Approximately 12 million Americans engage in the habitual use of smokeless tobacco (ST), and although most wish to quit, many lack resources. In order to meet this need, the investigators recently completed a randomized clinical trial, funded by the National Cancer Institute, to develop and evaluate the ChewFree.com ST cessation website. We enrolled 2,523 ST users and found the site to be effective, especially for those who were most engaged in using the web site. Based on this experience, we believe that increasing chewers' engagement with the program could increase its effectiveness. One avenue to explore for enhancing program engagement is the use of social support. The vast majority of ST users (""""""""chewers"""""""") are male, and most of their wives and domestic partners are eager for them to quit. Although much is known about social support for smokers, little is known about social support for ST users. During this developmental research study, we will test the feasibility of adding a partner support component to our web site in an effort to increase chewers' enrollment in, and engagement with, the program. Objectives: The primary aims of this study are to test the: 1) feasibility of recruiting female supporters via print and broadcast media and the Internet to a program aimed at helping them encourage their male ST-using partners to engage in a quitting program. This feasibility study will provide estimates of proportions of supporters who will enroll, for use in a future randomized trial and; 2) effectiveness of a partner support component on male chewers' use of the ChewFree.com self-help ST cessation program. The primary outcome measure will be ST users' engagement with the program, as measured by his logging on to the program. Methods: We plan to use our innovative and proven methods to recruit 944 women, and randomize them to one of two conditions: 1) The Control Condition will emulate the naturalistic referral of a male ST user to web resources by his wife or domestic partner. 2) In the Support Condition, we will also give the wife/partner advice on how to support the chewer in quitting, and provide her with her own social support network in the form of online peer and expert forums. During this R21, we will assess the feasibility of recruiting and intervening with female partners of male chewers and with assessing changes in their beliefs, attitudes, and behavior. Measures: Our primary outcome will be chewers' access of the ChewFree web site within the program, as measured via unobtrusive web logs. Chewers' cessation-related behavior and changes in support, self- efficacy, and relationship dynamics will be assessed by mailed surveys at 6 weeks and 4.5 months post- enrollment to obtain effect sizes for future research. To obtain effect size estimates, we will also assess the effect of the intervention on setting a quit date, cessation attempts, and rates of tobacco cessation. Benefits: The proposed research will: add to the social support literature by focusing explicitly on ST cessation and the specific dynamics of the male-user/female-supporter dyad; assist partners of ST users with skills training and social support, and; enhance the reach and effectiveness of our effective ST cessation program. Enlisting and enhancing the natural support of a spouse or domestic partner may increase the engagement and success of smokeless tobacco users in cessation programs.
This developmental study will test the feasibility of the additive effects of intervening with the female partners of male smokeless tobacco users, in the context of an effective web-based smokeless tobacco intervention. ? ? ?
| Akers, Laura; Gordon, Judith S (2018) Using Facebook for Large-Scale Online Randomized Clinical Trial Recruitment: Effective Advertising Strategies. J Med Internet Res 20:e290 |
