RESUMO
Background: Although the prevalence of smoking is significantly higher among sexual and gender minorities (SGM) than the general population, no text-based smoking cessation intervention has been specifically tailored to this group. The objective of this phase of our study was to develop SmokefreeSGM, an SGM-tailored text-based smoking cessation program, and pilot test its design to inform the refinement of the program. Methods: SmokefreeSGM was adapted from SmokefreeTXT, the National Cancer Institute's text-based smoking cessation program, to respond to the needs of SGM smokers. In addition to tailored text messages, SmokefreeSGM includes a new keyword, STRESS, to address the unique psychosocial stressors of SGM smokers. Text messages were distributed to users over a 6-week period, and participants were provided with nicotine patches to aid their efforts to quit smoking. Demographic and tobacco use information was collected at baseline. Quantitative (related to engagement and usability) and qualitative (related to usability and acceptability) data was also collected at the 1-month assessment. Results: A total of 18 SGM smokers were recruited for the pilot test. 38.9% of participants were male, 38.9% were female, and 22.2% were nonbinary. 27.8% of participants identified as gay, 11.1% as lesbians, 27.8% as bisexual females, 16.7% as bisexual males, and the remaining 16.7% as other. At baseline, two-thirds (66.7%) were moderate to highly dependent on nicotine and 44.4% had made more than five attempts to quit smoking. The average engagement rate for bidirectional text messages was 63.8%. However, the response rate to the tailored text messages (54%) was higher than the non-tailored text messages (41.9%). Nine participants completed the 1-month assessment and interview (50% retention rate). The System Usability Scale (SUS) score was 81.67 (±15.46). Furthermore, four major themes emerged from our qualitative analysis of the interviews (i.e., appreciation for the intervention, program, content, and drawbacks). Conclusions: Findings from the pilot test of SmokefreeSGM are not only encouraging in terms of engagement, usability and acceptability, but have also informed the refinement of the program prior to launching a feasibility trial.
RESUMO
BACKGROUND: Smoking among sexual and gender minority (SGM) groups, which include lesbian, gay, bisexual, transgender, and queer individuals, has been reported to be highly prevalent. This is attributed to several factors, including minority-specific stress and targeted tobacco marketing. Therefore, this population is at an increased risk for tobacco-related diseases. SMS text messaging programs have been found to be effective for smoking cessation and appeal to traditionally hard-to-reach populations over other interventions. It has also been suggested that targeted and tailored interventions could be more effective among SGM smokers because they can be designed to assure a safe, validating health care environment that enhances receptivity to cessation. OBJECTIVE: The aim of this study is to develop SmokefreeSGM, a text-based smoking cessation program tailored to and tested among SGM smokers. METHODS: The study consists of three phases, culminating in a feasibility trial. In Phase 1, our research team will collaborate with a Community Advisory Board to develop and pretest the design of SmokefreeSGM. In Phase 2, the tailored text messaging program will be beta tested among 16 SGM smokers. Our research team will use a mixed-methods approach to collect and analyze data from participants who will inform the refinement of SmokefreeSGM. In Phase 3, a feasibility trial will be conducted among 80 SGM smokers either enrolled in SmokefreeSGM or SmokefreeTXT, the original text-based program developed by the National Cancer Institute for the general population. Our research team will examine recruitment, retention, and smoking abstinence rates at 1-, 3-, and 6-month follow-up. Additionally, a qualitative interview will be conducted among 32 participants to evaluate the feasibility and acceptability of the programs (SmokefreeSGM and SmokefreeTXT). RESULTS: This study received approval from The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects to begin research on August 21, 2020. Recruitment for the beta testing of SmokefreeSGM (Phase 2) began in January 2022. We estimate that the feasibility trial (Phase 3) will begin in September 2022 and that results will be available in December 2023. CONCLUSIONS: Findings from this research effort will help reduce tobacco-related health disparities among SGM smokers by determining the feasibility and acceptability of SmokefreeSGM, an SGM-tailored smoking cessation intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05029362; https://clinicaltrials.gov/ct2/show/NCT05029362. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42553.
