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Evaluation of Smokefree.gov, a National Web-Assisted Tobacco Intervention

                                             Andrea L. Frydl, BS, CHES; Erik M. Augustson PhD MPH; Ami L. Hurd MPH; Jacqueline L. Stoddard, PhD
                                                       Frydl BS                 Augustson, PhD,           Hurd,                   Stoddard
Background                                                                                                  Results                                                                                       Results, continued
 Advantages of WATIs:                                              Demographic Variables                                                                  P-values                 SF.gov-specific Findings, All Visitors                   2008 (%)   2004 (%)    P-value
                                                                                                           2008 (%)                   2004 (%)                          Where did you find out about the website                            n= 1,674   n= 1,272
 • Able to reach large audiences
                                                            Gender*                                         n = 971                   n = 1,272                                                                           Search engine*      43.8       24.1
 • Able to make changes quickly and cost effectively                                                                                                                                                         Link from another website*       17.0       58.2
                                                                                         Female               68.7                       54.1
 • Able to have interactive design & features                                              Male               31.3                       45.9                                                                            Friend or Family      2.6        2.7
 • Able to conduct anonymous evaluation                     Age*                                            n = 968                   n = 1,259                                                                   Health care provider**       3.6        1.7
                                                                                      Under 24                17.7                       14.5                                                                      Colleague/Co-worker         2.3        2.8
                                                                                                                                                                                                                           Advertisement       7.0        6.0
                                                                                       25 – 50                59.4                       68.7
 WATIs Are:                                                                                                                                                             Have you ever visited a website other than this website?*           n= 1,674   n= 1,272
                                                                                          50+                 22.8                       16.9             * p < 0.001
 • An effective smoking cessation tool, as various RCTs     Education Level**                               n = 971                   n = 1,272          ** p = 0.002
                                                                                                                                                                                                                                      Yes     29.5       38.4
   show                                                                          Less than HS                 9.2                         8.7
                                                                                                                                                                                                                                      No      70.5       61.6
                                                                                                                                                                        How does this site compare to other websites*                       n = 494    n = 488    * p<0.001
 • Improved cessation rates when used in conjunction                          HS Degree/GED                   16.2                       20.8
                                                                                                                                                                                                          Not as good as other websites       21.9        4.9     **p=0.002
                                                                                 More than HS                 74.7                       70.5
   with other evidence-based interventions and treatments
              evidence based                                                                                                                                                                                   As good as other websites      68.4
                                                                                                                                                                                                                                              68 4       64.3
                                                                                                                                                                                                                                                         64 3
                                                            Smoking Status*                                n = 1,525                  n = 1,272
                                                                                                                                                                                                               Better than other websites      9.7       30.7
                                                                                  Current                     64.8                       81.5
 Need to:                                                                                                                                                               How do you most prefer to receive health information?*               n= 985    n= 1,163
                                                                                   Former                     22.8                       10.9
                                                                                                                                                                                                                     Web-based, internet      33.9       29.7
 • Determine whether WATI is reaching intended                                      Never                     12.5                        7.5
                                                                                                                                                                                                                          Text messaging       2.7        1.1
                                                            Smoking Behavior, Smokers
   audience                                                                                                                                                                                                                        E-mail     33.2       35.9
                                                            Cigarettes smoked per day*                      n = 981                    n = 1,030
 • Routinely evaluate WATI to ensure effectiveness                                                                                                                                                      E-documents that can be printed        9.6        8.3
                                                                                           1-10               29.6                        19.8                                                Print document that can be ordered online        7.7        4.7
 • Assess customer satisfaction and suggestions for                                       11-20               47.4                        50.2                                                                                 Telephone       2.8        1.0
   improvement                                                                             >20                23.0                        30.0            * p < 0.001                                                        Face-to-face      9.9       19.3
                                                            Quit attempts**                                 n = 976                     n = 957          ** p = 0.047
Methods and Procedure                                                                     None                12.1                        13.0                          Discussion
                                                                                            <5                54.5                        58.5
 • Anonymous follow-up customer satisfaction survey                                                                                                                     • SF.gov is reaching people with low to moderate levels of nicotine
                                                                                           5-10               25.2                        23.1
   administered online in September 2008 with over                                         >10                 8.2                         5.4                            dependence at approximately middle age, thus reducing the public
   1,600 surveys collected.                                         Cessation Method                       n = 1,217                   n = 1,176                          health burden of tobacco addiction.
