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Breast cancer survivors’ preferences for mHealth physical activity interventions: findings from a mixed methods study

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Abstract

Purpose

Despite the benefits of physical activity for breast cancer survivors, the majority remain insufficiently active. Mobile health (mHealth) physical activity interventions may be a more scalable strategy to increase activity among survivors. However, little is known about their preferences for mHealth intervention features. This study explored survivors’ preferences for these features.

Methods

Survivors (N = 96; Mage = 55.8 (SD = 10.2)) self-reported demographic and disease characteristics, physical activity. A subset (n = 28) completed a semi-structured phone interview. Transcribed interviews were evaluated using a thematic content analysis approach and consensus review. Following interviews, the full sample self-reported interests and preferences for intervention features via online questionnaires. Quantitative data were analyzed using descriptive statistics.

Results

Five themes emerged from interview data: (1) importance of relevance to breast cancer survivors; (2) easy to use; (3) integration with wearable activity trackers; (4) provide sense of accomplishment; and (5) variability in desired level of structure and personalization. The highest ranked intervention features were: daily and weekly progress feedback (87.5%), newsfeed (86.6%), activity challenges (81.3%), and scheduling tool (79.2%). Survivors were interested in receiving progress feedback (80.2%) and motivational (78.1%) and reminder (75.0%) messages.

Conclusions

Breast cancer survivors are interested in mHealth physical activity promotion interventions, but preferences varied around themes of relevance, ease of use, and enhancing personal motivation.

Implications for cancer survivors

Engaging survivors in developing and implementing remotely delivered mHealth activity promotion interventions may enhance their effectiveness.

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References

  1. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–89.

    Article  Google Scholar 

  2. Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA, et al. Mental and physical health–related quality of life among US cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomark Prev. 2012;21:2108–17.

    Article  Google Scholar 

  3. Baker F, Denniston M, Haffer SC, Liberatos P. Change in health-related quality of life of newly diagnosed cancer patients, cancer survivors, and controls. Cancer. 2009;115:3024–33.

    Article  PubMed  Google Scholar 

  4. Brenner DR, Neilson HK, Courneya KS, Friedenreich CM. Physical activity after breast cancer: effect on survival and patient-reported outcomes. Curr Breast Cancer Rep. 2014:1–12.

  5. Ibrahim EM, Al-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol. 2011;28:753–65.

    Article  PubMed  Google Scholar 

  6. Sabiston CM, Brunet J, Vallance JK, Meterissian S. Prospective examination of objectively-assessed physical activity and sedentary time after breast cancer treatment: sitting on the crest of the teachable moment. Cancer Epidemiol Biomark Prev. 2014;23:1324–30.

    Article  CAS  Google Scholar 

  7. Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23:8884–93.

    Article  PubMed  Google Scholar 

  8. Courneya KS, Katzmarzyk PT, Bacon E. Physical activity and obesity in Canadian cancer survivors. Cancer. 2008;112:2475–82.

    Article  PubMed  Google Scholar 

  9. Blanchard CM, Courneya KS, Stein K. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society's SCS-II. J Clin Oncol. 2008;26:2198–204.

    Article  PubMed  Google Scholar 

  10. Ottenbacher AJ, Yu M, Moser R, et al. Population estimates of meeting strength training and aerobic guidelines by gender and cancer survivorship status: findings from the Health Information National Trends Survey. J Phys Act Health. 2015;12:675–9.

    Article  PubMed  Google Scholar 

  11. White SM, McAuley E, Estabrooks PA, Courneya KS. Translating physical activity interventions for breast cancer survivors into practice: an evaluation of randomized controlled trials. Ann Behavl Med. 2009;37:10–9.

    Article  Google Scholar 

  12. Phillips SM, Alfano CM, Perna FM, Glasgow RE. Accelerating translation of physical activity and cancer survivorship research into practice: recommendations for a more integrated and collaborative approach. Cancer Epidemiol Biomark Prev. 2014;23:687–99.

