Background Increasing evidence shows that lifestyle interventions can improve the symptoms, quality of life (QoL), and even overall survival of patients with cancer. Digital therapeutics (DTx) can help implement behavioral modifications and empower patients through education, lifestyle support, and remote symptom monitoring. Objective We aimed to test the feasibility of a DTx program for patients with cancer, as measured by engagement, retention, and acceptability. In addition, we explored the effects of the program on cancer-related QoL. Methods We conducted a 4-week single-arm trial in Iceland, where DTx was delivered through a smartphone app. The intervention consisted of patient education about mindfulness, sleep, stress, and nutrition; lifestyle coaching; and the completion of daily missions for tracking physical activity and exercise, reporting patient-reported outcomes (PROs), practicing mindfulness, and logging healthy food intake. Information on program engagement and retention, step goal attainment, as well as PROs were collected throughout the study. QoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 at baseline and follow-up. Results In total, 30 patients with cancer undergoing active therapy were enrolled, and 29 registered in the app (23 female, 18 with breast cancer; mean age 52.6, SD 11.5 years). Overall, 97% (28/29) of participants were active in 3 of the 4 weeks and completed the pre- and postprogram questionnaires. The weekly active days (median) were 6.8 (IQR 5.8-6.8), and 72% (21/29) of participants were active at least 5 days a week. Users interacted with the app on average 7.7 (SD 1.9) times per day. On week 1, all 29 participants used the step counter and logged an average of 20,306 steps; 21 (72%) participants reached their step goals of at least 3000 steps per day. On week 4, of the 28 active users, 27 (96%) were still logging their steps, with 19 (68%) reaching their step goals. Of the 28 participants who completed the satisfaction questionnaire, 25 (89%) were likely to recommend the program, 23 (82%) said the program helped them deal with the disease, and 24 (86%) said it helped them remember their medication. QoL assessment showed that the average global health status, functioning, and symptom burden remained stable from baseline to follow-up. In all, 50% (14/28) of participants reported less pain, and the average pain score decreased from 31 (SD 20.1) to 22.6 (SD 23.2; P=.16). There was no significant change in PROs on the quality of sleep, energy, and stress levels from the first to the last week. Conclusions The high retention, engagement, and acceptability found in this study demonstrate that multidisciplinary DTx is feasible for patients with cancer. A longer, full-scale randomized controlled trial is currently being planned to evaluate the efficacy of the intervention.

BACKGROUND Digital lifestyle interventions can help cancer survivors better manage their disease through improved lifestyle choices. OBJECTIVE Our aim was to test the feasibility of a digital therapeutic (DTx) program for cancer patients, as measured by engagement, retention, and acceptability. We additionally explored the effects of the program on cancer-related quality of life. METHODS A four-week-long, single-arm trial was conducted in Iceland where the DTx was delivered through a smartphone app. The intervention consisted of completing daily missions (e.g., food logging, activity tracking, surveys) and receiving educational content about mindfulness, sleep, stress, and nutrition. Usage information such as engagement, retention, and step goal attainment, as well as patient-reported outcomes about energy, stress and quality of sleep were collected throughout the study. Cancer-specific quality of life using the EORTC QLQ-C30 questionnaire, as well as cardiovascular fitness and body composition were measured at baseline and follow-up. RESULTS Thirty cancer patients in active treatment were enrolled and 29 registered in the program (79% female, with mean age of 52.6 years, 62% with breast cancer). All 29 participants were active at least three out of four weeks, and 28 (97%) completed the pre- and post- program questionnaires. 72% were highly engaged, the median number of weekly active days were 6.8 (IQR: 5.8, 6.8), and mean daily mission interactions were 7.7 (SD = 1.9). On week one, all 29 participants used the step counter, and 72% reached their step goals; most of these individuals (n = 27) were still using the step counter on week four, with 70% reaching their step goals. The DTx had high acceptability, as 89% of participants said they were likely to recommend it, and 82% said the program helped them deal with the disease. Quality of life (QoL) assessment showed that global health status, functioning and symptom burden remained stable from baseline to follow-up. The largest improvement was observed in pain scores, which decreased from 31 (SD = 20.1) to 22.6 (SD = 23.2) (P= .16). CONCLUSIONS The high retention, engagement and acceptability found in this study demonstrate that a multidisciplinary DTx is feasible for cancer patients. A longer, full-scale randomized controlled trial (RCT) is currently being planned to evaluate the efficacy of the intervention.

Fólk með þroskahömlun hefur í gegnum tíðina verið jaðarsettur hópur og átt fá tækifæri til atvinnuþátttöku á almennum vinnumarkaði. Árið 2013 stofnuðu fimm nemendur í starfstengdu diplómanámi fyrir fólk með þroskahömlun við Háskóla Íslands kaffihúsið GÆS í starfsnámi sínu. Rannsóknin sem hér er til umfjöllunar hafði það að markmiði að draga fram og greina þá orðræðu sem skapaðist í samfélaginu um kaffihúsið GÆS en það hlaut mikla umfjöllun á frétta- og vefmiðlum. Auk þess var leitast við að fá fram með hvaða hætti orðræðan um GÆS mótaði reynslu stofnfélaganna fimm og í því skyni voru tekin einstaklings- og rýnihópaviðtöl við þau. Gögnin voru greind með orðræðugreiningu og þemagreiningu. Niðurstöður rannsóknarinnar benda til þess að orðræðan um GÆS hafi einkennst af jákvæðni í garð hópsins sem stóð að kaffihúsinu og birtist hún meðal annars í því að fjölmiðlar og almenningur sýndi kaffihúsinu mikinn áhuga og velvild. Í mótsögn við ofangreinda orðræðu litaðist orðræðan einnig af staðalmyndum um fólk með þroskahömlun sem byggjast meðal annars á því að líta á fólkið sem eilíf börn. Þessar hugmyndir leiddu til þess að fram komu ýmsar efasemdir um getu hópsins til að reka kaffihús og átti það stóran þátt í að rekstrinum var hætt. Jafnframt var stofnfélögunum fimm lýst sem ofurhetjum, snillingum og dugnaðarforkum á samfélagsmiðlum. Þó að orðræðan hafi á stundum virst viðhalda staðalmyndum um fólk með þroskahömlun má álykta að GÆS hafi átt þátt í að opna umræðuna um dugnað og hæfileika fólks með þroskahömlun og átt þátt í að breyta viðhorfum til hópsins.