Evaluating Text Messaging Approaches to Promote Enrollment in Smoking Cessation Treatment Among Latino Adults: A Pragmatic Randomized Clinical Trial.

Abstract

Little is known about the use of text messages to promote enrollment in smoking cessation treatment. What is the impact of the number of outreach messages and monetary incentives on enrollment in smoking cessation treatment among Latino adults? This pragmatic randomized clinical trial used a 3 × 2 factorial design. The first factor, monetary incentives, comprised 3 conditions: (1) receiving a small fixed amount ($5.00) when enrolling, (2) receiving a chance to win a large amount ($200.00) when enrolling, and (3) no monetary incentive when enrolling. The second factor, number of cycles, comprised 2 conditions: (1) 1 cycle of messages and (2) 4 cycles of messages. Latino adults who smoke (n = 2,826) were identified in electronic medical records. Participants were randomized in a 1:1:1 ratio to receive 1 of 3 monetary incentive conditions and in a 1:2 ratio to receive 1 or 4 cycles of messages. The main outcome was enrollment in a smoking cessation text messaging intervention. Enrollment rates ranged from 1.3% for the group that received no monetary incentive for enrollment and 1 cycle of messages to 5.4% for the group that received a fixed amount for enrollment and 4 cycles of messages. Receiving 4 cycles of messages was associated with a higher likelihood of enrollment compared with receiving 1 cycle of messages (OR, 1.92 [95% CI, 1.22-3.01]; P < .01). Monetary incentives were not associated with enrollment. Among Latino adults, enrollment in smoking cessation treatment increased significantly with an increasing number of cycles. In contrast, monetary incentives did not increase enrollment. Although modest, the 5.3% enrollment rate found among participants who received 4 cycles of messages and no monetary incentive can inform future population-level efforts to advance smoking cessation among Latino adults. ClinicalTrials.gov; No.: NCT05722132; URL: www. gov.