    Article  Google Scholar 

  13. Irwin ML. Weight loss interventions and breast cancer survival: the time is now. J Clin Oncol. 2014;32:2197–9.

    Article  PubMed  Google Scholar 

  14. Jones LW, Alfano CM. Exercise-oncology research: past, present, and future. Acta Oncol. 2013;52:195–215.

    Article  PubMed  Google Scholar 

  15. Kampshoff CS, Jansen F, van Mechelen W, May AM, Brug J, Chinapaw MJM, et al. Determinants of exercise adherence and maintenance among cancer survivors: a systematic review. Int J Behav Nutr Phys Act. 2014;11:80.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Igwebuike LT, Zhang X, Brown JC, Schmitz KH. Applying pre-participation exercise screening to breast cancer survivors: a cross-sectional study. Supp Care Cancer. 2017:1–7.

  17. Pew Research Cener. The best (and worst) of mobile connectivity. http://www.pewinternet.org/2012/11/30/the-best-and-worst-of-mobile-connectivity-2/

  18. Pew Research Center. U.S. smartphone use in 2015. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

  19. Fanning J, Mullen SP, McAuley E. Increasing physical activity with mobile devices: a meta-analysis. J Med Internet Res. 2012;14:e161.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Buchholz SW, Wilbur J, Ingram D, Fogg L. Physical activity text messaging interventions in adults: a systematic review. Worldviews Evid-Based Nurs. 2013;10:163–73.

    Article  PubMed  Google Scholar 

  21. Bort-Roig J, Gilson ND, Puig-Ribera A, Contreras RS, Trost SG. Measuring and influencing physical activity with smartphone technology: a systematic review. Sports Med. 2014;44:671–86.

    Article  PubMed  Google Scholar 

  22. Coughlin SS, Whitehead M, Sheats JQ, et al. A review of smartphone applications for promoting physical activity. Jacobs J Community Med. 2016;2(1).

  23. Phillips SM, Conroy DE, Keadle SK, Pellegrini CA, Lloyd GR, Penedo FJ, et al. Breast cancer survivors’ preferences for technology-supported exercise interventions. Supp Care Cancer. 2017;25:3243–52.

    Article  Google Scholar 

  24. Nguyen NH, Hadgraft NT, Moore MM, et al. A qualitative evaluation of breast cancer survivors’ acceptance of and preferences for consumer wearable technology activity trackers. Supp Care Cancer. 2017:1–10.

  25. Robertson MC, Tsai E, Lyons EJ, Srinivasan S, Swartz MC, Baum ML, et al. Mobile health physical activity intervention preferences in cancer survivors: a qualitative study. JMIR Mhealth Uhealth. 2017;5:e3.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tomlinson M, Rotheram-Borus MJ, Swartz L, Tsai AC. Scaling up mHealth: where is the evidence? PLoS Med. 2013;10:e1001382.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Phillips SM, Collins LM, Penedo FJ, Courneya KS, Welch W, Cottrell A, et al. Optimization of a technology-supported physical activity intervention for breast cancer survivors: Fit2Thrive study protocol. Contemp Clin Trials. 2018;66:9–19.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lynch BM, Nguyen NH, Reeves MM, Moore MM, Rosenberg DE, Wheeler MJ, et al. Study design and methods for the ACTIVity And TEchnology (ACTIVATE) trial. Contemp Clin Trials. 2018;64:112–7.

    Article  PubMed  Google Scholar 

  29. Hartman SJ, Nelson SH, Myers E, Natarajan L, Sears DD, Palmer BW, et al. Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: the memory & motion study. Cancer. 2018;124:192–202.

    Article  PubMed  Google Scholar 

  30. Ormel HL, van der Schoot GG, Westerink N-DL, et al. Self-monitoring physical activity with a smartphone application in cancer patients: a randomized feasibility study (SMART-trial). Supp Care Cancer. 2018;26:3915–23.

    Article  Google Scholar 

  31. Alfano CM, Bluethmann SM, Tesauro G, et al. NCI funding trends and priorities in physical activity and energy balance research among cancer survivors. J Natl Cancer Inst. 2015;108.

