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The Ask
While the rates of smoking have reduced for the general population over the last 50 years, up to 80% of people with serious mental illness (SMI) are still smokers. This drastically underserved population, whose mental and behavioral diagnoses range from schizophrenia to chronic major depression, is estimated to smoke 45% of all cigarettes consumed in the United States. Out of the 530+ smoking cessation applications currently in-market, none directly address the unique needs of the SMI community, and only two have been tested with users, and none with SMI.
Furthermore, research shows that 70% of this population has some form of mobile device or direct access to the internet. With the belief that a clinically-supported mobile application could provide around-the-clock patient access and support, Dr. Roger Vilardaga of Duke University (and formally with the University of Washington) sought and received a grant by the National Institute of Drug Abuse and partnered with Smashing Ideas to create a smoking cessation application that used a new behavioral therapy approach, called Acceptance Commitment Therapy (ACT), to teach the SMI community the tools they needed to quit smoking.
Dr. Roger Vilardaga, Acting Assistant Professor at the Department of Psychiatry and Behavioral Sciences at the University of Washington https://cbsopenlab.com/
“Smashing Ideas became a true strategic partner by taking very complex treatment technique found in Acceptance Commitment Therapy and translated them into a digital experience I haven’t seen yet in smoking cessation mHealth.”– Dr. Roger Vilardaga, Associate Professor, Duke University
The Actualization
With the physical and behavioral limitations of the user group, the app was designed with a muted color palette to lessen sensitivity to over-stimulation, buttons were created instead of swiping to account for users with pharma-induced tremors, and simple illustrations conveyed complex, abstract concepts. Through progressive disclosure, the experience guides the user along a visual path to track progress, participate in multifaceted exercises throughout the duration of the journey, and plan for future success in becoming cigarette free. Each point in the journey provides them with positive reinforcement and lessons in which they’re able to understand their urges, rather than the standard approach of jumping straight into quitting, providing increased motivation to continue. As the user moves through the actual quitting process they track their mood, how physical aids are contributing, cost savings tallies, and are provided immediate access to a pre-designated quit coach via the application.
What began as 200 hours of patient testing with simple paper prototypes has progressed into a high-fidelity application that initially underwent rigorous National Institute of Health funded user testing through the University of Washington and Harborview Medical Center. Now at Duke University, Dr. Vilardaga is conducting a second phase of randomized clinical trials.
