Formative evaluation of a text messaging intervention to promote cessation medication adherence among tobacco-dependent persons with HIV

Introduction: Despite high motivation to quit smoking among people living with HIV/AIDS (PLWHA), research demonstrating effective approaches to treating nicotine dependence in this population is minimal. This study reports formative evaluation data from tobacco-dependent PLWHA (N=29) regarding a text message intervention to increase adherence to smoking cessation medication (Varenicline). Methods: Four focus groups were conducted using open-ended questions and survey measures to assess: a) beliefs and preferences regarding use of Varenicline, b) preferences for receiving tobacco-related texts, and c) acceptability of 100 draft text messages. Results: Themes that emerged from the focus groups were: 1) participants have misgivings and want to discuss Varenicline carefully with healthcare providers, 2) they prefer simple messages that were positive and encouraging, 3) messages should emphasize tobacco cessation and not Varenicline adherence, and 4) that texts would serve as a reminder about goals and foster support and connectedness with the healthcare team. Overall, 46 out of the 100 messages received a grade of C or less (rated on 5 point scale from A-F), the majority of which focused on medication adherence. All participants reported that they were likely to read the messages and 77% of the participants felt that the messages were designed for them or other people like them. A majority (64%) indicated that they preferred receiving 2 or more messages per day. Implications: Receiving participant feedback provides critical input in intervention planning. This program could offer significant value and fill a gap in smoking cessation research in this understudied high-risk population.