  32. Nilsen W, Kumar S, Shar A, et al. Advancing the science of mHealth. J Health Commun. 2012;7:5–10.

    Article  Google Scholar 

  33. Lloyd GR, Hoffman SA, Welch WA, et al. Breast cancer survivors’ preferences for social support features in technology-supported physical activity interventions: findings from a mixed methods evaluation. Tranls Behav Med. 2018.

  34. IBM SPSS Statistics for Windows, Version 19.0 In. Armonk, NY: IBM Corp. 2010.

  35. Glaser BG, Strauss AL. Discovery of grounded theory: strategies for qualitative research. New York: Routledge; 1999.

    Google Scholar 

  36. Boyatzis RE. Transforming qualitative information: thematic analysis and code development. Washington, D.C.: Sage Publications; 1998.

    Google Scholar 

  37. Bernard HR. Research methods in anthropology: qualitative and quantitative approaches. Lanhan: Rowman & Littlefield; 2018.

    Google Scholar 

  38. Cresswell JW. Qualitative inquiry and research design: choosing among five traditions. Washington, D.C.: Sage Publications; 1998.

    Google Scholar 

  39. NVivo qualitative data analysis software. In 11 Edition. QSR International Pty Ltd. 2015.

  40. O'Brien HL, Toms EG. What is user engagement? A conceptual framework for defining user engagement with technology. J Assoc Inf Sci Technol. 2008;59:938–55.

    Article  Google Scholar 

  41. Perski O, Blandford A, West R, Michie S. Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis. Transl Behav Med. 2016;7:254–67.

    Article  PubMed Central  Google Scholar 

  42. Hartman SJ, Nelson SH, Weiner LS. Patterns of Fitbit use and activity levels throughout a physical activity intervention: exploratory analysis from a randomized controlled trial. JMIR mHealth uHealth. 2018;6:e29.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Norman GJ. Answering the “what works?” question in health behavior change. Am J Prev Med. 2008;34:449–50.

    Article  PubMed  PubMed Central  Google Scholar 

  44. King AC, Ahn DF, Atienza AA, Kraemer HC. Exploring refinements in targeted behavioral medicine intervention to advance public health. Ann Behav Med. 2008;35:251–60.

    Article  PubMed  Google Scholar 

  45. Collins LM, Murphy SA, Strecher V. The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): new methods for more potent eHealth interventions. Am J Prev Med. 2007;32:S112–8.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Collins LM, Kugler KC, Gwadz MV. Optimization of multicomponent behavioral and biobehavioral interventions for the prevention and treatment of HIV/AIDS. AIDS Behav. 2016;20:197–214.

    Article  PubMed Central  Google Scholar 

  47. Klasnja P, Hekler EB, Shiffman S, Boruvka A, Almirall D, Tewari A, et al. Microrandomized trials: an experimental design for developing just-in-time adaptive interventions. Health Psychol. 2015;34:1220–8.

    Article  PubMed Central  Google Scholar 

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Acknowledgments

This work was supported by the National Cancer Institute [K07CA196840] and an award from the Robert H. Lurie Comprehensive Cancer Center of Northwestern University awarded to Siobhan Phillips. The Lurie Cancer Center is supported in part by a NCI Cancer Center Support Grant P30CA060553. Whitney Welch and Kara Gavin are supported by NCI training grant CA193913 (PI: Bonnie Spring and Frank Penedo). We would like to thank Gillian Lloyd and Magaret Moran for their help with interview transcript coding.

Funding

This study was funded by the National Cancer Institute (K07CA196840 and CA193913) and the Robert H. Lurie Comprehensive Cancer Center which is supported in part by a NCI Cancer Center Support Grant #P30CA060553.

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Correspondence to Siobhan M. Phillips.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board at Northwestern University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Phillips, S.M., Courneya, K.S., Welch, W.A. et al. Breast cancer survivors’ preferences for mHealth physical activity interventions: findings from a mixed methods study. J Cancer Surviv 13, 292–305 (2019). https://doi.org/10.1007/s11764-019-00751-3

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