded by the Tobacco Prevention Fund (OFSP) Already 1’700 participants (September 2016) Follow-up rates - 40% after 3 months - 25% after 6 months

Impact = participation * efficacy Conclusions Impact = participation * efficacy Small efficacy (2% above ‘placebo’ app?) but Large, global enrollment: - 314’000 users since 2012 - retention: 21% after 1 month App should be integrated in medical care: - participants are encouraged to see Dr, addresses provided - app should be prescribed by physicians - patients should use of the app between medical visits Future developments: - develop social network - improve compliance with medications