Tag Archives: Eline Smit

Altendorf, M.B., van Weert, J.C.M., Hoving, C., Smit, E.S. (2019). Should or could? Testing the use of autonomy-supportive language and the provision of choice in online computer-tailored alcohol reduction communication, Digital Health, 5, 1-15, DOI: 10.1177/2055207619832767

Abstract:

Individuals can feel more motivated to change health behaviour when perceiving autonomy-support, as induced through non-pressuring message phrasing and the provision of choice: autonomy-supportive message framing. Additionally, controlling message phrasing – commands that do not provide choice – can thwart autonomy and lead to reactance, which is detrimental to the persuasiveness of health messages. Many health messages have not been formulated in an autonomy-supportive manner and therefore could arouse reactance, resulting in reduced intervention effectiveness. We aimed to test the effects of autonomy-supportive vs. controlling alcohol reduction message frames on individuals’ perceived autonomy-support from these messages; and their reactance towards the message while considering the individual need for autonomy in the context of an online computer-tailored alcohol reduction intervention. A 2 (autonomy-supportive language vs. controlling language) × 2 (choice vs. no choice) between-subjects experiment (N = 521) was conducted using an online computer-tailored alcohol reduction intervention. Outcome measures were perceived autonomy-support and reactance and we investigated whether an individual’s need for autonomy moderated the effect of autonomy-supportive and controlling message frames on those outcome variables. Multiple linear regression analyses showed that neither autonomy-supportive nor controlling message frames had significant effects on perceived autonomy-support or reactance, and there was no moderation from the need for autonomy. Overall, participants evaluated the intervention as positive and perceived high levels of autonomy-support, regardless of the message frame used. Future research needs to test whether the positive intervention evaluation is due to content tailoring, and whether more distinguishable manipulations of message frames could be effective.

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De Ruijter, D., Hoving, C., Evers, S., Hudales, R., de Vries, H., Smit, E.S. (2019). An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses, Patient Education & Counseling, 02(10), 1802-1811, DOI: 10.1016/j.pec.2019.07.015

Abstract:

Objective

To conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses’ smoking cessation guideline adherence.

Methods

The economic evaluation was embedded in a randomized controlled trial, in which 269 practice nurses recruited 388 smoking patients. Cost-effectiveness was assessed using guideline adherence as effect measure on practice nurse level, and continued smoking abstinence on patient level. Cost-utility was assessed on patient level, using patients’ Quality Adjusted Life Years (QALYs) as effect measure.

Results

The e-learning program was likely to be cost-effective on practice nurse level, as adherence to an additional guideline step cost €1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: €7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: €18,431) on patient level.

Conclusion

Providing practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Though, cost-effectiveness on patient level was not found after twelve months, potentially resulting from smoking relapse.

Practice implications

Widespread implementation of the e-learning program can improve the quality of smoking cessation care in general practice. Strategies to prevent patients’ smoking relapse should be further explored to improve patients’ long-term abstinence.

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Altendorf, M.B., Hoving, C., van Weert J.C.M., Smit, E.S. (2020). Effectiveness of Message Frame-Tailoring in a Web-based Smoking Cessation Program: Randomized Controlled Trial. Journal of Medical Internet Research, 22(4):e17251.

Abstract:

Background: The content of online computer-tailored interventions is often determined to match an individual’s characteristics, beliefs, and behavioral factors. These content-tailored interventions lead to better message processing and a higher likelihood of behavior change such as smoking cessation. However, a meta-analysis of online computer-tailored interventions showed that effect sizes, albeit positive, remain small, suggesting room for improvement. A promising strategy to enhance the effectiveness of online computer-tailored interventions is to tailor the message frame (ie, how a message is communicated) based on the preferred communication style of the user in addition to content-tailoring. One factor that determines an individual’s communication style preference is the need for autonomy; some individuals prefer an autonomy-supportive communication style (offering choice and use of suggestive language), whereas others might prefer a directive communication style, which is replete with imperatives and does not provide choice. Tailoring how messages are presented (eg, based on the need for autonomy) is called message frame-tailoring.

Objective: The aim of the present study was to test the effectiveness of message frame-tailoring based on the need for autonomy, in isolation and in combination with content-tailoring, within the context of an online computer-tailored smoking cessation intervention. The primary outcome measure was the 7-day point-prevalence of smoking abstinence. Secondary outcomes were perceived message relevance, self-determined motivation to quit smoking, and sociocognitive beliefs.

Methods: A randomized controlled trial with a 2 (message frame-tailoring vs no message frame-tailoring) by 2 (content-tailoring vs no content-tailoring) design was conducted among adult smokers intending to quit smoking (N=273).

