Mobile Health Intervention for Family Smoking Cessation in Romania (2017-2020)

This project will contribute to the evidence base for the use of mobile technology to improve clinical outcomes and public health while building research capacity in Romania and developing LMIC research networks. Our partnership in research and capacity building could be a model for other LMICs in CEE (e.g. Moldova, Serbia), East Asia (e.g. Armenia, Georgia), and other regions. The research will contribute to our knowledge of pregnancy smoking prevention by assessing whether a culturally sensitive pregnancy and postnatal mHealth intervention grounded in theory and enhanced by addressing couples’ dyadic efficacy for smoking cessation is feasible, acceptable, and potential efficacious.

The long term goal of our research program is to develop, implement, and disseminate effective and sustainable mHealth interventions to prevent and reduce smoking in families over the reproductive life span while building mHealth research capacity and developing research networks in CEE and neighboring countries.

Aim 1. Test the implementation feasibility, acceptability, and initial efficacy of a culturally-adapted mHealth smoking cessation intervention among couples during pregnancy and postpartum in Romania. We will recruit 60 pregnant smokers and their partners. The RCT will compare text messages, video counselling, and combined text and video counseling, delivered via smartphones, with a control group. Primary outcomes include maternal pregnancy smoking cessation and postnatal relapse, with secondary hypotheses regarding maternal smoking reduction, and spousal cessation, relapse and reduction.

Aim 2. Develop mHealth research capacity by enhancing individual and institutional research capabilities in Romania and expanding the existing international research network.  Formal, educational training will be provided, in addition to the collaborative research, leading to a sustainable network of mHealth scholars.

With respect to expected outcomes, the proposed application is anticipated to advance understanding of the effectiveness of a proactive mHealth couple intervention enhanced by addressing couples’ dyadic efficacy for smoking cessation in reducing pregnancy smoking and postnatal relapse. Such results are anticipated to have a system wide sustainable positive impact on the prevention of prenatal and postnatal family smoking as the intervention has a high potential to be adopted in the universal health system in Romania, with applications to the US and other populations. This research is also expected to have a significant impact on the methodology and design of mHealth interventions during the reproductive years. While our focus is using pregnancy and the reproductive years as a window of opportunity for couple smoking cessation, the approach is relevant for delivering other mHealth interventions during the reproductive years, with lifetime implications for the entire family. The development of the international research network and the individual and institutional mHealth research capacity building is expected to positively impact mHealth research in CEE and the neighboring region applied to tobacco control and other locally-relevant topics.

Coordinator: Michigan State University, USA

Funder: National Institutes of Health (NIH), grant number 1R21TW010896-01

Budget for BBU: 116 625 USD