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Mixed methods investigation of user engagement with a smoking cessation app

By Christian Jules Cerrada


2019-03-12Mobile smoking cessation apps have the potential to reduce smoking rates on a large scale but app abandonment after minimal use remains a significant challenge. Furthermore, little is known about the diverse ways smokers use quit apps and how usage mediates positive cessation outcomes. Thus, the overarching aim of this dissertation was to better understand user engagement (UE) with a recently developed cessation app, MQU, over the course of a quit attempt. Following a mixed methods approach, user logs of interaction with each of MQU’s features were combined with semi-structured interviews to examine longitudinal trends in usage, factors that influenced usage over time, and relevant mechanisms for lapse avoidance. Multilevel latent class analysis was used to explore underlying day-level UE patterns and to examine their association with covariates and a lapse outcome. ❧ Our findings illustrated differences in usage trends between “PUSH” and “PULL” app features over time and highlighted the second week of the quit attempt as an important time point for changes in usage and perceptions of MQU novelty and usefulness. Multilevel latent class analysis uncovered three day-level UE patterns within users: Active, Passive, and Low UE patterns. Relative to Low UE days, Active UE days were less probable among loan phone users and as days passed in the quit attempt. Contrary to our hypothesis, Active UE days were associated with greater probability of same-day lapse relative to Low and Passive UE days. Finally, we elucidated mechanisms for lapse avoidance attributable to MQU usage, such as behavioral regulation and increased motivation to quit, along with mechanisms not related to MQU, such as momentary lack of access to cigarettes and availability to smoke. ❧ Based on our findings, we provide recommendations for strategies to promote re- engagement with quit apps over time, such as dynamically adapting the content and frequency of II reminders to increase their perceived novelty and usefulness. Furthermore, we describe a strategy to enhance MQU effectiveness by promoting the occurrence of a day-level UE pattern found to be associated with reduced probability of lapse (Passive UE days). These strategies may be applicable to other quit apps that combine PUSH and PULL features and after further testing, could inform the development of future quit apps that users are motivated to use throughout a quit attempt and provide effective cessation support

Topics: Preventive Medicine (Health Behavior Research), user engagement; smoking cessation; mixed methods; mobile app
Publisher: University of Southern California. Libraries
Year: 2019
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Provided by: USC Digital Library
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