Mixed methods evaluation of the 'real-world' implementation of group-based behavioral stop smoking support through Facebook

Laura Heavey; Rachel Wright; Muiriosa Ryan; Edward Murphy; Martina Blake; Ben Cloney; Paul Kavanagh; Frank Doyle

doi:10.18332/tpc/149910

Mixed methods evaluation of the 'real-world' implementation of group-based behavioral stop smoking support through Facebook

Tob Prev Cessat. 2022 Jun 24:8:24. doi: 10.18332/tpc/149910. eCollection 2022.

Authors

Laura Heavey¹, Rachel Wright², Muiriosa Ryan², Edward Murphy³, Martina Blake⁴, Ben Cloney², Paul Kavanagh^{4

5}, Frank Doyle⁵

Affiliations

¹ Department of Public Health Medicine, HSE Midlands, Tullamore, Ireland.
² HSE Communications, Dublin, Ireland.
³ HSE Tobacco Free Ireland Programme, EET Hospital, Cork, Ireland.
⁴ HSE Tobacco Free Ireland Programme, Strategic Planning and Transformation, HSE Oak House, Nass, Ireland.
⁵ Royal College of Surgeons, Division of Population Health Sciences, University of Medicine and Health Sciences, Dublin, Ireland.

Abstract

Introduction: While promising evidence from trials of social-media-based stop smoking support informs service-planning, there is a need for more prospective, observational studies of smoking cessation interventions to build 'real-world' evidence. Specifically, user experiences have been under-explored with qualitative methods to date. This mixed-method evaluation of a closed Facebook group-based behavioral stop smoking support program, which was conducted in Ireland in 2018, aimed to address these issues.

Methods: Pre- and post-program surveys measured smoking abstinence (self-reported 7-day point prevalence), changes in smoking attitudes and behavior, and participant experiences. Engagement with Facebook was measured through counting 'likes' and comments, and was used to categorize groups as 'more active' and 'less active' over a 12-week period of support. Thematic content analysis of semi-structured participant interviews explored program experience in depth.

Results: In total, 13 of 52 participants reported smoking abstinence post-program (25.0%, 95% CI: 14.0-39.0). Participant engagement with Facebook was variable and decreased over the program. Membership of a 'more active' group was associated with better reported participant experience (e.g. 90.9% agreeing 'Facebook group helped me to quit or reduce smoking', versus 33.3% in the 'less active' group, p<0.05). Qualitative analysis identified three over-arching themes: importance of social interactions; perception of health information; and appeal of online support.

Conclusions: Facebook can be used to deliver group-based behavioral stop smoking support in the real world. In Ireland, the one-month post-program abstinence outcomes achieved by other stop smoking services is approximately 50%, and while the outcomes for this service was lower (25%), it is still better than outcomes estimated for unassisted quitting. Engagement and peer-to-peer interactivity should be maximized to support positive participant experience.

Keywords: internet-based intervention; program evaluation; real-world effectiveness; smoking cessation; social media; tobacco use disorder.