Engagement with an online cessation support network (OCSN), such as New Zealand’s Quitline ‘Quit Blogs’ is associated with higher smoking abstinence rates. Because OCSNs have wide reach, 24/7 availability and low marginal cost, improvements in their efficacy may have high value. Greater knowledge of how OCSN users interact could inform innovations to increase engagement with OCSNs and improve the success of cessation attempts.
This ASPIRE2025 study aimed to identify patterns in individual use of the Quitline Quit Blogs and explore their implications for future intervention design by analysing metadata relating to 134,663 OCSN interactions during 2011 and 2012.
We found repeating periodic peaks and troughs in aggregate activity related to seasonality (e.g., New Year), external events, and day of the week. Highly engaged users contributed the majority of all OCSN interactions. The results suggest interventions targeted at specific user groups or defined points in time may promote activity, and hence cessation support, within OCSNs.
ABSTRACT
Objectives:
Online Cessation Support Networks (OCSNs) are associated with increased quit success rates, but few studies have examined their use over time. We identified usage patterns in New Zealand’s largest OCSN over two years and explored implications for OCSN intervention design and evaluation.
Methods:
We analysed metadata relating to 133,096 OCSN interactions during 2011 and 2012. Metrics covered aggregate network activity, user posting activity and longevity, and between-user commenting. Binary logistic regression models were estimated to investigate the feasibility of predicting low user engagement using early interaction data.
Results:
Repeating periodic peaks and troughs in aggregate activity related not only to seasonality (e.g., New Year), but also to day of the week. Out of 2,062 unique users, 69 Highly Engaged Users (180+ interactions each) contributed 69% of all OCSN interactions in 2012 compared to 1.3% contributed by 864 Minimally Engaged Users (<= 2 items each). The proportion of Highly Engaged Users increased with network growth between 2011 and 2012 (with marginal significance), but the proportion of Minimally Engaged Users did not decline substantively. First week interaction data enabled identification of Minimally Engaged Users with high specificity and sensitivity (AUROC = 0.94).
Implications:
Results suggest future research should develop and test interventions that promote activity, and hence cessation support, amongst specific user groups or at key time points. For example, early usage information could help identify Minimally Engaged Users for tests of targeted messaging designed to improve their integration into, or re-engagement with, the OCSN. Furthermore, although we observed strong growth over time on varied metrics including posts and comments, this change did not coincide with large gains in first-time user persistence. Researchers assessing intervention effects should therefore examine multiple measures when evaluating changes in network dynamics over time.
For more information please contact:
Ben Healey
University of Otago, Wellington
email: ben.healey@otago.ac.nz