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Clinical Trials Research Unit

Mobile phone health interventions

Dr Robyn Whittaker

Clinical Trials Research Unit

• Large scale and multinational clinical trials

• Population health interventions focused on major risks & burden of disease– Tobacco, Health Tech, CVD, Nutrition &

Physical Activity

• Researchers, biostatisticians, data management, IT, project mgmt

Why is tobacco control a priority ?

• 1.1 billion smokers worldwide, 800 million in developing countries

• By 2030: 10 million deaths/year, and tobacco is likely to be the biggest cause of death worldwide

• Tobacco is very addictive, its hard to quit

Source: Curbing the Epidemic, 1999

Annual deaths from smoking

www.deathsfromsmoking.net All developed countries, year 2000

• Smoking kills about 1.9 million people a year in all developed countries

• About 1 million die in middle age from smoking

• About 22 years of life are lost, on average, by those killed in middle age by smoking

• NZ estimated 5,000 deaths/year

0

340

520

70

500

220

190

0

100

200

300

400

500

1950 2000 2025 2050

Year

Toba

cco

deat

hs (m

illio

n)

Baseline

If proportion ofyoung adultstaking up smokinghalves by 2020

If adultconsumptionhalves by 2020

Source: Peto and others, 1994.

Predictions

mesolimbic dopamine pathway

reduced craving &

withdrawal

Binds to nACh receptors

Increase indopamine

nicotine

Why mobile phones?

• >4m mobile phone accounts in NZ

• 89.4% of NZ 14-15 year olds

• Integrated into daily life

• Greater penetration than household computers/internet (NZHES) & greater increase in uptake in lower SES

Mobile phone health programmes

• Inexpensive, personalized, age-appropriate and not location-dependent

• Always on and with people – send messages at any time & on demand– time sensitive messages- deal with cravings - reminders, positive reinforcement,

motivation- social support

STOMP: stop smoking study

• Regular personalised text messages providing smoking cessation advice, support & distraction

• Based on known effective brief intervention for cessation & theory of behaviour change

• Turned into 160 characters & txt lingo

Study flowchartVoice or web registration

•smoking history, triggers etc0 weeks

Quit Day•free text messaging begins1-3 weeks

Daily text message countdown + action planQuit calendar web pagePersonalised text message tipsIntroduction to CellPall (“quit buddy”)

Text your friends“TXT crave”4 personalised text message tips per day Quiz or poll eg “top 5 reasons to quit”Web page Quit Meter (eg $ saved), profiles

Target Date

Quit Relapse

6 weeks

26 weeks

STOMP Study

• RCT of 1705 participants across NZ

• 28% self-reported point prevalence quit rate after 6 weeks – double the control group 13%(RR2.20, 95% CI 1.79-2.70)

• Clear benefits among important groups e.g. Māori, low income, teenagers

Publications

• Rodgers A, Corbett T, Bramley D, Riddell T, Wills M, Lin R, Jones M. Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tobacco Control 2005

• Bramley D, Riddell T, Whittaker R et al. Smoking cessation using mobile phone text messaging is as effective in Māori as non-Māori. NZMJ 2005

Study supported by: Vodafone New Zealand Ltd; Alcatel; Cancer Society; National Heart Foundation of NZ

STOMP programme now…

• Licensed by Healthphone Solutions Ltd who are implementing internationally

• Implemented nationwide in NZ via Quitline, funded by Ministry of Health, free to participants

• Also being tested in large UK study

• Capitalise on advances in mobile technology to include multimedia content & keep programme ‘new’

But what next?

STUB IT

• Video messages from role models

• Real life stories & quitting tips

• On demand help for cravings

• Anti-tobacco industry

• Animations

• Content submitted by participants

STUB IT System

• CTRU IT team developed programme for message delivery

• Via SMS gateway to Vodafone customers

• Participants receive txt message with embedded URL for specific video

• Video message played from WAPsite (at any time)

STUB IT study

• One year of development – Experts, focus groups, pre-testing,

finding role models & filming, IT system development & testing systems

• Currently testing in a 1300 participant randomised controlled trial

• Supported by Health Research Council; Ministry of Health, Digital Strategy, Vodafone NZ Ltd

Wanna quit smoking?

www.stubit.co.nz

0800 STUBIT

5552

Want to work with us?

b.gray@ctru.auckland.ac.nz

Barry Gray, IT Manager