Pilot Randomized Controlled Trial of Feasibility, Acceptability, and Preliminary Efficacy of a Web-Based Physical Activity and Sedentary Time Intervention for Survivors of Physical Inactivity-Related Cancers

Abstract

Background This pilot study explored the feasibility, acceptability, and usability of a web-based intervention for survivors of physical inactivity-related cancers through a two-arm, 12-week randomized controlled trial. Secondarily, this study tested the change in physical activity (PA) and sedentary time with intervention exposure. Methods Prior to randomization to the intervention ( n = 45) or behavior “as usual” wait-listed control ( n = 40) groups, participants completed baseline surveys and an accelerometer protocol. The intervention focused on increasing PA and decreasing sedentary time through social cognitive theory techniques. Follow-up acceptability/usability surveys (intervention group only) and accelerometers were sent after the intervention period. Information on intervention completion, adverse events, and user statistics were collected to determine feasibility. Median login time and mean acceptability/usability scores were calculated. Results Participants (mean age = 60 ± 7 years) included female ( n = 80, 94%) and male survivors of breast (82%), colon (6%), endometrial (6%), bladder (4%), and kidney (2%) cancer. Seventy-eight (91.7%) participants returned partially or fully complete post-intervention data. There were no reported injuries or safety concerns. Intervention participants logged into the website for a total of 95 min (Q1, Q3 = 11, 204). System usability scores (72 ± 3) indicated above average usability of the website. Changes in time spent active and sedentary were not statistically significantly different between groups ( p = 0.45), but within-group changes suggested intervention group participants spent more time active and less time sedentary after the intervention. Conclusion Results of this pilot study suggest its feasibility and acceptability for survivors of several inactivity-related cancers. Additional research to determine long-term efficacy is warranted. This low-cost online-only intervention has the potential to have a very broad reach. Trial Registration Clinical Trials Number: NCT03983083. Date registered: June 12th, 2019

mHealth Interventions to Promote a Healthy Diet and Physical Activity among Cancer Survivors: A Systematic Review of Randomized Controlled Trials

“…Most studies ( n = 16 described in 18 articles) included breast cancer, prostate cancer, and/or colorectal cancer survivors [ 23 , 25 , 26 , 27 , 28 , 29 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 ]. Besides these 16 studies, four studies included survivors of breast cancer and other cancer types (gynecologic cancer, testicular cancer, gastrointestinal cancer, lung cancer, osteosarcoma, and other rare cancers) [ 22 , 30 , 40 , 45 ], one included survivors of colorectal cancer and gynecologic cancer [ 32 ], one study included survivors of breast cancer, colorectal cancer, and other cancer types (endometrial cancer, bladder cancer, kidney cancer) [ 21 ], and one study included survivors of leukemia and lymphoma [ 24 ]. The most prevalent type of cancer diagnosis was breast cancer ( n = 1000), followed by prostate cancer ( n = 713) and colorectal cancer ( n = 650).…”

“…Among the 15 studies [ 22 , 23 , 28 , 29 , 30 , 32 , 35 , 36 , 38 , 39 , 41 , 42 , 43 , 44 , 45 ] that reported information on the education of their participants, more than half (58%) of the participants were college-educated. Among the 10 studies [ 21 , 23 , 28 , 29 , 30 , 38 , 39 , 42 , 43 , 44 ] that reported participants’ work status, 49% of participants worked full- or part-time.…”

“…Table 2 shows that, across the 23 interventions, 19 used websites/mobile apps, 15 included wearable activity trackers, 13 included in-person/telephone/video call/email coaching by study staff, and eight sent automated short message service (SMS) text messages to their participants. The most common combination of tools was a web/mobile app intervention with a wearable activity tracker and coaching by group session, email, or phone video call ( n = 6) [ 22 , 26 , 27 , 31 , 32 , 42 , 43 ], followed by five studies that examined a web/mobile app intervention alone ( n = 5) [ 21 , 29 , 40 , 44 , 45 ]. Across the eight studies that used text messages as one of the intervention tools, the frequency of text messages varied from once weekly to once daily.…”

“…Most studies used usual care and/or information concerning a healthy diet and/or physical activity as their comparator (control) intervention ( n = 14). Six studies had waitlist controls where participants in the control group had the option to receive a delayed intervention [ 21 , 25 , 28 , 31 , 39 , 41 ]. Four studies [ 22 , 24 , 30 , 39 ] had Fitbit-only controls.…”

“…It was defined differently across studies, including as website/mobile app usage, the wear time of wearable activity trackers, and/or response rates to text messages. Among the 19 studies that included a website/mobile app, six studies [ 21 , 23 , 28 , 31 , 44 ] with 12-week interventions reported the median number of days participants visited the website/mobile app; these numbers varied from 2% to 15% of the 84 study days. One study by Finlay et al measured website usage by the number of physical activity logs completed across one control and two intervention arms [ 29 ].…”