Skip to main content

Advertisement

Log in

Feasibility and acceptability of intensive longitudinal data collection of activity and patient-reported outcomes during chemotherapy for breast cancer

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Ecological momentary assessment (EMA) may help us better understand biopsychosocial determinants and outcomes of physical activity during chemotherapy, but may be burdensome for patients. The purpose of this study was to determine the feasibility and acceptability of using EMA to assess activity, symptoms, and motivation among early-stage breast cancer patients undergoing chemotherapy.

Methods

Women were instructed to wear an accelerometer 24/7 (hip during day and wrist overnight). Text message prompts were sent 4 times/day concerning patient-reported symptoms and motivational factors for 10 consecutive days (3 days pre-, day of, and 6 days post-chemotherapy dose). These measures occurred at the beginning, middle, and end of a full course of chemotherapy. At study conclusion, participants reported on perceived study acceptability, burden, and reactivity.

Results

Of the 75 women who consented to participate, 63 (84%) completed all 3 assessment time points. Participants responded to 86% of total text prompts and had valid accelerometer data on 82% of study days. Compliance was similar across all time points. The majority (78%) rated their study experience as positive; 100% were confident in their ability to use study technology. Reactivity varied with 27% indicating answering symptom questions did not affect how they felt and 44% and 68% indicated answering questions and wearing the accelerometer, respectively, made them want to increase activity.

Conclusions

Findings indicate EMA methods are feasible for breast cancer patients undergoing chemotherapy. EMA may help us better understand the biopsychosocial processes underlying breast cancer patients’ activity in the context of daily life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. SEER Cancer Statistics Review, 1975–2008. (2011). http://seer.cancer.gov/csr/1975_2009_pops09/. Accessed based on November 2010 SEER data submission, posted to the SEER website, 2011.

  2. Medicine, I. O. (2005). In M. Hewitt, S. Greenfield, & E. Stovall (Eds.), From cancer patient to cancer survivor: Lost in transition. Washington, D.C.: National Academies Press.

    Google Scholar 

  3. Waart, H. V., Stuiver, M. M., Harten, W. H. V., Geleijn, E., Kieffer, J. M., Buffart, L. M., et al. (2015). Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: Results of the PACES randomized clinical trial. Journal of Clinical Oncology,33(17), 1918–1927.

    Article  Google Scholar 

  4. Mustian, K. M., Cole, C. L., Lin, P. J., Asare, M., Fung, C., Janelsins, M. C., et al. (2016). Exercise recommendations for the management of symptoms clusters resulting from cancer and cancer treatments. Seminars in Oncology Nursing,32(4), 383–393.

    Article  Google Scholar 

  5. Fairman, C. M., Focht, B. C., Lucas, A. R., & Lustberg, M. B. (2016). Effects of exercise interventions during different treatments in breast cancer. The Journal of Community and Supportive Oncology,14(5), 200–209.

    Article  CAS  Google Scholar 

  6. Courneya, K. S., Segal, R. J., McKenzie, D. C., Dong, H., Gelmon, K., Friedenreich, C. M., et al. (2014). Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Medicine and Science in Sports and Exercise,46(9), 1744–1751.

    Article  CAS  Google Scholar 

  7. Speck, R. M., Courneya, K. S., Masse, L. C., Duval, S., & Schmitz, K. H. (2010). An update of controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Journal of Cancer Survivorship,4(2), 87–100.

    Article  Google Scholar 

  8. Holick, C. N., Newcomb, P. A., Trentham-Dietz, A., Titus-Ernstoff, L., Bersch, A. J., Stampfer, M. J., et al. (2008). Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiology, Biomarkers and Prevention,17(2), 379–386.

    Article  Google Scholar 

  9. Irwin, M. L., Crumley, D., McTiernan, A., Bernstein, L., Baumgartner, R., Gilliland, F. D., et al. (2003). Physical activity levels before and after a diagnosis of breast carcinoma. Cancer,97(7), 1746–1757.

    Article  Google Scholar 

  10. Littman, A. J., Tang, M.-T., & Rossing, M. A. (2010). Longitudinal study of recreational physical activity in breast cancer survivors. Journal of Cancer Survivorship,4(2), 119–127.

