Process and Information Needs When Searching for and Selecting Apps for Smoking Cessation: Qualitative Study Using Contextual Inquiry

Abstract

Background: Hundreds of apps are available to support people in their quest to quit smoking. It has been hypothesized that selecting an app from a sizable volume without any aid can be overwhelming and difficult. However, little is known about how people choose apps for smoking cessation and what exactly people want to know about an app before choosing to install it. Understanding the decision-making process may ultimately be helpful in creating tools to help people meaningfully select apps.

Objective: The aim of this study is to obtain insights into the process of searching and selecting mobile apps for smoking cessation and map the range of actions and the accompanying reasons during the search, focusing on the information needs and experiences of those who aim to find an app.

Methods: Contextual inquiries were conducted with 10 Dutch adults wanting to quit smoking by using an app. During the inquiries, we observed people as they chose an app. In addition, 2 weeks later, there was a short semistructured follow-up interview over the phone. Through convenience and purposive sampling, we included participants differing in gender, age, and educational level. We used thematic analysis to analyze the transcribed interviews and leveraged a combination of video and audio recordings to understand what is involved in searching and selecting apps for smoking cessation.

Results: The process of finding smoking cessation apps is comprehensive: participants explored, evaluated, and searched for information; imagined using functions; compared apps; assessed the trustworthiness of apps and information; and made several decisions while navigating the internet and app stores. During the search, the participants gained knowledge of apps and developed clearer ideas about their wishes and requirements. Confidence and trust in these apps to help quitting remained quite low or even decreased. Although the process was predominantly a positive experience, the whole process took time and energy and caused negative emotions such as frustration and disappointment for some participants. In addition, without the participants realizing it, errors in information processing occurred, which affected the choices they made. All participants chose an app with the explicit intention of using it. After 2 weeks, of the 10 participants, 6 had used the app, of whom only 1 extensively.

Conclusions: Finding an app in the current app stores that contains functions and features expected to help in quitting smoking takes considerable time and energy, can be a negative experience, and is prone to errors in information processing that affect decision-making. Therefore, we advise the further development of decision aids, such as advanced filters, recommender systems and curated health app portals, and make a number of concrete recommendations for the design of such systems.

Keywords: apps for smoking cessation; contextual inquiry; decision-making; mHealth and eHealth; mobile app search and selection; mobile apps; mobile phone.