Preferences of mHealth app features for weight management among breast cancer survivors from underserved populations

Abstract

KEYWORDS cancer, health status disparities, oncology, obesity management, telemedicine 1 | BACKGROUND A majority of U.S. adults own smartphones (77%), with similar ownership rates between gender and racial/ethnic groups. 1 mHealth has been gaining in popularity as scalable, personalized opportunities to provide effective behavioral change strategies for health promotion among cancer survivors. 2 A systematic review found digital interventions for cancer survivors resulted in improved moderate to vigorous physical activity behaviors and body weight; data was mixed for diet behaviors. 2 However, key questions remain in terms of how mHealth interventions should be optimally designed for breast cancer survivors from underserved populations based on their cultural and literacy differences 3 and the cancer-related disparities they face. 4 Obesity disproportionally affects underserved populations, and excess weight is associated with increased risk of recurrence and decreased survival among breast cancer survivors. 4 Reviewing the Behavior ChangeTechniques (BCTs) present in previous efficacious trials for weight loss among cancer survivors may provide a useful starting point to design mHealth interventions. We examined perceptions of evidenced-based features breast cancer survivors from underserved health disparity-facing populations would find important to include in an mHealth weight management app and to examine the usability of app prototypes.

Preferences of Older Adult Veterans With Heart Failure for Engaging With Mobile Health Technology to Support Self-care: Qualitative Interview Study Among Patients With Heart Failure and Content Analysis

“…The theory was chosen to guide this study because its structure focused research efforts on results that could be readily translated into practice. In addition, the interview guide included items related to preselected behavior change features (feedback on behavior, self-monitoring of the behavior, reducing negative emotions, instruction on how to perform the behavior, goal setting, social support, problem solving, and action planning) that were rated as important in the literature and our previous research [31,[44][45][46][47] (see Interview Guide in Multimedia Appendix 1).…”

Pilot study of implementing the Shared Healthcare Actions & Reflections Electronic systems in Survivorship (SHARE‐S) program in coordination with clinical care

“…Coaches engaged participants in the following behavior change techniques that were adopted as implementation strategies to: (1) prime patients to be active participants in their care and (2) enhance survivors' uptake and adherence to the SCP guidelines relevant to self‐management (e.g., healthy lifestyles) 26 : Shaping knowledge (overview of SCP), identity (values), regulation (reduce negative emotion with mindfulness—skill), goals and planning (goal setting, action planning, problem solving, review goals), feedback and monitoring (plan for self‐monitoring of behavior), comparison of outcomes (e.g., imagining/vision of future optimal health), and social support (emotional). 27 , 28 , 29 …”

“…Coaches engaged participants in the following behavior change techniques that were adopted as implementation strategies to: (1) prime patients to be active participants in their care and (2) enhance survivors' uptake and adherence to the SCP guidelines relevant to self-management (e.g., healthy lifestyles) 26 : Shaping knowledge (overview of SCP), identity (values), regulation (reduce negative emotion with mindfulness-skill), goals and planning (goal setting, action planning, problem solving, review goals), feedback and monitoring (plan for self-monitoring of behavior), comparison of outcomes (e.g., imagining/vision of future optimal health), and social support (emotional). [27][28][29] Coaches supported autonomy by providing a range of general topics for guiding creation of personalized health goals, which were adapted from another telephone lifestyle coaching study as informed by our preliminary work: (1) Eat wisely; (2) Be physically active; (3) Be tobacco-free/limit alcohol; (4) Strengthen social connections; ( 5) Restore (e.g., manage Stress); (6) Get adequate rest; (7) Engage in preventive care; (8) Other personal development (e.g., spiritual, work, finance). 30,31 That is, patient-selected goals were open-ended and personalized to realistically fit into their life context.…”

App-Based Digital Health Equity Determinants According to Ecological Models: Scoping Review

“…At the interpersonal level, factors related to feedback, monitoring, communication, technology sharing, and design standardization were addressed in a total of ten papers. Although only two papers were published in 2019 [34,35] and one in 2020 [24], the number was expected to increase to six by 2021 [16,[26][27][28][29]31,33]. At the community and societal levels, factors such as regional differences, integrated network infrastructure, and Internet accessibility were explored in seven studies.…”