                                                            Telephone quit line**                              3.5                         4.8
                                                            Cessation class or support group*
                                                                               s pport gro p*                 6.9
                                                                                                              69                          14.1
                                                                                                                                          14 1
 • Q
   Quantitative d
         i i data collected on attitudes, d
                      ll    d     i d demographics,hi                                                                                                                   • Data reflects a decrease in evidence-based practices (EBPs) and an
                                                            One-on-one counseling*                            2.4                          6.3           * p < 0.001
   ranking, and behavior around Smokefree.gov (SF.gov)      The internet or world-wide-web*                   14.1                       19.3           ** p = 0.022      increase in the use of non-EBPs. This may be attributable to lack of
   and smoking cessation.                                   Books, pamphlets, videos , etc.*                   15.5                      30.1           *** p = 0.002     financial resources and an increase in alternative therapies in the US
                                                            Acupuncture or hypnosis***                         6.9                        4
 • Analyzed differences between 2008 and 2004 data for      Nicotine replacement*                             38.6                      62.88                           • Decrease in aggregate ranking and attitudes towards SF.gov may be
                                                            Prescription pill*                                21.5                      34.8
   all former and current smokers.                                                                                                                                        attributable to burgeoning WATI field as well as a desire for more
                                                                 Attitudes about SF.gov                   n = 1,033 (%)             n = 1,272 (%)
                                                                                                  Agree    Neutral Disagree    Agree Neutral Disagree
                                                                                                                                                        * p < 0.001       interactive features. However, overall attitudes towards SF.gov
                                                                                                                                                                                                       ,                              g
 • All tools were in compliance with OMB regulations.       Easy to find                           70.4      22.9        6.7   67.4    26.1        6.5
                                                                                                                                                       ** p = 0.037       remain positive.
                                                                                                                                                          In 2004,
                                                            Help me quit*                          51.6      39.7        8.7   47.5    47.6        4.8
                                                                                                                                                       7.5% did not
                                                            Message board*                         63.4      27.3        9.3   59.5    35.0        5.5
                                                                                                                                                         respond to     • Although SF.gov is not reaching young or heavy smokers, the
                         Questions?                         Navigate**                             76.1      19.2        4.7   76.1    21.0        2.8
                   Contact Andrea Frydl at                                                                                                             this question      majority of visitors are female; typically the gatekeeper of health
                                                            Confusing*                             12.3      22.9       64.8   14.6    29.5       56.0
                    frydlal@mail.nih.gov                                                                                                                                  information. Thus, they may use EBPs from SF.gov to facilitate
                                                                                                                                                                          quitting in their families.

