Aleksandra Herbec*, University College London, London, United Kingdom Jamie Brown*, University College London, London, United Kingdom Emma Beard, University College London, London, United Kingdom Ildiko Tombor, University College London, London, United Kingdom Robert West, University College London, London, United Kingdom Track: Research Presentation Topic: Web 2.0 approaches for behaviour change, public health and biosurveillance Presentation Type: Oral presentation Submission Type: Single Presentation Building: Mermaid Room: Room 1 - Newgate Date: 2013-09-23 02:00 PM – 03:30 PM Last modified: 2013-09-25

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Background: Smoking in pregnancy is associated with numerous health problems, including miscarriage and birth defects. Around 12% of pregnant women smoke in the UK throughout their pregnancy, and the uptake of smoking cessation services remains low among this group of smokers. Therefore, there is a pressing need to identify alternative support with quitting that would be effective and acceptable among pregnant smokers. Internet-based interventions may provide a viable alternative for women who are unable or unwilling to engage with face-to-face support, but limited research exists on their use and acceptability among these smokers.

Objectives: To develop and evaluate MumsQuit - a prototype of an internet-based smoking cessation intervention (ISCI) especially designed for pregnant smokers.

Methods: MumsQuit is based on an existing internet smoking cessation intervention for all adult smokers called StopAdvisor. Both programmes were developed using LifeGuide, an open-source software, and were informed by PRIME theory of motivation as well as research on behaviour change techniques that were shown to be effective in smoking cessation. The interventions offer tailored and personalised advice on quitting, and emulate the behavioural support delivered by an expert smoking cessation advisor as part of a structured, 4-week long intervention. The development of MumsQuit involved tailoring the content and appearance of the generic intervention to increase its relevance for pregnant smokers. For example, information on the risks of smoking in pregnancy was made prominent, behaviour change techniques such as ‘advise on medication’ included particular amendments appropriate to pregnancy, and imagery was used to appeal simultaneously to ex-smoker and mother identities. A qualitative interview study with participants (n=13) randomized to receive MumsQuit intervention was conducted to assess intervention acceptability and usability, as well as to identify potential ways for its improvement. Data were analysed using Framework Analysis. The effectiveness of the intervention in comparison to a control condition has been undergoing evaluation through an ongoing pilot internet randomized controlled trial, with primary outcomes being self-reported 4-week continuous abstinence at 8 weeks follow-up, and secondary outcomes including quantifiable indicators of website usage.

Results:. Baseline characteristics of the 200 participants and preliminary data on MumsQuit usage in the first two weeks following enrollment will be presented. The qualitative study identified features of ISCIs that may increase their attractiveness and use among pregnant smokers, including peer-to-peer communication tools, personal support, more intensive targeting to pregnancy, and post-relapse help. Finally, the findings also corroborated important challenges inherent to conducting randomized trials over the internet, including use of unassigned support and attrition following a successful quit attempt.

Conclusions: Tailoring generic interventions to target specific populations may increase their attractiveness and use. Using LifeGuide in the development and evaluation of the intervention allows researchers to introduce incremental changes to the existing programmes, the impact of which can be systematically assessed. Nevertheless, there is a need to establish more appropriate methodology than randomized controlled trials to evaluate digital interventions.