Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial



Determine the feasibility of a remotely delivered mobile health (mHealth)-supported intervention to improve diet and physical activity in hematologic malignancy survivors.


Pilot randomized controlled trial of a 16-week intervention for improving diet and physical activity: individualized goal-setting (daily steps, sodium, saturated fat, added sugar intake) per feedback from mHealth trackers (Fitbit for activity; Healthwatch360 for diet), supplemented by a Facebook peer support group. Controls accessed the trackers without goal-setting or peer support. Everyone received standardized survivorship counseling with tailored advice from a clinician. Actigraphy and food frequency questionnaires assessed activity and diet at baseline and follow-up.


Forty-one participants (51.2% male; median age 45.1 years; 7.0 years from treatment) were randomized (24 intervention; 17 control). Fitbit and Healthwatch360 use were more common among intervention versus control participants (75.0% versus 70.6% and 50.0% versus 17.7% of eligible days, respectively). Most intervention participants (66.7%) engaged with Facebook; overall, 91.7% interacted with the study’s mHealth applications. While no comparisons in activity or dietary outcomes between intervention versus control group met statistical significance, the intervention was associated with greater reductions in the targeted dietary factors and improvements in Healthy Eating Index-2015 score, moderate-vigorous physical activity time, and daily steps. Participant retention at 6 months was 90.2%.


An intervention for cardiovascular risk reduction based on individualized goal-setting enhanced by mHealth and social media peer support was feasible and acceptable among cancer survivors.

Implications for Cancer Survivors

Effective and easily disseminated strategies that improve diet and physical activity in this population are needed.

Trial registration

Registered in ClinicalTrials.gov (NCT03574012) on June 29, 2018.

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Funding was provided in part by P30 CA015704, R01 CA204378, and R01 CA215134 from the US National Institutes of Health, and in part by FHCRC philanthropic funds.

Author information




Study conception and design: EJC, CD, SHA, KSB, JBB, KWR, JMS, KLS, MLN, and JAM; patient selection: AKG and SJL; data collection: EJC, AMH, and SAT; data analysis: EJC, DRD, CD, and GW; initial manuscript draft: EJC and DRD; critical review and revision: all authors.

Corresponding author

Correspondence to Eric J. Chow.

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The authors report no relevant disclosures. All participants provided informed consent, and the protocol and procedures were approved by FHCRC’s institutional review board (file number 10037).

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The authors declare that they have no conflict of interest.

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Chow, E.J., Doody, D.R., Di, C. et al. Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial. J Cancer Surviv 15, 554–563 (2021). https://doi.org/10.1007/s11764-020-00949-w

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  • Cancer survivorship
  • Cardiovascular disease
  • Diet
  • Goal-setting
  • Peer support
  • Physical activity