Browne J, Halverson TF, Vilardaga R, Engagement with a digital therapeutic for smoking cessation designed for persons with psychiatric illness fully mediates smoking outcomes in a pilot randomized controlled trial, Translational Behavioral Medicine, Volume 11, Issue 9, September 2021, Pages 1717–1725, https://doi.org/10.1093/tbm/ibab100
This study investigated the meditational effect of a digital therapeutic for smoking cessation for adults with psychiatric disorders. Participants were 62 adults with severe mental illness who currently smoked, were adherent to psychiatric treatment, and lived in stable housing. Participants were randomly assigned to receive either a tailored smartphone app for persons with severe mental illness (Learn to Quit) or a smartphone app with health information for the general population (NCI QuitGuide). The Learn to Quit app includes 28 modules that provide information, skills, and recommendations for smoking cessation based on acceptance and commitment therapy. The study measured engagement by collecting background data of app utilization, such as number of interactions with app content, amount of time per day of app use, and number of days the app was used. The study also evaluated smoking cessation by reduction in cigarettes per day from baseline to the four-month follow-up. Results showed that number of app interactions fully mediated reduction in cigarettes per day in the Learn to Quit arm, but not in the NCI QuitGuide arm. Minutes per day of app use and number of days used were not significant mediators. These findings indicate that engagement with theory-based content in Learn to Quit functioned as intended.