Results: Structural equation modeling revealed that the content-tailored condition increased smoking abstinence rates 1 month after the start of the intervention (beta=.57, P=.02). However, neither message frame-tailoring nor its interaction with content-tailoring significantly predicted smoking abstinence. In our model, message frame-tailoring, content-tailoring, as well as their interaction significantly predicted perceived relevance of the smoking cessation messages, which consequently predicted self-determined motivation. In turn, self-determined motivation positively affected attitudes and self-efficacy for smoking cessation, but only self-efficacy consequently predicted smoking abstinence. Participants in the control condition perceived the highest level of message relevance (mean 4.78, SD 1.27). However, messages that were frame-tailored for individuals with a high need for autonomy in combination with content-tailored messages led to significantly higher levels of perceived message relevance (mean 4.83, SD 1.03) compared to those receiving content-tailored messages only (mean 4.24, SD 1.05, P=.003).

Conclusions: Message frame-tailoring based on the need for autonomy seems to be an effective addition to conventional content-tailoring techniques in online smoking cessation interventions for people with a high need for autonomy; however, this is not effective in its current form for people with a low need for autonomy.

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Eline Smit and colleagues receive a ZonMw grant

Together with colleagues from Maastricht (a/o Dr. Ciska Hoving) and Leiden Universities (a/o Dr. Matty Crone), ACHC researcher Eline Smit has received a grant from ZonMw to identify the effective ingredients in smoking cessation interventions available in the Netherlands (€49.525).

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Smit, E.S., Short, C.E., Vandelanotte, C., De Vries, H. (2019). Digital Health & Computer-Tailoring: The launch of an EHPS Special Interest Group, European Health Psychologist, 20(6), 568-572.

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Smit, E.S., Zeidler, C., Resnicow, K., de Vries, H. (2019). Identifying the Most Autonomy-Supportive Message Frame in Digital Health Communication: A 2×2 Between-Subjects Experiment, Journal of Medical Internet Research, 21(10):e1407.

Abstract:
BACKGROUND:
The effectiveness of digital health communication may be increased by enhancing autonomy supportiveness.
OBJECTIVE:
This study aimed to identify the most autonomy-supportive message frame within an intervention for increasing vegetable intake by testing the effect of the following 2 strategies: (1) using autonomy-supportive language and (2) providing choice.
METHODS:
A Web-based 2 (autonomy-supportive vs controlling language)×2 (choice vs no choice) experiment was conducted among 526 participants, recruited via a research panel. The main outcome measures were perceived autonomy support (measured using the Virtual Care Climate Questionnaire, answered with scores 1 to 5), perceived relevance (measured with one question, answered with scores 1 to 5), and overall evaluation of the intervention (measured with 1 open-ended question, answered with scores 1 to 10).
RESULTS:
Choice had a significant positive effect on the overall evaluation of the intervention (b=.12; P=.003), whereas for participants with a high need for autonomy, there was a significant positive effect on perceived relevance (b=.13; P=.02). The positive effect of choice on perceived autonomy support approached significance (b=.07; P=.07). No significant effects on any of the three outcomes were observed for language.
CONCLUSIONS:
Results suggest that provision of choice rather than the use of autonomy-supportive language can be an easy-to-implement strategy to increase the effectiveness of digital forms of health communication, especially for people with a high need for autonomy.

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Bol, N., Høie, N.M., Nguyen, M.H., Smit, E.S. (2019). Customization in mobile health apps: Explaining Effects on Physical Activity Intentions by the Need for Autonomy, Digital Health, 5, 1-12.

Abstract:
Given the widespread adoption and technical possibilities of mobile technology, mobile health apps could be potentially effective tools to intervene in people’s daily routines and stimulate physical activity. Self-determination theory and the motivational technology model both suggest that mobile technology can promote health behaviour change by allowing users to customize their online experience when using mobile health apps. However, we know very little about why and for whom customization is most effective. Using a between-subjects experimental design, we tested the effects of customization in mobile health apps among a convenience sample (N = 203). We assessed the effects of customization on perceived active control over mobile health apps, autonomous motivation to use mobile health apps, and intention to engage in physical activity, and tested the moderating role of need for autonomy. Structural equation modelling showed that customization in mobile health apps does not increase perceived active control, autonomous motivation, or the intention to engage in physical activity. However, an interaction effect between customization and need for autonomy showed that customization in mobile health apps leads to higher intentions to engage in physical activity for those with a greater need for autonomy, but not for those with a lesser need for autonomy. The implications for theory and practice are discussed.

