Acceptability of online exercise-based interventions after breast cancer surgery: systematic review and narrative synthesis

Abstract

Purpose eHealth and mHealth approaches are increasingly used to support cancer survivors. This review aimed to examine adherence, acceptability and satisfaction with Internet-based self-management programmes for post-surgical cancer rehabilitation and to identify common components of such interventions. Methods Nine electronic databases were searched from inception up to February 15, 2020, for relevant quantitative and qualitative studies evaluating Internet-based cancer rehabilitation interventions. Studies were required to include an exercise or physical activity–based self-management intervention and a measure of adherence, acceptability or user satisfaction with the programme. Two independent reviewers performed all data extraction and quality assessment procedures. Data were synthesized using a narrative approach. Results Six hundred ninety-six potential papers were identified and screened. Eleven met the inclusion criteria. Interventions had wide variations in levels of adherence, but the majority were reported as being acceptable to the users. Increased acceptability and user satisfaction were associated with interventions which were seen as time and cost-efficient, requiring acquisition of minimal or no new skills, which used coherent language, or which provided tailored information. The majority contained behaviour change components such as goal setting. Conclusions Despite high levels of heterogeneity between studies, Internet-based approaches may be an acceptable method for the delivery of self-management interventions in post-surgical cancer rehabilitation. Implications for Cancer Survivors There is a need for further studies exploring factors associated with increased user engagement and usage of digital interventions in cancer rehabilitation settings. These findings should be used to help develop interventions prior to testing their effectiveness in adequately powered randomized controlled trials.

Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework

“…Of the reviews exploring acceptability of a healthcare intervention, only 13 provided an a priori definition and they largely focused on whether those receiving a healthcare intervention found it to be “appropriate” and “fair” and “reasonable” [ 42 , 48 , 60 – 66 ]. Four reviews considered acceptability from the perspective of those delivering a healthcare intervention [ 61 , 62 , 65 , 66 ].…”

The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews

“…controlled trials (RCTs), 11,[24][25][26][27][28][29][30][31][32][33][34][35] nine (31%) were a combination of RCTs, non-randomized trials, and pre/post-test studies, 12,[36][37][38][39][40][41][42][43] and seven (24%) were of mixed-methods studies including cross-sectional, feasibility studies and qualitative designs. [44][45][46][47][48][49][50] Fifty-four percent of primary studies in SRs were conducted in the US (n ¼ 75), 11% in the Netherlands (n ¼ 15), 7% each in the UK (n ¼ 10), Australia (n ¼ 10), and Canada (n ¼ 10), 4% each in South Korea (n ¼ 5) and Spain (n ¼ 5), 3% in Sweden (n ¼ 2), 1.5% each in Germany (n ¼ 2), China (n ¼ 2), and Denmark (n ¼ 2), and 1% each in Belgium (n ¼ 1) and Finland (n ¼ 1). Primary studies of seven SRs (25%) involved only cancer survivors in the post-treatment phase (Figure 1).…”

“…One SR (3%) included only survivors with a history of melanoma, 44 and the remaining 14 SRs (48%) investigated a mix of cancer types. 11,25,30,31,34,[37][38][39][40]42,43,[46][47][48] Three SRs (10%) focused specifically on pediatric cancer survivors, 37,38,42 31,44,46,48 and four SRs (14%) focused only on telephone-delivered interventions. 29,32,33,47 For the primary studies which included a control group, the comparator was most often usual care or waitlist control, with other comparator groups including paper-based information provision or face-to-face care (Table 1).…”

Feasibility, acceptability, and efficacy of online supportive care for individuals living with and beyond lung cancer: a systematic review

“…The tool allows for a broad assessment of quantitative studies including non-randomised, pilot, and feasibility studies. The tool selected for this review was with consideration of the study designs [ 26 , 27 ] and prior literature [ 28 , 29 ] in mind. The tool was chosen based on the importance of including a wide range of study designs, as it has been noted that within single study designs, aspects such as feasibility, reliability, validity, and utility are variables often unmeasured [ 30 ].…”

“…Study quality was rated in accordance with the following accepted scoring methods, > 80% “strong”, 71–79% “good”, 50–70% “adequate”, and < 50% “poor” [ 28 , 29 , 31 ]. If any uncertainty surrounding the initial assessment of the level of bias within a study was noted between the two authors, a member of the research team (MPa) assisted in reaching a consensus.…”