Applying Collective Intelligence in Health Recommender Systems for Smoking Cessation: A Comparison Trial

Background: Health recommender systems (HRSs) are intelligent systems that can be used to tailor digital health interventions. We compared two HRSs to assess their impact providing smoking cessation support messages. Methods: Smokers who downloaded a mobile app to support smoking abstinence were randomly assigned to two interventions. They received personalized, ratable motivational messages on the app. The first intervention had a knowledge-based HRS (n = 181): it selected random messages from a subset matching the users' demographics and smoking habits. The second intervention had a hybrid HRS using collective intelligence (n = 190): it selected messages applying the knowledge-based filter first, and then chose the ones with higher ratings provided by other similar users in the system. Both interventions were compared on: (a) message appreciation, (b) engagement with the system, and (c) one's own self-reported smoking cessation status, as indicated by the last seven-day point prevalence report in different time intervals during a period of six months. Results: Both interventions had similar message appreciation, number of rated messages, and abstinence results. The knowledge-based HRS achieved a significantly higher number of active days, number of abstinence reports, and better abstinence results. The hybrid algorithm led to more quitting attempts in participants who completed their user profiles.