The past decade has seen an explosive growth in Internet use in the U.S., especially for health information. Self-help treatments for smoking cessation are effective, are greatly preferred by smokers, and have the potential to reach more individuals than costly, clinic-based programs. A self-help intervention for smoking cessation that incorporates counseling, behavioral skills training, and social support is particularly well suited to delivery via the Internet and has the potential to reach thousands of smokers. Although there have been no randomized, controlled trials of Internet interventions for smoking cessation, a wide variety of on-line smoking cessation treatment is now available. QuitNet TM (www.quitnet.com) is a commercial Website that provides comprehensive information, assistance and support to help people quit smoking. Recognized as a premiere Web site for smoking cessation information and resources, QuitNet provides evidence-based quitting services based on the Tobacco Cessation Guidelines from the U.S. Surgeon General and the AHRQ. Supplementing self-help programs with proactive telephone counseling has been shown to increase treatment adherence and reduce relapse to smoking. QuitNet proposes to partner with Group Health Cooperative (GHC), the sixth largest non-profit HMO in the U.S. and vendor of the evidence-based """"""""Free & Clear)"""""""" proactive telephone counseling program for smoking cessation, to develop a multi-modal program for smoking cessation. The goal of this Phase I project is to create the Telephone and Internet Program to Stop Smoking (TIPSS), which will integrate GHC's """"""""Free & Clear"""""""" program with QuitNet's Internet service. Central to the delivery of this program will be the creation of telephone and Internet user interface elements and a sophisticated data management system. The project will achieve the following specific aims: A.1. Create detailed specifications of the TIPPSS system. Specifications will describe: the integration of existing counseling protocols; the range of data elements required by all users of the TIPSS system; the needs of all end-users including QuitNet Web counselors, GHC telephone counselors, and smokers; and, the user interface elements for all end-users. Specifications will be completed by the end of Month 1. A.2. Develop and conduct preliminary testing of an initial prototype of the TIPSS system. Database programming will be consistent with QuitNet's existing core systems. Preliminary testing will be completed by the end of Month 2. A.3. Conduct Usability Testing of the telephone user-interface by the end of Month 3. GHC telephone counselors will evaluate the GHC telephone counselor user interface and feedback will be solicited in a focus group. We will also complete Acceptance Testing of an initial prototype of the QuitNet Web user interface in two focus groups with current QuitNet users. A.4. Incorporate feedback from usability and acceptance testing to finalize prototype development by the end of Month 4. A.5. Conduct Formal System Evaluation with current smokers in Month 5. Two focus groups will be held: one group will provide feedback on entry into the TIPSS system via QuitNet.com; the other group will provide feedback on entry into the TIPSS system via the GHC toll-free support line. GHC counselors will be asked to provide feedback via the beta test site. All feedback from focus groups will be incorporated into final product development in Month 6.
