Olga Perski

University of California, San Diego | UCSD · Herbert Wertheim School of Public Health and Human Longevity Science

UNSTRUCTURED Digital Therapeutics (DTx) are seen as a promising way to provide safe, effective, accessible, sustainable, scalable, and equitable approaches to advance individual, population, and public health. Developing DTx is inherently complex in that DTx may include multiple interacting components, such as tools to support activities like medic...

Introduction: Smoking lapses after the quit date often lead to full relapse. To inform the development of real-time, tailored lapse prevention support, we used observational data from a popular smoking cessation app to develop supervised machine learning algorithms to distinguish lapse from non-lapse reports. Methods: We used data from app users...

BACKGROUND With the proliferation of digital mental health interventions (DMHIs) guided by relational agents, little is known about the behavioral, cognitive and affective engagement components associated with symptom improvement over time. Obtaining a better understanding could lend clues about recommended use for particular subgroups of the popul...

Background: Several personality traits have been linked to addictive behaviours, including smoking and excessive drinking. We hypothesised that the combination of low conscientiousness, high extraversion and high neuroticism would be synergistically associated with smoking, excessive drinking and both behaviours combined. Methods: Respondents aged...

Background and aims: When attempting to stop smoking, discrete smoking events ('lapses') are strongly associated with a return to regular smoking ('relapse'). No study has yet pooled the psychological and contextual antecedents of lapse incidence, captured in Ecological Momentary Assessment (EMA) studies. This systematic review and meta-analysis a...

Aim To evaluate the effectiveness of the offer of Smoke Free – an evidence-informed, widely used app – for smoking cessation versus no support. Design Two-arm individually randomised controlled effectiveness trial. Setting Online with no restrictions on location. Participants 3,143 adult smokers (74.7% female; mean[SD] age 49.0 [11.5] years) mot...

As early career researchers (ECRs), our work and scientific practices are situated in a fast-changing and ever-evolving research landscape. We also live in times of great geopolitical and economic uncertainty. At the time of writing, we are in the midst of a global viral pandemic, with a need for rapid scientific insight into how the SARS-CoV-2 vir...

Background: The first UK COVID-19 lockdown had a polarising impact on drinking behaviour and may have impacted engagement with digital interventions to reduce alcohol consumption. Objective: We examined the effect of lockdown on engagement, alcohol reduction and the socio-demographic characteristics among users of the popular and widely availabl...

BACKGROUND The first UK COVID-19 lockdown had a polarising impact on drinking behaviour and may have impacted engagement with digital interventions to reduce alcohol consumption. OBJECTIVE We examined the effect of lockdown on engagement, alcohol reduction and the socio-demographic characteristics among users of the popular and widely available al...

BACKGROUND: Little is known about how individuals engage over time with smartphone app interventions and whether this engagement predicts health outcomes. OBJECTIVE: In the context of a randomized trial comparing 2 smartphone apps for smoking cessation, this study aimed to determine distinct groups of smartphone app log-in trajectories over a 6-mon...

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psych...

Background and Aims: When attempting to stop smoking, discrete smoking events (‘lapses’) are strongly associated with a return to regular smoking (‘relapse’). No study has yet pooled the psychological and contextual antecedents of lapse incidence, captured in Ecological Momentary Assessment (EMA) studies. This systematic review and meta-analysis ai...

Temporary smoking episodes after the quit date ('lapses') often lead to full relapse. Real-time support delivered via technology-mediated just-in-time adaptive interventions (JITAIs) offer a promising means of preventing lapses. To inform JITAI development, we used observational data from a popular smoking cessation app ('Smoke Free') to develop su...

Background Engagement with smartphone apps for smoking cessation tends to be low. Chatbots (ie, software that enables conversations with users) offer a promising means of increasing engagement. Objective We aimed to explore smokers’ experiences with a quick-response chatbot (Quit Coach) implemented within a popular smoking cessation app and identi...

Individual-level interventions for smokers unmotivated to quit remain scarce and have had limited success. Little is known about the potential of virtual reality (VR) for delivering messaging to smokers unmotivated to quit. This pilot trial aimed to assess the feasibility of recruitment and acceptability of a brief, theory-informed VR scenario and...

Smoking prevalence in several high-income countries is steadily declining but remains persistently high in ‘lower’ socioeconomic position (SEP) groups, contributing to inequities in morbidity and mortality. Smoking to relieve stress is a commonly endorsed motive for continued smoking; however, it remains unclear whether smoking to relieve stress ha...

Background: Little is known about how individuals engage over time with smartphone application interventions and whether this engagement predicts health outcomes. Objective: In the context of a randomized trial comparing two smartphone applications (apps) for smoking cessation, to determine: (1) distinct groups of smartphone app login trajectori...

Introduction: It has been estimated that smokers tend to fail to report unsuccessful quit attempts that lasted a short time and occurred a longer time ago. However, it is unclear whether the failure to report unsuccessful quit attempts varies by the type of cessation aid used. Methods: A total of 5,892 smokers aged 16+ years who had made 1+ quit...

