New study finds online ads may encourage pregnant smokers to quit

NIHR | April 2018 | Online ads effective at helping pregnant women stop smoking 

An NIHR funded study has found that an online advertising campaign may be more effective in encouraging expectant mothers to quit smoking, than a clinic based intervention. The study was part of a collaboration between the University of Cambridge, University of East Anglia (UEA), and the University of Nottingham (via UEA).

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One of the researchers, Dr Felix Naughton, developed MiQuit, which is a text-messaging intervention specifically for pregnant smokers. As it is automated, the women could use it without health professional’s involvement. In tandem with this the research team also  advertised links to a website providing MiQuit information on Google and Facebook, which incurred a cost. Adverts were also placed on the National Childbirth Trust and NHS Choices websites free of charge.

The team found that the Facebook advert generated initiations throughout pregnancy, around 50 per cent of those who initiated MiQuit via Google were within their first five weeks’ gestation. Adverts attached to online search engines may therefore be a useful way to reach women when they are first pregnant and looking for support or information about smoking during pregnancy. Currently, the earliest cessation interventions tend to target pregnant smokers at their antenatal booking appointment, at around 8-12 weeks’ gestation.

Lead author of the study, Dr Joanne Emery, Research Associate at the University of Cambridge, said: “This study shows that online advertising appears to be a valuable means of promoting health interventions to hard-to-reach groups.

“We found that a significant minority of pregnant smokers were willing to initiate an automated text messaging intervention when offered this online. Given the high reach of the internet this could translate into substantial numbers of pregnant smokers supported to quit.” As a result of this study’s findings, a more definitive trial is now underway.

An article based on this study has been published in the Journal of Medical Internet Research

ABSTRACT

Background: Smoking in pregnancy is a major public health concern. Pregnant smokers are particularly difficult to reach, with low uptake of support options and few effective interventions. Text message–based self-help is a promising, low-cost intervention for this population, but its real-world uptake is largely unknown.

Objective: The objective of this study was to explore the uptake and cost-effectiveness of a tailored, theory-guided, text message intervention for pregnant smokers (“MiQuit”) when advertised on the internet.

Methods: Links to a website providing MiQuit initiation information (texting a short code) were advertised on a cost-per-click basis on 2 websites (Google Search and Facebook; £1000 budget each) and free of charge within smoking-in-pregnancy webpages on 2 noncommercial websites (National Childbirth Trust and NHS Choices). Daily budgets were capped to allow the Google and Facebook adverts to run for 1 and 3 months, respectively. We recorded the number of times adverts were shown and clicked on, the number of MiQuitinitiations, the characteristics of those initiating MiQuit, and whether support was discontinued prematurely. For the commercial adverts, we calculated the cost per initiation and, using quit rates obtained from an earlier clinical trial, estimated the cost per additional quitter.

Results: With equal capped budgets, there were 812 and 1889 advert clicks to the MiQuitwebsite from Google (search-based) and Facebook (banner) adverts, respectively. MiQuitwas initiated by 5.2% (42/812) of those clicking via Google (95% CI 3.9%-6.9%) and 2.22% (42/1889) of those clicking via Facebook (95% CI 1.65%-2.99%). Adverts on noncommercial webpages generated 53 clicks over 6 months, with 9 initiations (9/53, 17%; 95% CI 9%-30%). For the commercial websites combined, mean cost per initiation was £24.73; estimated cost per additional quitter, including text delivery costs, was £735.86 (95% CI £227.66-£5223.93). Those initiating MiQuit via Google were typically very early in pregnancy (median gestation 5 weeks, interquartile range 10 weeks); those initiating via Facebook were distributed more evenly across pregnancy (median gestation 16 weeks, interquartile range 14 weeks).

Conclusions: Commercial online adverts are a feasible, likely cost-effective method for engaging pregnant smokers in digital cessation support and may generate uptake at a faster rate than noncommercial websites. As a strategy for implementing MiQuit, online advertising has large reach potential and can offer support to a hard-to-reach population of smokers.
Full reference: Emery, J.L, Coleman, T., Sutton, S., Cooper, S., Leonardi-Bee, J., Jones, M., & Naughton F. | Uptake of Tailored Text Message Smoking Cessation Support in Pregnancy When Advertised on the Internet (MiQuit): Observational Study | J Med Internet Res |2018| Vol. 20 |4| e146| DOI: 10.2196/jmir.8525|PMID: 29674308
Related: University of East Anglia Online ads help pregnant smokers quit

New technology supports new mums to breastfeed

Public Health England’s Start4Life and Amazon Alexa helping mothers to breastfeed for longer | Public Health England

Almost three-quarters of women start breastfeeding when their child is born, however by 6 to 8 weeks this drops to just 44%. This makes breastfeeding rates in England among the lowest in the world.

