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Clinical Trials Research Unit

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

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Clinical Trials Research Unit

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  1. Clinical Trials Research Unit Mobile phone health interventions Dr Robyn Whittaker

  2. 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

  3. 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

  4. Annual deaths from smoking • • 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 www.deathsfromsmoking.net All developed countries, year 2000

  5. Predictions Source: Peto and others, 1994.

  6. Increase in dopamine Binds to nACh receptors nicotine mesolimbic dopamine pathway reduced craving & withdrawal

  7. 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

  8. 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

  9. 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

  10. Voice or web registration • smoking history, triggers etc 0 weeks Daily text message countdown + action plan Quit calendar web page Personalised text message tips Introduction to CellPall (“quit buddy”) • Quit Day • free text messaging begins 1-3 weeks 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 6 weeks Target Date Relapse Quit 26 weeks Study flowchart

  11. 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

  12. 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

  13. 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

  14. But what next? • Capitalise on advances in mobile technology to include multimedia content & keep programme ‘new’

  15. 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

  16. 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)

  17. 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

  18. Wanna quit smoking? www.stubit.co.nz 0800 STUBIT 5552

  19. Want to work with us? b.gray@ctru.auckland.ac.nz Barry Gray, IT Manager

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