Skov‐Ettrup 2014.
Methods | Country: Denmark Setting: online, participants were members of Xhale.dk Study design: RCT |
|
Participants | Participants: 2030 (I = 1055, C = 975) daily smokers, 59.3% female Age range: 15‐25 years, mean (SD): I = 19.4 (3.1), C = 19.5 (3.2) Criteria for inclusion: daily smoker, aged 15‐25 years, valid email address or mobile phone number, self‐chosen quit date between 14 February 2007 and 1 August 2009 Follow‐up method: contacted via email to complete internet‐based questionnaire, email/text reminders sent after 4 days and after 11 days. If there was still no response after 18 days up to 4 attempts were made to contact participants over telephone Inducements to enter study: none Baseline characteristic equivalence: “At baseline there were no statistically significant differences between groups” Pre‐test smoking status assessment: self‐report, mean (SD) cpd: I = 15.4 (7.0), C = 15.6 (6.8) Post‐test smoking status assessment: self‐report |
|
Interventions | Intervention: access to programme website, which included smoking facts, tests, exercises, videos and a chat forum. In addition there was the option of receiving tailored text messages. This entailed a weekly message up to 4 weeks before their quit date, and a daily message 1–3 days before the quit date. Then they received 2 tailored text messages/d during a period of 4 weeks. For the following 4 weeks, the frequency of text messages declined to 4‐5 text messages/week. The system generated 3 types of tailored messages based on 3 different tailoring parameters: self‐efficacy, beliefs about smoking and themes chosen by the user. Theoretical basis for intervention: Stage of Change theory and theory of planned behaviour Control: also had access to website and the option to activate text messages. These messages were less frequent and untailored. Messages were sent once daily for 5 weeks beginning 5 days before the chosen quit date. Weekly messages were sent for the following 3 weeks. |
|
Outcomes | Measurement: 30‐day PPA Relevant follow‐up periods: 12 months Verification: none Loss to follow‐up: I = 73.7%, C = 71.9% |
|
Notes | New for 2017 update. This review used all randomized participants, whether or not they chose to activate text messages. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Abstract states participants were "consecutively randomized", the meaning of which is unclear. No further details of the randomization process were present. |
Allocation concealment (selection bias) | Unclear risk | Same problems as random sequence generation (above) |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Participants were unaware of the random allocation. Personnel did not deliver the intervention, as it was through text messaging and email. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | The majority of follow‐up took place online (although if participants did not respond to online prompts, interviews took place via telephone ‐ unclear whether assessors were blinded) |
Incomplete outcome data (attrition bias) All outcomes | High risk | High rates of dropout as would be expected from online intervention however rates above 50%, 73.7% in intervention group and 71.9% in control group |
Other bias | High risk | Participants were given the option to receive text messages so not all participants benefited from differential treatment between study arms. |