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Evidence shows the right support helps mothers to breastfeed for longer. A recent survey found that almost two thirds (64%) felt that access to 24 hours a day, 7 days a week breastfeeding support, such as a phoneline, website or chatbot, would make new mothers:

  • more likely to have a positive experience of breastfeeding
  • more likely to decide to try breastfeeding (59%)
  • breastfeed for longer (58%)

PHE’s programme Start4Life has created the Breastfeeding Friend to encourage parents to adopt healthy behaviours. It is available for free on a range of platforms, including Facebook Messenger, and now for the first time it will also be available as a skill for Amazon Alexa’s voice service.

Mothers can ask Alexa a variety of questions about breastfeeding and the answers will be provided tailored to the age of the baby. This means that they can get helpful advice even when their hands are full.

Full details at Public Health England

Related:

High-impact innovations for patient benefit

App that helps pregnant women monitor hypertension among new NHS innovations that will save lives and improve treatment | NHS England

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A wireless sensor that better detects breathing rate in hospital patients, an app to help pregnant women monitor hypertension and another that directs patients with minor injuries to treatment units with the shortest queues are among the latest innovations set to be spread across the NHS.

Eleven projects are being backed in the latest round of NHS England’s programme to develop and spread pioneering ideas, equipment and technology that have the potential to save lives as well as money.

Further detail of this latest round of the NHS Innovation Accelerator (NIA) programme  can be found at NHS England

 

 

Screen time and young children: Promoting health and development in a digital world

Position statement from the Canadian Paediatric Society

https://www.flickr.com/photos/zionfiction/14229339157/
Image source: r. nial bradshaw – Flickr // CC BY 2.0

The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children under 5 years old, focusing on developmental, psychosocial and physical health. Evidence-based guidance to optimize and support children’s early media experiences involves four principles: minimizing, mitigating, mindfully using and modelling healthy use of screens. Knowing how young children learn and develop informs best practice strategies for health care providers.

Read the full statement here

Using Technology to Reduce Childrens’ Anxiety Throughout the Perioperative Period

Goldschmidt, K. & Woolley, A. Journal of Pediatric Nursing | Published online: 27 April 2017

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In the U.S. each year, approximately 5 million children undergo a surgical procedure (Perry, Hooper, & Masiongale, 2012). Surgery is one of the most stressful medical procedures that a child can experience. In fact, approximately 50% of children are reported to experience significant anxiety in the preoperative period (Perry et al., 2012). Pediatric nurses know the importance of incorporating parents into the child’s plan of care and understand that the child is comforted by the presence of someone that they know and love.

Read the abstract here

New resource to reduce barriers to breastfeeding

Public Health England (PHE) and NHS England have conducted a survey which found that of the three-quarters of the new mums who start breastfeeding, only 40% were still breastfeeding two months later.

To help dispel some of the concerns women have about breastfeeding, PHE’s Start4 life programme has launched a new interactive Breastfeeding Friend (BFF) ChatBot. The BFF can be accessed through Facebook messenger and provides personal support for mothers at any time of the day or night. The ChatBot works as a live chat tool which is able to respond to questions about breastfeeding posed by the user.

Read more on this at Public Health England

Self-management and social welfare of children with cystic fibrosis

Calvo-Lerma, J. et al. (2017) Innovative approach for self-management and social welfare of children with cystic fibrosis in Europe: development, validation and implementation of an mHealth tool (MyCyFAPP). BMJ Open. 7:e014931

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Introduction: For the optimal management of children with cystic fibrosis, there are currently no efficient tools for the precise adjustment of pancreatic enzyme replacement therapy, either for advice on appropriate dietary intake or for achieving an optimal nutrition status. Therefore, we aim to develop a mobile application that ensures a successful nutritional therapy in children with cystic fibrosis.

Methods and analysis: A multidisciplinary team of 12 partners coordinate their efforts in 9 work packages that cover the entire so-called ‘from laboratory to market’ approach by means of an original and innovative co-design process. A cohort of 200 patients with cystic fibrosis aged 1–17 years are enrolled. We will develop an innovative, clinically tested mobile health application for patients and health professionals involved in cystic fibrosis management. The mobile application integrates the research knowledge and innovative tools for maximising self-management with the aim of leading to a better nutritional status, quality of life and disease prognosis. Bringing together different and complementary areas of knowledge is fundamental for tackling complex challenges in disease treatment, such as optimal nutrition and pancreatic enzyme replacement therapy in cystic fibrosis. Patients are expected to benefit the most from the outcomes of this innovative project.

Read the full protocol here