Actívatexto: Advancing smoking cessation and physical activity among Latinos

PROJECT SUMMARY Overcoming the burden of tobacco use among Latinos demands innovative, effective, accessible, culturally appropriate, and community-engaged solutions. Over the past eight years, in partnership with the Latinos Contra el Tabaco (Spanish for: Latinos Against Tobacco) Community Advisory Board (CAB), our team has developed Decídetexto, the first culturally-accommodated smoking cessation text messaging intervention for Latinos (available in English and Spanish). Our recently completed randomized controlled trial (RCT; n=457) demonstrated that Latinos receiving the Decídetexto intervention were significantly more likely than those receiving standard of care (smoking cessation printed materials) to be smoking abstinent at Month 6 (34.1% vs 20.6%; p<0.001). Despite the proven efficacy of Decídetexto among Latinos, we did not address the fact that 75% of participants did not meet the recommended levels of physical activity [at least 150 minutes of moderate to vigorous physical activity (MVPA) per week]. Moreover, we did not leverage the potential role of physical activity in enhancing cessation rates despite evidence suggesting that MVPA may enhance cessation rates. Thus, we developed Actívatexto, an innovative mobile intervention that incorporates physical activity into the Decídetexto intervention. Specifically, Actívatexto integrates four components: 1) a text messaging program that promotes both smoking cessation and physical activity, 2) wearable devices to monitor physical activity, 3) smoking cessation pharmacotherapy (i.e., nicotine replacement therapies), and 4) an online dashboard where the research team manages participants’ incoming and outgoing data from both the text messaging program and wearable devices. Pilot tested among Latinos who smoke and do not meet the recommended levels of physical activity (n=20), Actívatexto generated high satisfaction, increased minutes of MVPA per week, and resulted in noteworthy cessation rates (70% of participants were smoking abstinent at Month 3). Our multidisciplinary team is uniquely poised to conduct the first comprehensive research effort to study the synergism of smoking cessation and physical activity in a mobile intervention among Latinos. We will use a hybrid type I effectiveness- implementation research design to assess the efficacy of Actívatexto and the barriers and facilitators of its implementation. Specific aims are: Aim 1. Assess the efficacy of Actívatexto, a mobile intervention that promotes both smoking cessation and physical activity, compared to a mobile intervention that solely promotes smoking cessation, on smoking abstinence at Month 6 among Latinos. Aim 2. Assess physical activity, self-efficacy, and perceived stress as mediators of the presumed treatment effect on cotinine-verified 7-day point prevalence abstinence at Month 6 among Latinos. Aim 3. Examine the barriers and facilitators to implement Actívatexto among Latinos.