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Clinical Trials Research Unit

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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

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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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