There is no more important target audience for smoking cessation efforts than pregnant women. The goal of this Fast Track project is to establish the scientific and technical feasibility of using an interactive text- and web-based application to support smoking cessation among pregnant women. This project aims to develop the first-ever text message based smoking cessation product for pregnant women (quit4babySM), conduct a randomized trial to pilot test quit4baby and develop a plan for disseminating quit4baby.This project is innovative because it offers an intensive, interactive and personalized way to reach a population at high risk - pregnant smokers - with a set of evidence and theory-based tools to support smoking cessation. It also builds upon an existing national text-based educational program for pregnant women and new mothers, text4baby, which to date has enrolled over 260,000 enrollees, and is thus in a position to be scaled rapidly and cost-effectively if the product proves to be effective.
The aim of Phase I of this project is to build a prototype of a text-based interactive tool that counsels and supports pregnant smokers on smoking cessation and conforms with appropriate guidelines (DHHS 2008), adapting text2quit, and an existing application for smoking cessation during pregnancy. The prototype will be tested in a pilot study among pregnant smokers in the Washington, DC area. Also during Phase I, a brief text-based survey instrument will be designed and tested so that pregnant smokers who are enrolled in text4baby will self-identify. In Phase II, Quit4Baby will be fully configured and evaluated as an optional scalable text4baby module, incorporating user feedback from the Phase I pilot study and the survey questions designed in Phase I to recruit 500 participants for a randomized clinical trial. Quit4baby will be evaluated to determine if pregnant smokers receiving quit4baby as well as text4baby report: more knowledge acquisition;higher use of quit lines and/or cessation counseling;and achieve more favorable quitting outcomes than users of text4baby alone. The proposal is being submitted by Voxiva, the small business that co-founded text4baby and provides the mHealth platform on which it is based. George Washington University and Healthy Mothers Health Babies (HMHB) Coalition HMHB, the national coalition leading text4baby, will conduct the evaluation. The team, led by Principal Investigators Pamela Johnson, Lorien Abroms and Richard Windsor includes experts with strong academic and research credentials and decades of experience in mobile health, smoking cessation among pregnant women, evaluation research and product development. Proprietary and Confidential

Public Health Relevance

The goal of this research is to develop, test and introduce an interactive text-based product to help pregnant women quit smoking. It builds on Voxiva's decade-long experience with the creation of mobile health applications including text4baby and text2quit. We will develop and evaluate the effectiveness of an application to reduce smoking in pregnant women that incorporates the best evidence about smoking cessation in pregnancy and can be delivered cost effectively and sustainably at national scale. Addressing the single most preventable cause of maternal and infant morbidity, this approach has the potential to rapidly and cost-effectively increase the scale and effectiveness of prevention efforts directed at reducing smoking during pregnancy and become established as a vital and successful product. .

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1)
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Grossman, Debra
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Voxiva, Inc.
United States
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Abroms, Lorien C; Johnson, Pamela R; Leavitt, Leah E et al. (2017) A Randomized Trial of Text Messaging for Smoking Cessation in Pregnant Women. Am J Prev Med 53:781-790
Leavitt, Leah; Abroms, Lorien; Johnson, Pamela et al. (2017) Recruiting pregnant smokers from Text4baby for a randomized controlled trial of Quit4baby. Transl Behav Med 7:157-165