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Outcomes of a text message, Fitbit, and coaching intervention on physical activity maintenance among cancer survivors: a randomized control pilot trial



We aimed to determine the effect of a health coach, text message, and Fitbit intervention on moderate-to-vigorous physical activity (MVPA) maintenance in cancer survivors following a supervised exercise program compared to provision of a Fitbit alone.


Participants were recruited during the last month of an exercise-based oncology rehabilitation program and randomly assigned to the full intervention (n = 34) or Fitbit-only control groups (n = 32). In total, 59 cancer survivors completed the program (81% female; mean age 61.4 ± 9.0). Group by time differences in accelerometer-measured MVPA was assessed using linear mixed models. Additionally, we examined mean weekly Fitbit-derived MVPA levels.


Intervention participants maintained weekly MVPA from pre- (295.7 ± 139.6) to post-intervention (322.0 ± 199.4; p = 0.37), whereas those in the Fitbit-only group had a significant decrease in MVPA (305.5 ± 181.1 pre vs 250.7 ± 166.5 post; p = 0.03, effect size 0.57). The intervention participants maintained recommended levels of MPVA for health benefits during the 8-week intervention, whereas the Fitbit-only control group did not.


The findings demonstrate that a remote intervention delivered through health coaching, text messages, and Fitbit can promote maintenance of MVPA after a structured program for cancer survivors. However, use of a Fitbit alone was not sufficient to prevent expected decline in MVPA. Additional research is warranted to examine long-term impacts and efficacy in a more diverse population of cancer survivors.

Implications for Cancer Survivors

Use of a wearable tracker alone may not be sufficient for exercise maintenance among cancer survivors after transition to an independent program. Additional planning for relapse prevention is recommended.

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We would like to thank Daniel Ebenstein, Jessica Symonds, and Emma O’Brien for their assistance with this research.


This work was supported by Institutional Research Grant 14-196-01 from the American Cancer Society.

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Correspondence to Nancy M. Gell.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gell, N.M., Grover, K.W., Savard, L. et al. Outcomes of a text message, Fitbit, and coaching intervention on physical activity maintenance among cancer survivors: a randomized control pilot trial. J Cancer Surviv 14, 80–88 (2020).

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  • Exercise
  • Accelerometry
  • Wearable tracker
  • SMS