BACKGROUND Drink Less is a behavior change app to help higher-risk drinkers in the United Kingdom reduce their alcohol consumption. The app includes a daily notification asking users to “ Please complete your drinks and mood diary, ” yet we did not understand the causal effect of the notification on engagement nor how to improve this component of D...

Background: Drink Less is a behavior change app to help higher-risk drinkers in the United Kingdom reduce their alcohol consumption. The app includes a daily notification asking users to "Please complete your drinks and mood diary," yet we did not understand the causal effect of the notification on engagement nor how to improve this component of D...

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psych...

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools acr...

BACKGROUND Engagement with smartphone apps for smoking cessation tends to be low. Chatbots (ie, software that enables conversations with users) offer a promising means of increasing engagement. OBJECTIVE We aimed to explore smokers’ experiences with a quick-response chatbot ( Quit Coach ) implemented within a popular smoking cessation app and iden...

Background: Several personality traits have been linked to addictive behaviours, including smoking and excessive drinking. We hypothesised that the combination of low conscientiousness, high extraversion and high neuroticism would be synergistically associated with smoking, excessive drinking and both behaviours combined. Methods: Respondents aged...

Background: It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We first examined the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory viral infections a year previous. Second, we examined the concordance between smoking status recorded on the electronic he...

This study investigated UK adults’ changes in cigarette smoking and vaping during the COVID-19 pandemic and factors associated with any changes. Data were from an online longitudinal study. A self-selected sample (n = 332) of 228 smokers and 155 vapers (51 participants were both smokers and vapers) completed 5 surveys between April 2020 and June 20...

Background: Digital health devices, such as health and well-being smartphone apps, could offer an accessible and cost-effective way to deliver health and well-being interventions. A key component of the effectiveness of health and well-being apps is user engagement. However, engagement with health and well-being apps is typically poor. Previous st...

Background: Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. Drink Less is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refi...

Background: It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We first examined the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory viral infections a year previous. Second, we examined the concordance between smoking status recorded on the electronic he...

Background Improving adherence to self-protective behaviours is a public health priority. We aimed to assess the potential effectiveness and ease of use of an online version of the Risk Acceptance Ladder (RAL) in promoting help-seeking for cigarette smoking, excessive alcohol consumption, insufficient physical activity, or low fruit and vegetable c...

Introduction: Considerable observational evidence suggests that cancer online support groups reduce feelings of isolation, depression and anxiety, enhance coping and self-management, and lead to better informed patients. Other studies indicate that cancer online support groups can increase distress. Yet no studies theorise the complex, context-dep...

Background and Aims Lapse risk when trying to stop or reduce harmful substance use is idiosyncratic, dynamic and multi-factorial. Just-in-time adaptive interventions (JITAIs) aim to deliver tailored support at moments of need or opportunity. We aimed to synthesise evidence on decision points, tailoring variables, intervention options, decision rule...

Background: It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We first examined the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory viral infections a year previous. Second, we examined the concordance between smoking status recorded on the electronic he...

Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity in hospitalised patients, and iv) mortality from SARS-CoV-2/COVID-19 disease. Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and...

AIMS: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity in hospitalised patients, and iv) mortality from SARS-CoV-2/COVID-19 disease. DESIGN: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and...

Introduction Ecological momentary assessment (EMA) involves repeated, real-time assessments of phenomena (eg, cognitions, emotions, behaviours) over a period of time in naturalistic settings. EMA is increasingly used to study both within-person and between-person processes. We will review EMA studies investigating key health behaviours and synthesi...

Background: Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. Drink Less is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refi...

BACKGROUND: Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. Drink Less is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refi...

Purpose: Increasing personal protective behaviours is critical for stopping the spread of respiratory viruses, including SARS-CoV-2: We need evidence to inform how to achieve this. We aimed to synthesize evidence on interventions to increase six personal protective behaviours (e.g., hand hygiene, face mask use, maintaining physical distancing) to...

Despite the positive health effect of physical activity, one third of the world’s population is estimated to be insufficiently active. Prior research has mainly investigated physical activity on an aggregate level over short periods of time, e.g., during 3 to 7 days at baseline and a few months later, post-intervention. To develop effective interve...

Acceptability is a core concept in digital health. Available frameworks have not clearly articulated why and how researchers, practitioners and policy makers may wish to study the concept of acceptability. Here, we aim to discuss (i) the ways in which acceptability might differ from closely related concepts, including user engagement; (ii) the util...

PURPOSE: Increasing personal protective behaviours is critical for stopping the spread of respiratory viruses, including SARS-CoV-2: we need evidence to inform how to achieve this. We aimed to synthesise evidence on interventions to increase six personal protective behaviours (e.g. hand hygiene, face mask use) to limit the spread of respiratory vir...

BACKGROUND Digital health media, such as health and wellbeing smartphone apps, could offer an accessible and cost-effective way to deliver health and wellbeing interventions. A key component of the effectiveness of these apps is user engagement. However, engagement with health and wellbeing apps is typically sub-optimal. Previous studies have ident...