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Evaluation of Smokefree.gov: A National Web-Assisted Tobacco Intervention

  • 1. Evaluation of Smokefree.gov, a National Web-Assisted Tobacco Intervention Andrea L. Frydl, BS, CHES; Erik M. Augustson PhD MPH; Ami L. Hurd MPH; Jacqueline L. Stoddard, PhD Frydl BS Augustson, PhD, Hurd, Stoddard Background Results Results, continued Advantages of WATIs: Demographic Variables P-values SF.gov-specific Findings, All Visitors 2008 (%) 2004 (%) P-value 2008 (%) 2004 (%) Where did you find out about the website n= 1,674 n= 1,272 • Able to reach large audiences Gender* n = 971 n = 1,272 Search engine* 43.8 24.1 • Able to make changes quickly and cost effectively Link from another website* 17.0 58.2 Female 68.7 54.1 • Able to have interactive design & features Male 31.3 45.9 Friend or Family 2.6 2.7 • Able to conduct anonymous evaluation Age* n = 968 n = 1,259 Health care provider** 3.6 1.7 Under 24 17.7 14.5 Colleague/Co-worker 2.3 2.8 Advertisement 7.0 6.0 25 – 50 59.4 68.7 WATIs Are: Have you ever visited a website other than this website?* n= 1,674 n= 1,272 50+ 22.8 16.9 * p < 0.001 • An effective smoking cessation tool, as various RCTs Education Level** n = 971 n = 1,272 ** p = 0.002 Yes 29.5 38.4 show Less than HS 9.2 8.7 No 70.5 61.6 How does this site compare to other websites* n = 494 n = 488 * p<0.001 • Improved cessation rates when used in conjunction HS Degree/GED 16.2 20.8 Not as good as other websites 21.9 4.9 **p=0.002 More than HS 74.7 70.5 with other evidence-based interventions and treatments evidence based As good as other websites 68.4 68 4 64.3 64 3 Smoking Status* n = 1,525 n = 1,272 Better than other websites 9.7 30.7 Current 64.8 81.5 Need to: How do you most prefer to receive health information?* n= 985 n= 1,163 Former 22.8 10.9 Web-based, internet 33.9 29.7 • Determine whether WATI is reaching intended Never 12.5 7.5 Text messaging 2.7 1.1 Smoking Behavior, Smokers audience E-mail 33.2 35.9 Cigarettes smoked per day* n = 981 n = 1,030 • Routinely evaluate WATI to ensure effectiveness E-documents that can be printed 9.6 8.3 1-10 29.6 19.8 Print document that can be ordered online 7.7 4.7 • Assess customer satisfaction and suggestions for 11-20 47.4 50.2 Telephone 2.8 1.0 improvement >20 23.0 30.0 * p < 0.001 Face-to-face 9.9 19.3 Quit attempts** n = 976 n = 957 ** p = 0.047 Methods and Procedure None 12.1 13.0 Discussion <5 54.5 58.5 • Anonymous follow-up customer satisfaction survey • SF.gov is reaching people with low to moderate levels of nicotine 5-10 25.2 23.1 administered online in September 2008 with over >10 8.2 5.4 dependence at approximately middle age, thus reducing the public 1,600 surveys collected. Cessation Method n = 1,217 n = 1,176 health burden of tobacco addiction. Telephone quit line** 3.5 4.8 Cessation class or support group* s pport gro p* 6.9 69 14.1 14 1 • Q Quantitative d i i data collected on attitudes, d ll d i d demographics,hi • Data reflects a decrease in evidence-based practices (EBPs) and an One-on-one counseling* 2.4 6.3 * p < 0.001 ranking, and behavior around Smokefree.gov (SF.gov) The internet or world-wide-web* 14.1 19.3 ** p = 0.022 increase in the use of non-EBPs. This may be attributable to lack of and smoking cessation. Books, pamphlets, videos , etc.* 15.5 30.1 *** p = 0.002 financial resources and an increase in alternative therapies in the US Acupuncture or hypnosis*** 6.9 4 • Analyzed differences between 2008 and 2004 data for Nicotine replacement* 38.6 62.88 • Decrease in aggregate ranking and attitudes towards SF.gov may be Prescription pill* 21.5 34.8 all former and current smokers. attributable to burgeoning WATI field as well as a desire for more Attitudes about SF.gov n = 1,033 (%) n = 1,272 (%) Agree Neutral Disagree Agree Neutral Disagree * p < 0.001 interactive features. However, overall attitudes towards SF.gov , g • All tools were in compliance with OMB regulations. Easy to find 70.4 22.9 6.7 67.4 26.1 6.5 ** p = 0.037 remain positive. In 2004, Help me quit* 51.6 39.7 8.7 47.5 47.6 4.8 7.5% did not Message board* 63.4 27.3 9.3 59.5 35.0 5.5 respond to • Although SF.gov is not reaching young or heavy smokers, the Questions? Navigate** 76.1 19.2 4.7 76.1 21.0 2.8 Contact Andrea Frydl at this question majority of visitors are female; typically the gatekeeper of health Confusing* 12.3 22.9 64.8 14.6 29.5 56.0 frydlal@mail.nih.gov information. Thus, they may use EBPs from SF.gov to facilitate quitting in their families.