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dr. Eline Smit

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Smit, E.S., Bol, N. (2020). From Self-Reliers to Expert-Dependents: Identifying Classes Based on Health-Related Need for Autonomy and Need for External Control Among Mobile Users, Media Psychology, 23:3, 391-414, DOI: 10.1080/15213269.2019.1604235

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Early Career Award for Eline Smit

This summer, Dr. Eline Smit received the prestigious Early Career Award from the European Health Psychology Society (EHPS). Continue reading >>

De Ruijter, D., Candel, M.J.J.M., Smit, E.S., de Vries, H., Hoving, C. (2018). The effectiveness of a computer-tailored e-learning program for practice nurses to improve their adherence to smoking cessation counseling guidelines: randomized controlled trial, Journal of Medical Internet Research, 20(5):e193, DOI:10.2196/jmir.9276

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Smit, E.S., Brinkhues, S., de Vries, H., Hoving, C. (2018). Do subgroups exist among smokers in the preparation stage of change? A cluster analysis, Substance Use & Misuse, 53(3), 400-511, DOI: 10.1080/10826084.2017.1334062

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Eline and Julia received grant from Dutch Cancer Society

On Christmas Eve, Eline and Julia received some good news: together with a colleague from Maastricht University, they were awarded a grant from the Dutch Cancer Society for a three-year PhD-project on the  effectiveness of message frame tailoring in online smoking cessation communication. Continue reading >>

‘You must drink less’ – and why this message often doesn’t work

Eline Smit received a Veni grant for research into tailor-made health communication.

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De Ruijter, D., Smit, E.S., De Vries, H., Goossens, L., Hoving, C. (2017). Exploring Dutch practice nurses’ needs for web-based support to improve their adherence to smoking cessation guidelines. BMJ Open, 7:e014154. doi: 10.1136/bmjopen-2016- 014154

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De Ruijter, D., Smit, E.S., De Vries, H., & Hoving, C. (2017). Factors influencing Dutch practice nurses’ adherence to evidence-based guidelines during smoking cessation counseling: A cross-sectional study. Family Practice. Advanced online publication. doi:10.1093/fampra/cmx039

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Smit, E. S., Dima, A. L., Immerzeel, S. A. M., Van den Putte, B., & Williams, G. C. (2017). The Virtual Care Climate Questionnaire: Development and validation of a questionnaire measuring perceived support for autonomy in a virtual care setting. Journal of Medical Internet Research, 19(5), e155. doi:10.2196/jmir.6714

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Blankers, M., Smit, E.S ., Van der Pol, P., De Vries, H., Hoving, C., & Van Laar, M. (2016). The missing=smoking assumption: A fallacy in internet-based smoking cessation trials? Nicotine and Tobacco Research, 18(1), 25-33. doi:10.1093/ntr/ntv055

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De Ruijter, D., Smit, E. S., De Vries, H., & Hoving, C. (2016). Web-based computer-tailoring for practice nurses aimed to improve smoking cessation guideline adherence: A study protocol for a randomized controlled effectiveness trial. Contemporary Clinical Trials, 48, 125–132. doi:10.1016/j.cct.2016.04.007

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Prenger, R., Pieterse, M.E., Braakman-Jansen, L.M.A., Feenstra, T. Smit, E.S., Hoving, C,… van der Palen, J. (2016). Dealing with delayed behavioral effects in health promotion research by modeling cognitive parameters in cost-effectiveness analyses of behavioral interventions: A validation study. Health Economics, 25(1), 24-39. doi:10.1002/hec.3119

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Smit, E. S., Candel, M. J. J. M., Hoving, C., & De Vries, H. (2016). Results of the PAS study: A randomized controlled trial evaluating the effectiveness of a web-based multiple tailored smoking cessation program combined with tailored counseling by practice nurses. Health Communication, 31(9), 1165–1173. doi:10.1080/10410236.2015.1049727

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Reinwand, D., Crutzen, R., Elfeddali, I., Schneider, F., Schulz, D.N., Smit, E.S., … De Vries, H. (2015). Impact of educational level on study attrition and appreciation of web-based computer-tailored interventions: Results from seven randomized controlled trials. Journal of Medical Internet Research, 17(10), e228. doi:10.2196/jmir.4941

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Smit, E. S., de Vries, H., Oberjé, E. J. M., & Evers, S. M. A. A. (2015). Easier said than done: Overcoming challenges in the economic evaluation of Internet-based lifestyle interventions. European Health Psychologist, 17(1), 39-44.

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Smit, E. S., Linn, A. J., & Van Weert, J. C. M. (2015). Taking online computer-tailoring forward: The potential of tailoring the message frame and delivery mode of online health behaviour change interventions. European Health Psychologist, 17(1), 25-31.

