1. Sense
Investigating views on a client-advisor data sharing and communication facility within a cessation smartphone app (Q Sense)
Sarah Hopewell, Research Assistant, University of Cambridge
Dr Jo Emery, Dr Felix Naughton, Dr Neal Lathia, Prof. Cecilia Mascolo, Prof Stephen Sutton,, University of Cambridge
Andy McEwen, National Centre for Smoking Cessation Training

2. Q Sense recap
Report each smoking episode (before & after quit-date), including:
Complete a daily evening survey
How many cigarettes smoked that day
Frequency and strength of urges
Hardest situation
Confidence at quitting for good
Context (work, home, socialising, other)
Who with (colleagues, others, alone)
Whether others they are with are smoking
Stress levels
Current mood
Strength of craving

3. How the data could look…

4. Why data-sharing/communication link?
BlueStar app by WellDoc, helps patients with type 2 diabetes to monitor their behaviour, and provides feedback to their healthcare provider.
Tailored interventions shown to improve outcomes in smoking cessation support (iQuit in Practice)
Data-sharing apps in other areas of healthcare have indicated positive impact on patient care
Reduced uptake in stop smoking service support – data-sharing/communication link could improve scope and engagement.
BUT…would clients and advisors be interested?
A-CHESS for people with alcohol use problems includes a feature to alert their alcohol counsellor if the user is inputting data that’s a cause for concern.

5. Smoking cessation professionals
Participants
Smoking cessation professionals
Q Sense app users
Participants recruited from two stop smoking services and one GP practice
10 interviewees in total (8 female)
7 stop smoking advisors, 2 admin staff, 1 HCA
Staff had been in their roles for between one month and 10+ years
9 participants interviewed (4 female)
4 participants had engaged with smoking cessation support alongside Q Sense
Broad range of app experience

6. Sample data format provided to advisors

7. Views from app users (part 1)
Participants who had accessed Stop Smoking Support
3 out of 4 happy for their advisor to have
access to their data
Perceived as additional support
Did not feel it would impact on the information that they reported
Some were concerned as to whether advisors would have time
One felt that advisor having access would
take away from the privacy of the app
Yeah, I think it could actually work because the more support you have, the better it’s going to be. (p1)
If they shared that input they could obviously have a chat with you and help you (p3)
My instinct is to go, “I don’t want everyone seeing my” - we’ve got enough data out there already…

8. Views from app users (part 2)
Participants who had not accessed formal support
Felt they’d be more likely to engage with
stop smoking support if via an app rather
than in person
Flexibility of an app, rather than attending face-to-face
Some saw the app as their equivalent of
an advisor, didn’t feel the need for
professional support
Those who weren’t interested in data-sharing
with an advisor were happy to share data with selected friends or other quitters.
Right then in that moment I could have done with someone to, you know, talk to actually. (p21)
You know this [Q SENSE] was my stop smoking adviser, so you know, at the end of the day you’re putting all of the same information on there what someone would be telling you over a desk, in a sense. So you know that was my advisor. (p42)

9. Views from advisors (part 1)
I think this would help because we could go into it and say, “Right, you had a bad day, how can we sort that out for you?” and talk about that problem rather than talk about the whole area (advisor 8)
Seen as way to provide additional support to clients
Way of improving time-efficiency of appointments
Opportunity for improved guidance around NRT
Could increase engagement/re-engagement
Potentially of particular benefit with certain groups, e.g. pregnant smokers, people with communication difficulties etc.
It would almost even be interesting to try and gauge how the urges are throughout the day as well, because that may have an impact on what sort of nicotine replacement therapy we might be able to identify that they need (advisor 3)

10. Views from advisors (part 2)
Yeah, I’d say like how the advisor would interpret the information would be the issue. They might get it wrong. (Advisor 1)
Concerns over uniform implementation,
although others felt that training would resolve any issues
Questions about whether clients would be honest
Linking with Quit Manager – current QM use & perceived value of communication link
App seen as most helpful during sessions, rather than between sessions
Beneficial for post-12 week period
That’d come with you learning the system, wouldn’t it, you know, training and learning the system (advisor 5)
because we do like three months, six months and twelve months’ reengagement calls. So if we saw that… yeah, she relapsed and she’s still looking for help, yeah, we could give her a call and you know, just signpost her again. (admin 1)

11. Add-on suggestions from clients and advisors
Documenting times when urges were resisted
Opportunity to provide more detailed smoking reports
Chances to report mood at other times of the day
Concept of data-sharing seen as broadly beneficial by both clients and advisors.
An area worth further investigating…?