背景:为了解决与年龄相关的长期烟草差异,在老年人(65岁以上)中推广戒烟治疗至关重要。数字健康平台为广泛传播基于证据的行为停止支持提供了机会。然而,现有的数字戒烟治疗并不是针对独特的与衰老相关的需求和偏好,导致低吸收。需要有关如何为该年龄组最好地适应这些治疗方法的详细信息。
目的:我们旨在收集详细的,关于吸烟老年人戒烟数字治疗的期望和偏好的假设生成信息。
方法:对目前吸烟或在过去一个月内戒烟的65岁以上的成年人进行半结构化访谈。访谈包括关于数字健康平台的先前经验以及通过各种方式对戒烟治疗的期望和偏好的开放式问题(应用程序交付,基于短信,或视频会议咨询)。访谈还引发了有关整合社交组件(应用程序提供的社交论坛和团体视频会议咨询)的数字模式的问题。使用迭代,基于团队的方法,主题分析确定了有意义的主题。访谈补充了评估社会人口统计的定量指标,数字素养,和身体健康的症状。
结果:参与者(12/20,60%男性;15/20,75%白人;4/20,20%黑人或非裔美国人;1/20,5%亚洲人)目前吸烟(17/20,85%)或最近戒烟(3/20,15%)。主题分析在所有数字模式中确定了三个有意义的主题:便利性,可访问性,和个性化。数字平台的预期好处包括方便的治疗访问,不依赖运输。参与者更喜欢个性化治疗,并提供超出标准教育的内容或策略。大多数(17/20,85%)不熟悉戒烟应用程序,但鉴于提供新颖的戒烟策略的潜力,发现它们具有吸引力。应用程序易用性(例如,容易导航)是首选。一半(10/20,50%)会尝试基于短信的干预,许多人更喜欢和辅导员发短信,而不是自动发消息。大多数(17/20,85%)会使用视频会议,并期望这种方式比通过电话提供更好的质量咨询。预期的视频会议挑战包括在屏幕上看起来像样,技术困难,隐私或安全。视频会议被认为是最个性化的数字治疗,然而,独特的应用程序交付和短信为基础的治疗包括匿名和获得治疗24/7。参与者希望将社交组件整合到数字治疗中,对戒烟成功和社交联系有用,然而,他们担心可能的人际挑战。
结论:因为长期尝试戒烟和熟悉标准戒烟建议在吸烟的老年人中很常见,数字平台可能会提供吸引人的新颖的戒烟策略,这些策略既方便又方便。总的来说,该人群对尝试数字戒烟治疗持开放态度,并希望这些平台优先考虑易用性和个性化内容。这些发现挑战了老年人对行为健康的数字治疗不感兴趣或不愿意参与的偏见。
BACKGROUND: To address enduring age-related tobacco disparities, it is critical to promote cessation treatment among older adults (aged 65+ years). Digital health platforms offer opportunities for wide dissemination of evidence-based behavioral cessation support. However, existing digital cessation treatments are not tailored to unique aging-related needs and preferences, resulting in low uptake. Detailed information is needed about how to best adapt these treatments for this age group.
OBJECTIVE: We aimed to collect detailed, hypothesis-generating information about expectations and preferences for cessation digital treatment among older adults who smoke cigarettes.
METHODS: Semistructured interviews were conducted with adults aged 65+ years currently smoking or who had quit within the past month. Interviews included open-ended questions regarding prior experiences with digital health platforms and expectations and preferences for cessation treatment via various modalities (app-delivered, texting-based, or
videoconferencing counseling). Interviews also elicited questions regarding digital modalities that integrated social components (app-delivered social forums and group
videoconferencing counseling). Using an iterative, team-based approach, the thematic analysis identified meaningful themes. Interviews were supplemented with quantitative measures assessing sociodemographics, digital literacy, and physical health symptoms.
RESULTS: Participants (12/20, 60% men; 15/20, 75% White; 4/20, 20% Black or African American; 1/20, 5% Asian) were currently smoking (17/20, 85%) or had recently quit (3/20, 15%). Thematic analysis identified 3 meaningful themes across all digital modalities: convenience, accessibility, and personalization. Expected benefits of digital platforms included convenient treatment access, without reliance on transportation. Participants preferred treatments to be personalized and deliver content or strategies beyond standard education. Most (17/20, 85%) were unfamiliar with cessation apps but found them appealing given the potential for offering a novel quitting strategy. App ease of use (eg, easy navigation) was preferred. Half (10/20, 50%) would try a texting-based intervention, with many preferring texting with a counselor rather than automated messaging. Most (17/20, 85%) would use
videoconferencing and expected this modality to deliver better quality counseling than via telephone. Expected
videoconferencing challenges included looking presentable onscreen, technological difficulties, and privacy or security.
Videoconferencing was regarded as the most personalized digital treatment, yet benefits unique to app-delivered and texting-based treatments included anonymity and access to treatment 24/7. Participants expected integrating social components into digital treatment to be useful for quit success and social connection, yet were concerned about possible interpersonal challenges.
CONCLUSIONS: Because a long history of quit attempts and familiarity with standard quitting advice is common among older adults who smoke cigarettes, digital platforms might offer appealing and novel strategies for cessation that are accessible and convenient. Overall, this population was open to trying digital cessation treatments and would prefer that these platforms prioritize ease of use and personalized content. These findings challenge the bias that older adults are uninterested or unwilling to engage with digital treatments for behavioral health.