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Van Rossem, C., Spigt, M., Smit, E.S., Viechtbauer, W., Mijnheer, K., Van Schayck, C.P., & Kotz, D. (2015). Combining intensive practice nurse counselling or brief general practitioner advice with varenicline for smoking cessation in primary care: Study protocol of a pragmatic randomized controlled trial. Contemporary Clinical Trials, 41, 298-312. doi: 10.1016/j.cct.2015.01.017

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Hoving, C., Smit, E.S., & De Vries H. (2014). Wie kiest er voor PAS? Tijdschrift voor Praktijkondersteuning, 9(3), 66-71. doi:10.1007/s12503-014-0042-z

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Schulz, D. N., Smit, E. S., Stanczyk, N. E., Kremers, S. P. J., De Vries, H., & Evers, S. M. A. A. (2014). Economic evaluation of a web-based tailored lifestyle intervention for adults: Findings regarding cost-effectiveness and cost-utility from a Randomized Controlled Trial. Journal of Medical Internet Research, 16(3), e91. doi: 10.2196/jmir.3159

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Smit, E. S., Hoving, C., Schelleman-Offermans, K., West, R., & De Vries H. (2014). Predictors of successful and unsuccessful quit attempts among smokers motivated to quit. Addictive Behaviors, 39(9), 1318-1324. doi:10.1016/j.addbeh.2014.04.017

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Stanczyk, N. E., Bolman, C., Smit, E. S., Candel, M. J. J. M., Muris, J. W. M., & De Vries, H. (2014). How to encourage smokers to participate in web-based computer-tailored smoking cessation programs: A comparison of different recruitment strategies. Health Education Research, 29(1), 23-40. doi:10.1093/her/cyt104

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Stanczyk, N. E., Smit, E. S., Schulz, D. N., De Vries, H., Bolman, C., Muris, J. W. M., & Evers, S. M. A. A. (2014). An economic evaluation of a video- and text-based computer-tailored intervention for smoking cessation: A cost-effectiveness and cost-utility analysis of a randomized controlled trial. PlosOne, 9(10), e110117. doi:10.1371/journal.pone.0110117

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Willems, R.A., Willemsen, M.C., Smit, E.S., Nagelhout, G.E., Janssen, E., & De Vries, H. (2014). Which smoking cessation aids are proven effective according to smokers who want to quit smoking? A report from the Netherlands. Tobacco Control, 23(6), 525-526. doi: 10.1136/tobaccocontrol-2013-051076

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Smit, E. S., de Vries, H., de Munter, L., Hoving, C. (2013). Depressive symptoms’ association with smoking related cognitions and their influence on smoking cessation behaviour, OA Epidemiology, 1(2): 13.

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Smit, E.S., De Vries, H., & Hoving, C. (2013). Determinants of the intention to implement a new smoking cessation intervention in Dutch general practices. Journal of Advanced Nursing, 69(12), 2665-2674. doi: 10.1111/jan.12153

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Smit, E. S., Evers, S., De Vries, H., & Hoving, C. (2013). Cost-effectiveness and cost-utility of a web-based multiple tailored smoking cessation programme and tailored counseling by practice nurses. Journal of Medical Internet Research, 15(3), e57. doi:10.2196/jmir.2059

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Smit, E. S., Hoving, C., & De Vries, H. (2013). Persoonlijk Advies bij het Stoppen met roken: Online advies-op-maat via de huisartsenpraktijk [Personal Advice in Quitting Smoking: Web-based computer-tailoring via the general practice]. eSup, 3, 6-9.

Smit, E. S., De Vries, H., & Hoving, C. (2012). Effectiveness of a web-based multiple tailored smoking cessation programme: A randomized controlled trial. Journal of Medical Internet Research, 14(3), e82. doi:10.2196/jmir.1812

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Leitlein, L., Smit, E. S., De Vries, H., & Hoving, C. (2012). Factors influencing Dutch practice nurses’ intention to adopt the new smoking cessation intervention. Journal of Advanced Nursing, 68(10), 2185-2194. doi:10.1111/j.1365-2648.2011.05903.x

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Smit, E. S., Hoving, C., Cox, V. C. M., & De Vries, H. (2012). Praktijkondersteuners bereiken de gemotiveerde rokers [Practice nurses reach the motivated smokers]. Tijdschrift voor Praktijkondersteuning, 7(5), 118-124.

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Willems, R. A., Willemsen, M. C., Nagelhout, G. E., Smit, E. S., Janssen, E., Van den Putte, B., & De Vries, H. (2012). Evaluatie van de ‘Echt stoppen met roken kan met de juiste hulp’ campagne, Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University.

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Smit, E. S., Hoving, C., Cox, V. C. M., & De Vries, H. (2012). Influence of recruitment strategy on the reach and effect of a web‑based multiple tailored smoking cessation intervention amongst Dutch adult smokers. Health Education Research, 27(2), 191-199. doi:10.1093/her/cyr099

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