@Article{info:doi/10.2196/10976,
author="Brinker, Titus Josef
and Brieske, Christian Martin
and Esser, Stefan
and Klode, Joachim
and Mons, Ute
and Batra, Anil
and R{\"u}ther, Tobias
and Seeger, Werner
and Enk, Alexander H
and von Kalle, Christof
and Berking, Carola
and Heppt, Markus V
and Gatzka, Martina V
and Bernardes-Souza, Breno
and Schlenk, Richard F
and Schadendorf, Dirk",
title="A Face-Aging App for Smoking Cessation in a Waiting Room Setting: Pilot Study in an HIV Outpatient Clinic",
journal="J Med Internet Res",
year="2018",
month="Aug",
day="15",
volume="20",
number="8",
pages="e10976",
keywords="face aging; smoking cessation; HIV; mobile apps; HIV patients; HIV seropositivity; smoking; cessation; tobacco smoking; morphing",
abstract="Background: There is strong evidence for the effectiveness of addressing tobacco use in health care settings. However, few smokers receive cessation advice when visiting a hospital. Implementing smoking cessation technology in outpatient waiting rooms could be an effective strategy for change, with the potential to expose almost all patients visiting a health care provider without preluding physician action needed. Objective: The objective of this study was to develop an intervention for smoking cessation that would make use of the time patients spend in a waiting room by passively exposing them to a face-aging, public morphing, tablet-based app, to pilot the intervention in a waiting room of an HIV outpatient clinic, and to measure the perceptions of this intervention among smoking and nonsmoking HIV patients. Methods: We developed a kiosk version of our 3-dimensional face-aging app Smokerface, which shows the user how their face would look with or without cigarette smoking 1 to 15 years in the future. We placed a tablet with the app running on a table in the middle of the waiting room of our HIV outpatient clinic, connected to a large monitor attached to the opposite wall. A researcher noted all the patients who were using the waiting room. If a patient did not initiate app use within 30 seconds of waiting time, the researcher encouraged him or her to do so. Those using the app were asked to complete a questionnaire. Results: During a 19-day period, 464 patients visited the waiting room, of whom 187 (40.3{\%}) tried the app and 179 (38.6{\%}) completed the questionnaire. Of those who completed the questionnaire, 139 of 176 (79.0{\%}) were men and 84 of 179 (46.9{\%}) were smokers. Of the smokers, 55 of 81 (68{\%}) said the intervention motivated them to quit (men: 45, 68{\%}; women: 10, 67{\%}); 41 (51{\%}) said that it motivated them to discuss quitting with their doctor (men: 32, 49{\%}; women: 9, 60{\%}); and 72 (91{\%}) perceived the intervention as fun (men: 57, 90{\%}; women: 15, 94{\%}). Of the nonsmokers, 92 (98{\%}) said that it motivated them never to take up smoking (men: 72, 99{\%}; women: 20, 95{\%}). Among all patients, 102 (22.0{\%}) watched another patient try the app without trying it themselves; thus, a total of 289 (62.3{\%}) of the 464 patients were exposed to the intervention (average waiting time 21 minutes). Conclusions: A face-aging app implemented in a waiting room provides a novel opportunity to motivate patients visiting a health care provider to quit smoking, to address quitting at their subsequent appointment and thereby encourage physician-delivered smoking cessation, or not to take up smoking. ",
issn="1438-8871",
doi="10.2196/10976",
url="http://www.jmir.org/2018/8/e10976/",
url="https://doi.org/10.2196/10976",
url="http://www.ncbi.nlm.nih.gov/pubmed/30111525"
}