# FHIR-ed Up for Tobacco Cessation

> **NIH NIH R43** · PRO-CHANGE BEHAVIOR SYSTEMS, INC. · 2021 · $378,553

## Abstract

Summary
Tobacco use remains the leading preventable cause of death in the US, contributing to more than 480,000
premature deaths each year. The well-established Tobacco Treatment Guidelines and recently released
American College of Cardiology Expert Consensus Decision Pathway for tobacco cessation treatment
underscore the need to conceptualize tobacco use as a chronic substance use disorder and to offer any patients
who use tobacco products brief interventions that include prescriptions for proven pharmacological smoking
cessation aids and proactive connections to evidence-based behavioral support. The rapid expansion of smart
phone capabilities enhances the potential for tobacco cessation apps to personalize behavior change guidance
and to send contextually relevant tailored behavior change nudges based not just on readiness to quit, but also
based on electronic heath record (EHR) data. Rich data from EHRs are now available to third-party apps from
the Health app (iOS) via Fast Healthcare Interoperability Resources (FHIR) standard Application
Programming Interface (API). The proposed research represents an innovative approach in that it will develop
and examine the feasibility, acceptability, and preliminary effects of FHIR-ed Up- a theoretically-grounded,
highly individualized tobacco cessation Health-Kit enabled app. Unlike existing tobacco cessation apps, FHIR-
ed Up will: 1) implement a full range of best practices in tailored health behavior change communications; 2)
individualize messaging based on Health app data and behavior change constructs; and 3) provide data and
key insights back to electronic health records via HL7 transmissions from the server-portion of the FHIR-ed
Up app. Developed in collaboration with interoperability and app development experts, FHIR-ed Up will
achieve sustained use by hyper-personalizing the user experience for patients and integrating actionable
insights seamlessly into the clinical workflow of their clinicians. Extensive end user and stakeholder input will
ensure FHIR-ed Up is designed for rapid dissemination. Potential end users (n=8 tobacco users aged 18 and
older) will be recruited via community and social media ads. Formative qualitative data will be combined with
input from four experts and five clinician stakeholders to develop a prototype of FHIR-ed Up. Iterative
usability testing (n=10) will allow the prototype to be refined before patients of an integrated delivery system
with an upcoming appointment (n=100) are recruited to participate in a 30-day pilot test. Pilot participants
will provide quantitative and qualitative data, and utilization and acceptability data will be examined. Pre-post
comparisons of psychosocial expectancies for smoking will provide preliminary data on the effects of the
program. Acceptability data from participating clinicians (n=5) who receive and deliver EHR prompts will also
be gathered. The results will inform program modifications needed to proceed with the Phase II ef...

## Key facts

- **NIH application ID:** 10156252
- **Project number:** 1R43HL156588-01A1
- **Recipient organization:** PRO-CHANGE BEHAVIOR SYSTEMS, INC.
- **Principal Investigator:** SARA S JOHNSON
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $378,553
- **Award type:** 1
- **Project period:** 2021-05-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10156252

## Citation

> US National Institutes of Health, RePORTER application 10156252, FHIR-ed Up for Tobacco Cessation (1R43HL156588-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10156252. Licensed CC0.

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