SBIR-STTR Award

Latinos Kick Buts: Mobile Engagement and Cessation Support for Latino Smokers Latinos are less likely than non-Hispanic whites to have access to health, to have knowledge of existing smoking cessation resources, to receive advice to stop smoking, and to participate in smoking cessation programs. Mobile technologies can dramatically enhance the reach of effective smoking cessation interventions. However, the reach of mobile interventions among Latinos remains minimal despite the fact that Latinos utilize smartphone at a higher rate. An effective, feasible model for reaching and treating Latino smokers through mobile technologies has the potential for immediate widespread adoption. The objective of this proposal is to adapt the Kick Buts messaging and web content to be culturally relevant and linguistically appropriate to improve access to and utilization of smoking cessation resources among Latinos. This new version will also be expanded to engage and promote a dialogue among Latino smokers, regardless of their readiness to quit, aimed at creating a culture of quitting and thus affecting a measurable increase in quit attempts as well as the utilization of cessation resources. Automated and interactive text messaging will be used in combination with web-based content accessible via text-embedded links to cost effectively build and reinforce key behavioral skills and to: 1) implement a personal, culturally-relevant quit plan, 2) facilitate access to ordering nicotine replacement therapy as needed directly via mobile phone; 3) automatically link smokers to online social support, and 4) coordinate the critical follow-up that smokers need after a cessation attempt. All participants will complete follow-up assessment at the end of treatment (Week 12). Aim #1: Build the foundation to support future large-scale evaluations of Latinos Kick Buts. Aim # 2: Identify the perceived efficacy and relevance of various different types of text messages for Latinos. This project will lead to the development of an evidence-based, cost efficient and commercially viable text-messaging program designed for and broadly accessible to Latino smokers. This Phase I project will directly lead to a Phase II randomized trial that will determine the overall impact of this culturaly tailored mobile intervention. Based on the success of our existing Kick Buts program across multiple market segments, we believe Latinos Kick Buts could generate substantial interest among private and public sponsors and providers of health and wellness programs.

Public Health Relevance Statement:


Public Health Relevance:
Latinos are the largest and fastest growing population in the U.S., and tobacco use is the leading preventable cause of disease and death among U.S. Latinos. Although enhancing tobacco use treatment for this at-risk, underserved group is a critical public health priority, little is known about effectively treating Latino smokers. This innovative study will directly evaluate a culturally-enhanced technology- driven, smoking cessation intervention for Latino smokers, with the long-term goal of reducing tobacco- related health disparities, disease and death among Latinos.

Project Terms:
Abstinence; Address; Adopted; Adoption; Affect; base; Behavior; Behavioral; Businesses; Car Phone; Cellular Phone; Cessation of life; Clinical; Communication; Communities; cost; cost effective; cost efficient; Country; design; Development; Disease; Employee; English Language; Evaluation; evidence base; Face; follow-up; Foundations; Future; Goals; Health; health disparity; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Improve Access; improved; innovation; Insurance Carriers; interest; Internet; Intervention; Kansas; Knowledge; Language; Latino; Lead; Link; Maintenance; Marketing; Measurable; Medical center; mHealth; Modeling; nicotine replacement; Not Hispanic or Latino; Online Systems; Outcome; Outcome Assessment (Health Care); Participant; Patients; Pharmacotherapy; Phase; Play; Population; prevent; primary outcome; programs; prototype; Provider; public health priorities; public health relevance; randomized trial; Readiness; Relapse; Resources; Risk; Role; Schedule; Services; skills; Small Business Technology Transfer Research; Smoker; Smoking; smoking cessation; Smoking Cessation Intervention; Social support; Solutions; Staging; Structure; success; Technology; Testing; Text; Tobacco; Tobacco use; Translating; United States; Universities; Wellness Program; Withholding Treatment; Work

Despite a growing need for smoking cessation services, Latino smokers face notable disparities in cessationtreatment. Consequently, there is a big opportunity, both from a scientific and a business perspective, to developand test the most optimal culturally tailored approaches to enroll and engage Latino Smokers into cessationprograms. The Kick Buts program owned by Agile Health has shown to be a highly effective mobile text message-based smoking cessation program in clinical trials and is now available to more than 1.8 million employees andpatients. However, Latino smokers' engagement rates in the program are very low. In the STTR Phase I, wedeveloped and tested a culturally-relevant version of the Kick Buts program in English and Spanish to betterengage, increase quit attempts and improve cessation outcomes among Latino smokers, Latinos Kick Buts(LKB). The next step to assure the commercialization of the LKB will be to improve the reach, enrollment andretention in the LKB. In this Phase II our goal is to compare the impact of 4 theory-based text message types(reward, scarcity, fear/self-efficacy and social norms) on enrollment of Latino smokers into LKB. We will deploythese messages among Latino smokers served by Hackensack Meridian Health, one of the largest healthcaresystems in the U.S., to increase the enrollment and retention of Latino smokers in the Latinos Kick Buts program.Latino smokers (N = 2,600) will be randomized to receive up to five messages/week (once a day at differenttimes of the day and different days of the week) from one of the four message types. Smokers responding tothese messages will be automatically enrolled in the LKB program and begin to receive "quit decision support"messages designed to guide smokers to develop a personalized quit plan. Two weeks later, smokers who donot respond to the first type of messages will be re-randomized to receive one of the top two performing messagetypes arising from the first cycle of messaging. Non-responders to the second cycle will be re-randomized againto receive another cycle of the top two performing messages. After all three cycles are complete, we expect thatat least 629 Latino smokers will enroll in LKB. We will carefully track engagement, retention, and satisfactionwith LKB. Aim 1. To compare the impact of 4 theory-based text message types on enrollment of Latino smokersinto LKB. Aim 2: To identify days of the week and times of the day most likely to lead to enrollment as well asunderstand enrollment into different messages by age, gender, socioeconomic status, and country of birth. Aim3: To assess engagement and satisfaction with LKB in a clinic population and generate estimates of cessationamong diverse group of Latinos.

Public Health Relevance Statement:
PROJECT NARRATIVE Latino smokers (N = 2,600) will be randomized to receive up to five messages/week from one of the four message types (reward, scarcity, fear/self-efficacy and social norms). Smokers responding to these messages will be automatically enrolled in the Latinos Kick Buts program and begin to receive "quit decision support" messages designed to guide smokers to develop a personalized quit plan. Smokers who do not respond to the first type of messages will be re-randomized to receive one of the top two performing message types arising from the first cycle of messaging. Non-responders to the second cycle will be re-randomized again to receive another cycle of the top two performing messages. After all three cycles are complete, we expect that at least 629 Latino smokers will enroll in LKB.

Project Terms: