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Physical Activity and Sedentary Behavior in Older Gastrointestinal Cancer Survivors: Need and Acceptability of Digital Health Interventions

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Abstract

Purpose

This study aimed to characterize physical activity (PA) and sedentary behavior (SB) profiles in older gastrointestinal (GI) cancer survivors, assess their interest in interventions to modify these behaviors, and evaluate the acceptability of digital tools for delivering interventions to modify these behaviors.

Methods

Survivors (M = 65 years) from an outpatient survivorship clinic at the Penn State Cancer Institute completed a questionnaire during a clinic appointment.

Results

Most survivors failed to attain the recommended level of PA (79%) or exceeded an average of 8 h of daily SB (42%). Access to internet and text messaging capabilities were high (70%), yet few survivors had access to smartphones or tablets (< 40%) or reported interest in using digital tools to improve PA or reduce SB (< 30%). Digital PA and SB interventions were more acceptable to younger survivors, survivors reporting more SB, and survivors engaging in more PA. The monetary value ascribed to digital health interventions did not differ as a function of mode of delivery (i.e., text messages, web, e-mail, tablet computer apps, or smartphone apps).

Conclusions

Older GI cancer survivors can benefit from interventions to increase PA and decrease SB. Interest in such interventions was moderate and the acceptability of digital health tools for these interventions was limited. At the present time, behavioral interventions for older GI cancer survivors should not be delivered exclusively through digital tools and strategies to improve adoption of various technologies should be implemented when using these tools to modify PA and SB.

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References

  1. Sellar CM, Courneya KS. Physical activity and gastrointestinal cancer survivorship. Recent Results Cancer Res. 2011;186:237–53. https://doi.org/10.1007/978-3-642-04231-7_10.

    Article  PubMed  Google Scholar 

  2. 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;66:271–89. https://doi.org/10.3322/caac.21349.

    Google Scholar 

  3. SEER Cancer Stat Facts. https://seer.cancer.gov/statfacts/. Accessed 8 Nov 2017.

  4. Moore SC, Lee I-M, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176:816–25. https://doi.org/10.1001/jamainternmed.2016.1548.

    Article  Google Scholar 

  5. Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012;8:CD007566. https://doi.org/10.1002/14651858.CD007566.pub2.

    Article  Google Scholar 

  6. Lynch BM, Leitzmann MF. An evaluation of the evidence relating to physical inactivity, sedentary behavior, and cancer incidence and mortality. Curr Epidemiol Rep. 2017;4:221–31. https://doi.org/10.1007/s40471-017-0119-7.

    Article  Google Scholar 

  7. Buffart LM, Galvão DA, Brug J, Chinapaw MJM, Newton RU. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev. 2014;40:327–40. https://doi.org/10.1016/j.ctrv.2013.06.007.

    Article  CAS  Google Scholar 

  8. Kim RB, Phillips A, Herrick K, Helou M, Rafie C, Anscher MS, et al. Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey. PLoS One. 2013;8:e57598. https://doi.org/10.1371/journal.pone.0057598.

    Article  CAS  Google Scholar 

  9. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:243–74. https://doi.org/10.3322/caac.21142.

    Google Scholar 

  10. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42:1409–26. https://doi.org/10.1249/MSS.0b013e3181e0c112.

    Article  Google Scholar 

  11. Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. 2015;121:4044–52. https://doi.org/10.1002/cncr.29620.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ganz PA. Institute of Medicine Report on delivery of high-quality Cancer care. J Oncol Pract. 2014;10:193–5. https://doi.org/10.1200/JOP.2013.001369.

    Article  PubMed  Google Scholar 

  13. Roberts AL, Fisher A, Smith L, Heinrich M, Potts HWW. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2017;11:704–19. https://doi.org/10.1007/s11764-017-0632-1.

    Article  PubMed  PubMed Central  Google Scholar 

  14. 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. https://doi.org/10.2196/mhealth.6970.

    Article  Google Scholar 

  15. Pew Research Center (2017) Tech adoption climbs among older adults. http://assets.pewresearch.org/wp-content/uploads/sites/14/2017/05/16170850/PI_2017.05.17_Older-Americans-Tech_FINAL.pdf. Accessed 8 Nov 2017.

  16. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81. https://doi.org/10.1016/j.jbi.2008.08.010.

    Article  Google Scholar 

  17. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.

