Uthman, Olalekan A., Nduka, Chidozie, Abba, Mustapha, Enriquez, Rocio, Nordenstedt, Helena, Nalugoda, Fred, Kengne, Andre and Ekström, Anna Mia (2019) Comparison of mHealth and face-to-face interventions for smoking cessation among people living with HIV : meta-analysis. JMIR mHealth and uHealth, 7 (1). e203. doi:10.2196/mhealth.9329 ISSN 2291-5222.

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Abstract

Background:
The prevalence of smoking among people living with HIV (PLHIV) is higher than in the general population and a significant risk factor for non-communicable diseases in this group. Mobile phone interventions to promote healthier behaviours (mHealth) have the potential to reach a large number of people at a low cost. It has been hypothesized that mHealth interventions may not be as effective as face-to-face strategies in achieving smoking cessation, but there is no systematic evidence to support this, especially among PLHIV.

Objective:
To compare two modes of intervention delivery (mobile technology versus face-to-face) for smoking cessation among PLHIV.

Methods:
Literature on randomised controlled trials (RCTs) investigating the effects of mHealth or face-to-face intervention strategies on short-term (4 weeks to <6 months) and long-term (≥6 months) smoking abstinence among PLHIV were sought. We systematically reviewed the relevant RCTs and conducted pairwise meta-analyses to estimate the relative treatment effects of mHealth and face-to-face interventions using standard care as comparison. Given the absence of head-to-head trials comparing mHealth with face-to-face interventions, we performed an adjusted indirect comparison meta-analyses to compare these interventions.

Results:
Ten studies involving 1,772 PLHIV met the inclusion criteria. Average age of the study population was 45 years and women comprised about 37%. At short term, mHealth delivered interventions were significantly more efficacious in increasing smoking cessation than no intervention control (Risk Ratios [RR] 2.81, 95% CI 1.44 to 5.49) and face-to-face interventions (RR 2.31, 95% CI 1.13 to 4.72). At short-term, face-to-face interventions were no more effective than no intervention in increasing smoking cessation (RR 1.22, 95% CI 0.94 to 1.58). In terms of achieving long term results among PLHIV, there was no significant difference in the rates of smoking cessation between mHealth delivered, face-to-face interventions and those who received no intervention.

Conclusions:
Compared with face-to-face interventions, mHealth delivered interventions can better increase smoking cessation rate in the short term. However, it remains unclear how long the effects of such interventions last. Future research should focus on strategies for sustaining the treatment effect in the long term.

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	JMIR mHealth and uHealth
Publisher:	JMIR Publications
ISSN:	2291-5222
Official Date:	January 2019
Dates:	Date Event January 2019 Published 2018 Available 19 June 2018 Accepted
Volume:	7
Number:	1
Article Number:	e203
DOI:	10.2196/mhealth.9329
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	11 September 2018
Date of first compliant Open Access:	9 January 2019

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