    Article  Google Scholar 

  11. Fassier, P., Zelek, L., Partula, V., Srour, B., Bachmann, P., Touillaud, M., et al. (2016). Variations of physical activity and sedentary behavior between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Sante cohort. Medicine,95, 40.

    Article  Google Scholar 

  12. De Groef, A., Geraerts, I., Demeyer, H., Van der Gucht, E., Dams, L., de Kinkelder, C., et al. (2018). Physical activity levels after treatment for breast cancer: Two-year follow-up. The Breast,40, 23–28.

    Article  Google Scholar 

  13. Maddocks, M., Byrne, A., Johnson, C. D., Wilson, R. H., Fearon, K. C., & Wilcock, A. (2010). Physical activity level as an outcome measure for use in cancer cachexia trials: A feasibility study. Supportive Care in Cancer,18(12), 1539–1544.

    Article  Google Scholar 

  14. Broderick, J., Ryan, J., O’Donnell, D., & Hussey, J. (2014). A guide to assessing physical activity using accelerometry in cancer patients. Supportive Care in Cancer,22(4), 1121–1130.

    Article  CAS  Google Scholar 

  15. Shiffman, S., & Stone, A. A. (1998). Ecological momentary assessment: A new tool for behavioral medicine research. Technology and methods in behavioral medicine (pp. 117–131). Mahwah: Lawrence Erlbaum.

    Google Scholar 

  16. Harvey, E. J., Rubin, L. F., Smiley, S. L., Zhou, Y., Elmasry, H., & Pearson, J. L. (2018). Mobile phone ownership is not a serious barrier to participation in studies: Descriptive study. JMIR mHealth and uHealth,6(2), e21–e21. https://doi.org/10.2196/mhealth.8123.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chen, K. Y., Janz, K. F., Zhu, W., & Brychta, R. J. (2012). Redefining the roles of sensors in objective physical activity monitoring. Medicine and Science in Sports and Exercise,44(1 Suppl 1), S13–S23.

    Article  Google Scholar 

  18. Ginexi, E. M., Riley, W., Atienza, A. A., & Mabry, P. L. (2014). The promise of intensive longitudinal data capture for behavioral health research. Nicotine & Tobacco Research,16(Suppl 2), S73–S75.

    Article  Google Scholar 

  19. Maher, J. P., Rebar, A. L., & Dunton, G. F. (2018). Ecological momentary assessment is a feasible and valid methodological tool to measure older adults’ physical activity and sedentary behavior. Frontiers in Psychology,9, 1485.

    Article  Google Scholar 

  20. Kratz, A. L., Kalpakjian, C. Z., & Hanks, R. A. (2017). Are intensive data collection methods in pain research feasible in those with physical disability? A study in persons with chronic pain and spinal cord injury. Quality of Life Research,26(3), 587–600.

    Article  CAS  Google Scholar 

  21. Hacker, E. D., & Ferrans, C. E. (2007). Ecological momentary assessment of fatigue in patients receiving intensive cancer therapy. Journal of Pain and Symptom Management,33(3), 267–275.

    Article  Google Scholar 

  22. Sibaud, V., Lebœuf, N. R., Roche, H., Belum, V. R., Gladieff, L., Deslandres, M., et al. (2016). Dermatological adverse events with taxane chemotherapy. European Journal of Dermatology,26(5), 427–443.

    PubMed  Google Scholar 

  23. Society, A. C. (2016, February 15). Chemotherapy side effects. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html.

  24. Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences,10(3), 141.

    CAS  Google Scholar 

  25. Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., et al. (2007). The patient-reported outcomes measurement information system (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Medical Care,45(5 Suppl 1), S3–S11.

    Article  Google Scholar 

  26. Troiano, R. P., Berrigan, D., Dodd, K. W., Mâsse, L. C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise,40(1), 181.

    Article  Google Scholar 

  27. Yost, K. J., Eton, D. T., Garcia, S. F., & Cella, D. (2011). Minimally important differences were estimated for six patient-reported outcomes measurement information system-cancer scales in advanced-stage cancer patients. Journal of Clinical Epidemiology,64(5), 507–516.