    Article  Google Scholar 

  18. Dunstan DW, Barr ELM, Healy GN, Salmon J, Shaw JE, Balkau B, et al. Television viewing time and mortality: the Australian diabetes, obesity and lifestyle study (AusDiab). Circulation. 2010;121:384–91. https://doi.org/10.1161/CIRCULATIONAHA.109.894824.

    Article  CAS  Google Scholar 

  19. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41:998–1005. https://doi.org/10.1249/MSS.0b013e3181930355.

    Article  PubMed  Google Scholar 

  20. Harvey JA, Chastin SFM, Skelton DA. How sedentary are older people? A systematic review of the amount of sedentary behavior. J Aging Phys Act. 2015;23:471–87. https://doi.org/10.1123/japa.2014-0164.

    Article  PubMed  Google Scholar 

  21. Sun F, Norman IJ, While AE. Physical activity in older people: a systematic review. BMC Public Health. 2013;13:449. https://doi.org/10.1186/1471-2458-13-449.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Phillips SM, Dodd KW, Steeves J, McClain J, Alfano CM, McAuley E. Physical activity and sedentary behavior in breast cancer survivors: new insight into activity patterns and potential intervention targets. Gynecol Oncol. 2015;138:398–404. https://doi.org/10.1016/j.ygyno.2015.05.026.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “silver tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomarkers Prev. 2016;25:1029–36. https://doi.org/10.1158/1055-9965.EPI-16-0133.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Martin EC, Basen-Engquist K, Cox MG, Lyons EJ, Carmack CL, Blalock JA, et al. Interest in health behavior intervention delivery modalities among cancer survivors: a cross-sectional study. JMIR Cancer. 2016;2:e1. https://doi.org/10.2196/cancer.5247.

    Article  Google Scholar 

  25. Crombie IK, Irvine L, Williams B, McGinnis AR, Slane PW, Alder EM, et al. Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents. Age Ageing. 2004;33:287–92. https://doi.org/10.1093/ageing/afh089.

    Article  Google Scholar 

  26. Sander AP, Wilson J, Izzo N, Mountford SA, Hayes KW. Factors that affect decisions about physical activity and exercise in survivors of breast cancer: a qualitative study. Phys Ther. 2012;92:525–36. https://doi.org/10.2522/ptj.20110115.

    Article  PubMed  Google Scholar 

  27. Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15:621–30. https://doi.org/10.1007/s00520-006-0207-6.

    Article  PubMed  Google Scholar 

  28. Blanchard CM, Denniston MM, Baker F, Ainsworth SR, Courneya KS, Hann DM, et al. Do adults change their lifestyle behaviors after a cancer diagnosis? Am J Health Behav. 2003;27:246–56.

    Article  Google Scholar 

  29. Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56. https://doi.org/10.1186/1479-5868-5-56.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Healy GN, Clark BK, Winkler EAH, Gardiner PA, Brown WJ, Matthews CE. Measurement of adults’ sedentary time in population-based studies. Am J Prev Med. 2011;41:216–27. https://doi.org/10.1016/j.amepre.2011.05.005.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

Funding for this study was provided by the Penn State Cancer Institute, Social Science Research Institute, and the Penn State Clinical and Translational Research Institute, Pennsylvania State University CTSA, NIH/NCATS Grant Numbers UL1 TR000127 and UL1 TR002014. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NCATS.

Author information

Authors and Affiliations

  1. Department of Kinesiology, The Pennsylvania State University, 266 Recreation Building, University Park, PA, 16802, USA

    Ashley B. Sanders & David E. Conroy

  2. Department of Preventive Medicine, Northwestern University, Chicago, IL, USA

    David E. Conroy

  3. Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA

    Kathryn H. Schmitz & Niraj Gusani

  4. Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA

    Niraj Gusani

Authors
  1. Ashley B. Sanders
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  2. David E. Conroy
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  3. Kathryn H. Schmitz
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  4. Niraj Gusani
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Corresponding author

Correspondence to David E. Conroy.

Ethics declarations

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

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Sanders, A.B., Conroy, D.E., Schmitz, K.H. et al. Physical Activity and Sedentary Behavior in Older Gastrointestinal Cancer Survivors: Need and Acceptability of Digital Health Interventions. J Gastrointest Canc 50, 703–708 (2019). https://doi.org/10.1007/s12029-018-0128-x

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  • DOI: https://doi.org/10.1007/s12029-018-0128-x

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