Sitting in the chair during a routine dental appointment, while getting her teeth cleaned, Dr. Belinda Borrelli had an idea: “This would be a really good time for smoking cessation counseling,” she recalled thinking.
The idea didn’t come completely out of left field. Borrelli, professor of Health Policy & Health Services and director of the Center for Behavioral Sciences Research at the Henry M. Goldman School of Dental Medicine (GSDM), has been researching smoking cessation for 28 years and is an internationally recognized expert in the field.
Borrelli expanded her initial idea into a pilot study – and then, in August 2019, secured a $493,873 grant from the National Institute of Dental and Craniofacial Research (NIDCR) to expand the trial into a full-blown research study. If the study meets certain milestones over the first year, Borrelli will be eligible for an additional $4.1 million over the subsequent five years.
“I am so proud of Dr. Borrelli for receiving this prestigious grant,” said GSDM Dean Jeffrey W. Hutter. “Her hard work and dedication to the field of smoking cessation has not gone unnoticed. Please join me in congratulating her on this well-deserved accomplishment.”
The pilot trial included 23 adult dental patients who were current smokers. During their teeth cleaning, participants wore a virtual reality (VR) headset that delivered two five-minute long videos—one targeting the smokers who were not ready to quit, and one targeting those who were ready to quit. Borrelli decided to use VR glasses as she thought it would provide a more immersive and private experience.
“There were high levels of satisfaction,” said Borrelli, who noted that participants were interviewed after watching the video and filling out questionnaires. “Both the quantitative and the qualitative data indicated that participants had high levels of satisfaction with both the content of the video and the whole experience of watching it through the glasses.”
After 30 days, Borrelli found that five out of the 23 participants self-reported that they had quit smoking—the resultant numbers she said that were high for smoking cessation interventions, and, in particular, for a pilot study. Additionally, 14 participants attempted to quit for at least 24 hours.
“We weren’t expecting people to quit because it wasn’t an effectiveness study—it was a feasibility study, [to see] if it was going to work,” Borrelli said.
Borrelli submitted the study for an NIDCR grant, and received funding on the first try. The pilot study was also published by Translational Behavioral Medicine in October 2019.
Over the next year, Borrelli and her colleagues will expand the project. They will enroll 15 patients and will also interview the providers in the study, to make sure that the intervention has potential to integrate into the Patient Treatment Center.
The next phase of the study will also include a new component: a month-long interactive text message program that will motivate patients to connect with smoking cessation resources, including a smoking cessation telephone service (quitline), medicines to help people quit, and a clinic-based smoking cessation program.
“It’s trying to reach people who might not be motivated to quit—dispelling some of the myths about quitting and showing them that there are new and effective options out there in case they should decide to quit. Watching the video through VR glasses during their teeth cleaning is a way to distract them from the cleaning and also provide information at the same time”
If Borrelli secures the additional funding after the first year, she and her colleagues will launch a randomized control trial to see if the intervention out-performs a control group.
Borrelli said that the main goal of the project is simple—to get people to stop smoking—but she also hopes to see if this method of delivery is successful.
“[The goal is to see] if it’s effective and disseminating to other clinics (patient treatment centers,” she said.
Borrelli received her MA and PhD in Clinical Psychology from the University of Illinois at Chicago, and completed her residency and fellowship training in Behavioral and Preventive Medicine at Brown University, where she remained as professor through 2014. She has worked at GSDM since 2014 and is a visiting professor at the University of Manchester in the United Kingdom.