Pilot randomised controlled trial of a culturally aligned smoking cessation app for American Indian persons.
Dana Mowls Carroll, Dylan Jennings, Antony Stately, Amika Kamath, Katelyn M Tessier, Crina Cotoc, Andrew Egbert, Abbie Begnaud, Michael Businelle, Dorothy Hatsukami, Wyatt Pickner
Author Information
Dana Mowls Carroll: Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA dcarroll@umn.edu. ORCID
Dylan Jennings: Sigurd Olson Environmental Institute, Northland College, Ashland, Wisconsin, USA.
Antony Stately: Native American Community Clinic, Minneapolis, Minnesota, USA.
Amika Kamath: American Indian Cancer Foundation, Minneapolis, Minnesota, USA. ORCID
Katelyn M Tessier: Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.
Crina Cotoc: Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.
Andrew Egbert: Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.
Abbie Begnaud: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Michael Businelle: TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Dorothy Hatsukami: Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA. ORCID
Wyatt Pickner: American Indian Cancer Foundation, Minneapolis, Minnesota, USA.
OBJECTIVE: To pilot test QuitGuide for Natives, a culturally aligned version of the National Cancer Institute's QuitGuide smartphone app for smoking cessation. METHODS: This randomised controlled trial was conducted remotely during 2022-2023. American Indian adults who smoked and resided in the Midwest (n=115) were randomised to QuitGuide for Natives or the general audience QuitGuide smartphone-based intervention. Group differences in feasibility (times the app was initiated), usability, acceptability ('How likely would you be to recommend the app to a friend?'), fit of app with culture and preliminary efficacy (24-hour quit attempts, cotinine-confirmed self-reported 7-day abstinence) outcomes were examined. RESULTS: QuitGuide for Natives versus the general audience QuitGuide did not differ in the number of times the app was opened (adjusted incidence rate ratio 0.94 (95% CI 0.63 to 1.40); p=0.743) nor in usability score (adjusted mean difference (aMD) 0.73 (95% CI: -5.00 to 6.46); p=0.801) or likeliness of recommending the app to a friend (aMD 0.62 (95% CI -0.02 to 1.27); p=0.058). Differences were observed for all cultural fit outcomes such as 'The app fits my American Indian culture (aMD 0.75 (95% CI 0.35 to 1.16); p<0.001). QuitGuide for Natives versus the general audience QuitGuide resulted in an average of 6.6 vs 5.1 24-hour quit attempts (p=0.349) and cotinine-confirmed 7-day abstinence was achieved by 6.9% vs 3.5% (p=0.679). CONCLUSIONS: Acceptability, cultural fit and preliminary efficacy findings are encouraging and will inform future, larger-scale evaluation of culturally aligned digital smoking cessation resources for American Indian adults.