Background Digital health devices, such as health and well-being smartphone apps, could offer an accessible and cost-effective way to deliver health and well-being interventions. A key component of the effectiveness of health and well-being apps is user engagement. However, engagement with health and well-being apps is typically poor. Previous stud...

Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identifi...

AIMS: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. DESIGN: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identifi...

Aims To explore i) associations between vaping and self-reported diagnosed/suspected Covid-19; ii) changes in vaping since Covid-19 and factors associated with these changes; iii) whether Covid-19 motivated current or recent ex-vapers to quit. Methods Cross-sectional online survey of 2791 UK adults recruited 30/04/2020–14/06/2020. Participants sel...

Objectives. User engagement with health and wellbeing apps is typically poor. Understanding factors that influence engagement can inform the design of more engaging apps. This study explored users’ experiences of and reasons for engaging and not engaging with health and wellbeing apps. / Methods. UK-based adults (N=17) interested in using a health...

BACKGROUND Health and wellbeing smartphone apps can be identified through different routes, including via curated health app portals, but little is known about people’s experiences of this. OBJECTIVE This study explored how people select health apps online and their views on curated portals. METHODS Eighteen UK-based adults were recruited and ask...

Background Health and well-being smartphone apps can provide a cost-effective solution to addressing unhealthy behaviors. The selection of these apps tends to occur in commercial app stores, where thousands of health apps are available. Their uptake is often influenced by popularity indicators. However, these indicators are not necessarily associat...

Introduction: Using WebQuit as a case study, a smoking cessation website grounded in Acceptance and Commitment Therapy, we aimed to identify sequence clusters of content usage and examine their associations with baseline characteristics, change to a key mechanism of action, and smoking cessation. Methods: Participants were adult smokers allocate...

Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identifi...

Background: Smartphone apps are increasingly used for health-related behaviour change and people discover apps through different sources. However, it is unclear whether users differ by mode of app discovery. Drink Less is an alcohol reduction app that received national media coverage in the UK caused by celebrity influence (a male TV and radio nati...

PURPOSE: Changing human behaviour is critical for stopping the spread of respiratory viruses, including SARS-CoV-2. This includes increasing personal protective behaviours: we need evidence to inform how to achieve this. We aimed to evaluate the acceptability, practicability, effectiveness, affordability, spill-over effects and equity impact of int...

Despite the positive health effect of physical activity, one third of the world’s population is estimated to be insufficiently active. Prior research has mainly investigated physical activity on an aggregate level over short period of time, e.g., during 3 to 7 days at baseline and few-month later, post intervention. To develop effective interventio...

Aims To explore i) associations between vaping and self-reported diagnosed/suspected Covid-19; ii) changes in vaping since Covid-19 and factors associated with these changes; iii) whether Covid-19 motivated current or recent ex-vapers to quit. Methods Cross-sectional online survey of 2791 UK adults recruited 30/04/2020–14/06/2020. Participants sel...

BACKGROUND: Behavior change apps can develop iteratively, where the app evolves into a complex, dynamic, or personalized intervention through cycles of research, development, and implementation. Understanding how existing users engage with an app (eg, frequency, amount, depth, and duration of use) can help guide further incremental improvements. We...

Background It is unclear whether smoking increases the risk of COVID-19 hospitalisation. We aimed to i) examine the association of smoking status with hospitalisation for COVID-19 compared with hospitalisation for other respiratory virus infections a year previous; ii) compare current smoking in cases with age- and sex-matched London prevalence; an...

Background/Aim: We have a limited understanding of the broader determinants of health of international migrants and how these change over time since migration to the United Kingdom (UK). To address this knowledge gap, we aim to conduct a prospective cohort study with data acquisition via a smartphone application (app). In this pilot study, we aim t...

Background/Aim : We have a limited understanding of the broader determinants of health of international migrants and how these change over time since migration to the United Kingdom (UK). To address this knowledge gap, we aim to conduct a prospective cohort study with data acquisition via a smartphone application (app). In this pilot study, we aim...

Introduction Smoking prior to major thoracic surgery is the biggest risk factor for development of postoperative pulmonary complications, with one in five patients continuing to smoke before surgery. Current guidance is that all patients should stop smoking before elective surgery yet very few are offered specialist smoking cessation support. Patie...

AIMS: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. DESIGN: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identifi...

Aims To estimate the association of smoking status with rates of (i) infection, (ii) hospitalization, (iii) disease severity and (iv) mortality from SARS‐CoV‐2/COVID‐19 disease. Design Living rapid review of observational and experimental studies with random‐effects hierarchical Bayesian meta‐analyses. Published articles and pre‐prints were identi...

Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identifi...

Introduction and aims: We aimed to explore UK-based Punjabi-Sikh men's views on: (i) alcohol consumption within the community; (ii) available support for alcohol reduction; and (iii) an evidence-informed alcohol reduction app. Design and methods: Semi-structured interviews and a think aloud method were employed. Participants (n = 15) were male,...