    Article  Google Scholar 

  28. Rovniak, L. S., Anderson, E. S., Winett, R. A., & Stephens, R. S. (2002). Social cognitive determinants of physical activity in young adults: A prospective structural equation analysis. Annals of Behavioral Medicine,24(2), 149–156.

    Article  Google Scholar 

  29. Matthews, C. E., George, S. M., Moore, S. C., Bowles, H. R., Blair, A., Park, Y., et al. (2012). Amount of time spent in sedentary behaviors and cause-specific mortality in US adults. The American Journal of Clinical Nutrition,95(2), 437–445.

    Article  CAS  Google Scholar 

  30. Jim, H. S., Small, B., Faul, L. A., Franzen, J., Apte, S., & Jacobsen, P. B. (2011). Fatigue, depression, sleep, and activity during chemotherapy: daily and intraday variation and relationships among symptom changes. Annals of Behavioral Medicine,42(3), 321–333.

    Article  Google Scholar 

  31. Bassett, D. R. (2000). Validity of four motion sensors in measuring moderate intensity physical activity. Medicine and Science in Sports and Exercise,32(9), S471.

    Article  Google Scholar 

  32. Tudor-Locke, C., Swift, D. L., Schuna, J. M., Dragg, A. T., Davis, A. B., Martin, C. K., et al. (2014). WalkMore: A randomized controlled trial of pedometer-based interventions differing on intensity messages. BMC Public Health,14(1), 168.

    Article  Google Scholar 

  33. SAS Institute Inc. (2013). SAS/ACCESS® 9.4 Interface to ADABAS: Reference. Cary, N. S. I. I.

  34. Hartman, S., Marinac, C., Bellettiere, J., Godbole, S., Natarajan, L., Patterson, R., et al. (2017). Objectively measured sedentary behavior and quality of life among survivors of early stage breast cancer. Supportive Care in Cancer,25(8), 2495–2503.

    Article  Google Scholar 

  35. Backman, M., Browall, M., Sundberg, C. J., & Wengström, Y. (2016). Experiencing health: Physical activity during adjuvant chemotherapy treatment for women with breast cancer. European Journal of Oncology Nursing,21, 160–167.

    Article  Google Scholar 

  36. Stone, A. A., Broderick, J. E., Schwartz, J. E., Shiffman, S., Litcher-Kelly, L., & Calvanese, P. (2003). Intensive momentary reporting of pain with an electronic diary: Reactivity, compliance, and patient satisfaction. Pain,104(1–2), 343–351.

    Article  Google Scholar 

  37. Dunton, G. F., Liao, Y., Intille, S. S., Spruijt-Metz, D., & Pentz, M. (2011). Investigating children’s physical activity and sedentary behavior using ecological momentary assessment with mobile phones. Obesity,19(6), 1205–1212.

    Article  Google Scholar 

  38. Dunton, G. F., Liao, Y., Kawabata, K., & Intille, S. (2012). Momentary assessment of adults’ physical activity and sedentary behavior: Feasibility and validity. Frontiers in Psychology,3, 260.

    Article  Google Scholar 

  39. McAuley, E. (1993). Self-efficacy and the maintenance of exercise participation in older adults. Journal of Behavioral Medicine,16(1), 103–113.

    Article  CAS  Google Scholar 

  40. Matthews, C. E., Keadle, S. K., Troiano, R. P., Kahle, L., Koster, A., Brychta, R., et al. (2016). Accelerometer-measured dose-response for physical activity, sedentary time, and mortality in US adults. The American Journal of Clinical Nutrition,104(5), 1424–1432.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported by the Lynn Sage Cancer Research Foundation (Phillips) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Dr. Welch and Dr. Gavin are supported on National Cancer Institute Training Grant aware number T32CA193193 (PI Spring). Dr. Phillips is also supported by the National Cancer Institute (K07CA196840).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Siobhan M. Phillips.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of and approved by the Northwestern University IRB (STU00201472) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Solk, P., Gavin, K., Fanning, J. et al. Feasibility and acceptability of intensive longitudinal data collection of activity and patient-reported outcomes during chemotherapy for breast cancer. Qual Life Res 28, 3333–3346 (2019). https://doi.org/10.1007/s11136-019-02278-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-019-02278-7

Keywords

Navigation