Feasibility and Preliminary Efficacy of an Online Intervention to Increase Physical Activity in Nova Scotian Cancer Survivors: A Randomized Controlled Trial

Abstract

BackgroundPhysical activity (PA) behavior change interventions among cancer survivors have used face-to-face, telephone, email, and print-based methods. However, computer-tailored, Internet-delivered programs may be a more viable option to achieve PA behavior change.ObjectiveThe objective of this study is to test the feasibility and preliminary efficacy of a Web-based PA behavior change program among cancer survivors.MethodsNova Scotian cancer survivors (N=415) who previously expressed interest in a research study were approached. Interested participants were asked to complete an online assessment of PA and quality of life (QOL) before being randomized to either a theory-based PA behavior change program using the PA tracking website UWALK (UCAN; n=48) or usual care (UC; n=47). After the intervention (9 weeks), participants completed another online assessment of PA and QOL as well as measures to evaluate the program and website. Descriptive analyses from surveys and Web analytic software were used to assess feasibility and mean change scores were used to test efficacy.ResultsOf all contacted survivors, 95 (22.3%, 95/415) completed baseline measures and were randomized with 84 (88%, 84/95) completing the 9-week assessment. The behavior change program and website were rated highly on the satisfaction items. Average logins were 10.3 (1.1 per week) and 26.0% (111/432) of the weekly modules were completed. Most participants (71%, 29/41) indicated they were more aware of their daily PA levels and 68% (28/41) found the site easily navigable. Adjusted group differences in total exercise minutes favored the UCAN group by an increase of 42 minutes (95% CI -65 to 150; P=.44, d=0.17). Results were more pronounced, though still nonsignificant, among those not meeting guidelines at baseline where UCAN increased PA by 52 minutes compared to a decrease of 15 minutes in UC (adjusted between group difference=75, 95% CI -95 to 244; P=.38, d=0.27).ConclusionsWe found that Internet-delivery may be a feasible alternative to more costly methods to promote PA among Nova Scotian cancer survivors. Moreover, there was a trend toward increased PA among those in the UCAN group, especially among those who were not meeting PA guidelines at baseline. Future research should focus on recruiting inactive cancer survivors and engaging them in the website to determine the optimal potential of Web-based interventions for promoting PA in cancer survivors.

Digital health interventions to help living with cancer: A systematic review of participants' engagement and psychosocial effects

“…Theories used included Bandura's theories (DI:; Theory:), gate control theory, and goal‐setting theory . The following theories were cited as theoretical frameworks but were not in fact used in the DI discussed: the trans‐theoretical model, planned‐behavior theory, self‐determination theory, the social contextual model, and self‐regulation theory . Data from the 24 studies are summarized in the Supporting Information (see Table 3 for patients and Table 4 for survivors).…”

A feasibility randomized trial of an identity-based physical activity intervention among university students

“…Retention was calculated at the six-week study endpoint by dividing a number of completed participants by the number of baseline participants. Satisfaction was evaluated via a 9-item satisfaction and evaluation questionnaire, adapted from the satisfaction questionnaire from Forbes, Blanchard, Mummery, and Courneya (2015) and Rhodes et al (Quinlan, Rhodes, Blanchard, Naylor, & Warburton, 2015;Rhodes, Naylor, & McKay, 2010). Sample questions included 'how interesting was the information provided in the workbooks?'…”

“…The exact wording of options 1 through 4 changed depending on the question. Similar to Forbes et al (2015), participant satisfaction was additionally assessed through optional exit interviews at the end of the intervention period (six weeks). The questionnaire included open ended questions designed to understand satisfaction with the overall content and delivery of the intervention.…”

Breast cancer survivors’ preferences for technology-supported exercise interventions

“…As technology-supported exercise interventions have demonstrated efficacy for increasing MVPA in other populations [15–18] and cellphones are becoming increasingly ubiquitous [19, 20], they may be a scalable, less resource-intensive strategy to reach more survivors. Despite their promise, only a few pilot studies have tested technology-supported exercise interventions among cancer survivors [21–23]. Among these studies, none included breast cancer survivors, and only a small number of ongoing studies are using technology to promote MVPA in this population [24, 25].…”