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      Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among American Indians and Alaska Natives: Results From the iCanQuit Trial

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          Abstract

          Introduction

          There is tremendous need for efficacious and accessible interventions for smoking cessation among American Indians and Alaska Natives. We tested the efficacy of an Acceptance and Commitment Therapy (ACT)-based smartphone application (iCanQuit) versus US Clinical Practice Guidelines-based smartphone application (QuitGuide) for smoking cessation among American Indians and Alaska Natives.

          Aims and Methods

          We compared cessation, changes in ACT-based processes, engagement and satisfaction between American Indian and Alaska Native iCanQuit (n = 89) and QuitGuide (n = 80) participants enrolled in the iCanQuit trial. The primary outcome was self-reported, complete-case, 30-day point-prevalence abstinence. Follow-up timepoints were 12, 6, and 3 months.

          Results

          Randomized American Indians and Alaska Natives from 31 US states (70% urban, 30% rural, with 25% of participants residing on tribal land). The outcome data retention rates were 93%, 92%, and 90% at the 12-, 6-, and 3-month follow-ups, respectively, with no differential retention between arms. The 30-day point-prevalence abstinence for iCanQuit versus QuitGuide was 30% versus 18% at 12 months (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 0.90 to 4.26) 25% versus 11% at 6 months (OR = 2.62; 95% CI: 1.06 to 6.45), and 15% versus 6% at 3 months (OR = 2.93; 95% CI: 0.90 to 9.59). Increases in acceptance of internal cues to smoke mediated the effect of treatment on smoking cessation at 12 months. iCanQuit arm participants were also significantly more engaged and satisfied with their assigned application.

          Conclusions

          In a nationwide sample with high data retention and participant engagement, this is the first study to show that a digital intervention may be efficacious for helping American Indians and Alaska Natives quit smoking.

          Implications

          This is the first study to provide evidence of an efficacious, accessible, and engaging treatment for helping American Indians and Alaska Natives quit smoking. Compared to a US Clinical Practice Guidelines-based smartphone application (QuitGuide), an ACT-based smartphone application (iCanQuit) was more efficacious, engaging, and satisfactory among American Indians and Alaska Natives nationwide. Our results will inform the tailoring of the iCanQuit smartphone application for American Indian and Alaska Native tribal communities and organizations with potential for broad dissemination and high impact.

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                Author and article information

                Contributors
                (View ORCID Profile)
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                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Nicotine & Tobacco Research
                Oxford University Press (OUP)
                1469-994X
                April 01 2022
                March 01 2022
                October 13 2021
                April 01 2022
                March 01 2022
                October 13 2021
                : 24
                : 4
                : 544-554
                Affiliations
                [1 ]Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
                [2 ]Department of Psychology, University of Washington, Seattle, WA,USA
                [3 ]Black Hills Center for American Indian Health, Rapid City, SD, USA
                [4 ]Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA
                [5 ]Washington State University College of Nursing, Spokane, WA, USA
                [6 ]Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
                Article
                10.1093/ntr/ntab213
                34644389
                a4230609-2300-428f-b981-d32c2be304c3
                © 2021

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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