A novel air quality feedback intervention trial using mHealth techniques across four European countries: the TackSHS Project Measuring for Change Study

Introduction Second-hand tobacco smoke exposure is a cause of serious ill-health for children, and in most European countries this exposure occurs predominantly in the home. There is therefore a great deal of research interest in reducing smoking at home, but few behaviour change interventions have been designed which are proven to promote smoke-free homes effectively. Within the TackSHS Project (www.tackshs.eu), the aim of “Measuring for Change” study was to design, implement and evaluate an intervention to promote smoke-free homes. Methods In this study, we monitored air quality (PM2.5 concentrations) in participants’ homes over one month. The intervention was conducted over the second and third weeks of the monitoring period to allow a week to measure baseline levels and a week after the intervention to estimate the changes in each participant home. During the two weeks of the intervention we have used mHealth techniques including daily SMS messages and weekly emails with visualisations of air quality data to provide participants with relevant, up-to-date information on the effect of smoking on their home’s air quality. Results In interim results from four centres in Scotland, Italy and Greece (55 households) the intervention was shown to lead to a small but significant decline of 21% (10% to 34%) in measured PM 2.5 between baseline and follow-up measurement periods, and to a fall in the amount of time that intervention homes had PM2.5 concentrations higher than the WHO guideline level. Conclusion Future interventions to reduce SHS exposure at home should consider the use of mHealth techniques and the advantages of internet-based monitoring to provide up-to-date feedback to participants.