nach oben

Erschienen in:

10.10.2020

Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial

verfasst von: Eric J. Chow, David R. Doody, Chongzhi Di, Saro H. Armenian, K. Scott Baker, Jonathan B. Bricker, Ajay K. Gopal, Anna M. Hagen, Tyler G. Ketterl, Stephanie J. Lee, Kerryn W. Reding, Jeannette M. Schenk, Karen L. Syrjala, Sarah A. Taylor, Guangxing Wang, Marian L. Neuhouser, Jason A. Mendoza

Erschienen in: Journal of Cancer Survivorship | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Determine the feasibility of a remotely delivered mobile health (mHealth)-supported intervention to improve diet and physical activity in hematologic malignancy survivors.

Methods

Pilot randomized controlled trial of a 16-week intervention for improving diet and physical activity: individualized goal-setting (daily steps, sodium, saturated fat, added sugar intake) per feedback from mHealth trackers (Fitbit for activity; Healthwatch360 for diet), supplemented by a Facebook peer support group. Controls accessed the trackers without goal-setting or peer support. Everyone received standardized survivorship counseling with tailored advice from a clinician. Actigraphy and food frequency questionnaires assessed activity and diet at baseline and follow-up.

Results

Forty-one participants (51.2% male; median age 45.1 years; 7.0 years from treatment) were randomized (24 intervention; 17 control). Fitbit and Healthwatch360 use were more common among intervention versus control participants (75.0% versus 70.6% and 50.0% versus 17.7% of eligible days, respectively). Most intervention participants (66.7%) engaged with Facebook; overall, 91.7% interacted with the study’s mHealth applications. While no comparisons in activity or dietary outcomes between intervention versus control group met statistical significance, the intervention was associated with greater reductions in the targeted dietary factors and improvements in Healthy Eating Index-2015 score, moderate-vigorous physical activity time, and daily steps. Participant retention at 6 months was 90.2%.

Conclusions

An intervention for cardiovascular risk reduction based on individualized goal-setting enhanced by mHealth and social media peer support was feasible and acceptable among cancer survivors.

Implications for Cancer Survivors

Effective and easily disseminated strategies that improve diet and physical activity in this population are needed.

Trial registration

Registered in ClinicalTrials.gov (NCT03574012) on June 29, 2018.

Nur mit Berechtigung zugänglich

Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA. 2003;290(21):2831–7.PubMed

Baker KS, Ness KK, Steinberger J, Carter A, Francisco L, Burns LJ, et al. Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study. Blood. 2007;109(4):1765–72.PubMed

Tichelli A, Bhatia S, Socie G. Cardiac and cardiovascular consequences after haematopoietic stem cell transplantation. Br J Haematol. 2008;142(1):11–26.PubMed

Chow EJ, Baker KS, Lee SJ, Flowers ME, Cushing-Haugen KL, Inamoto Y, et al. Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation. J Clin Oncol. 2014;32(3):191–8.PubMed

Leger KJ, Baker KS, Cushing-Haugen KL, Flowers MED, Leisenring WM, Martin PJ, et al. Lifestyle factors and subsequent ischemic heart disease risk after hematopoietic cell transplantation. Cancer. 2018;124(7):1507–15.PubMed

Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.PubMedPubMedCentral

Balatsoukas P, Kennedy CM, Buchan I, Powell J, Ainsworth J. The role of social network technologies in online health promotion: a narrative review of theoretical and empirical factors influencing intervention effectiveness. J Med Internet Res. 2015;17(6):e141.PubMedPubMedCentral

Teixeira PJ, Carraca EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act. 2012;9:78.PubMedPubMedCentral

Teixeira PJ, Carraca EV, Marques MM, Rutter H, Oppert JM, De Bourdeaudhuij I, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015;13:84.PubMedPubMedCentral

10.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67–74.PubMed

11.

Godin G, Jobin J, Bouillon J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health. 1986;77(5):359–62.PubMed

12.

Centers for Disease Control and Prevention. Behavioral risk factor surveillance system. http://www.cdc.gov/brfss/. Accessed 1 July 2020.

13.

Schwarzer R, Luszczynska A. Self-efficacy. http://cancercontrol.cancer.gov/brp/research/constructs/self_efficacy.html. Accessed 1 July 2020.

14.

Markland D, Tobin V. A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. J Sport Exerc Psychol. 2004;26(2):191–6.

15.

Hearty AP, McCarthy SN, Kearney JM, Gibney MJ. Relationship between attitudes towards healthy eating and dietary behaviour, lifestyle and demographic factors in a representative sample of Irish adults. Appetite. 2007;48(1):1–11.PubMed

16.

Patterson RE, Kristal AR, Tinker LF, Carter RA, Bolton MP, Agurs-Collins T. Measurement characteristics of the Women’s Health Initiative food frequency questionnaire. Ann Epidemiol. 1999;9(3):178–87.PubMed

17.

Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11 Suppl):S531–43.PubMed

18.

Sasaki JE, John D, Freedson PS. Validation and comparison of ActiGraph activity monitors. J Sci Med Sport. 2011;14(5):411–6.PubMed

19.

Committee on Cancer Survivorship. Improving Care and Quality of Life, National Cancer Policy Board. From cancer patient to cancer survivor: lost in transition. In: Hewitt M, Greenfield S, Stovall E, editors. . Washington, D.C: Institute of Medicine and National Research Council, National Academies Press; 2006.

20.

Schulman-Green D, Bradley EH, Knobf MT, Prigerson H, DiGiovanna MP, McCorkle R. Self-management and transitions in women with advanced breast cancer. J Pain Symptom Manag. 2011;42(4):517–25.

21.

Bricker JB, Watson NL, Mull KE, Sullivan BM, Heffner JL. Efficacy of smartphone applications for smoking cessation: a randomized clinical trial. JAMA Intern Med. 2020. https://doi.org/10.1001/jamainternmed.2020.4055. CrossRefPubMedPubMedCentral

22.

O'Connor M, Whelan R, Bricker J, McHugh L. Randomized controlled trial of a smartphone application as an adjunct to acceptance and commitment therapy for smoking cessation. Behav Ther. 2020;51(1):162–77.PubMed

23.

Van Horn L, Carson JA, Appel LJ, Burke LE, Economos C, Karmally W, et al. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) guidelines: a scientific statement from the American Heart Association. Circulation. 2016;134(22):e505–e29.PubMed

24.

Miropolsky EM, Baker KS, Abbey-Lambertz M, Syrjala K, Chow EJ, Ceballos R, et al. Participant perceptions on a Fitbit and Facebook intervention for young adult cancer survivors: a qualitative study. J Adolesc Young Adult Oncol. 2020;9(3):410–7.PubMedPubMedCentral

25.

Mendoza JA, Baker KS, Moreno MA, Whitlock K, Abbey-Lambertz M, Waite A, et al. A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: a pilot study. Pediatr Blood Cancer. 2017;64(12). https://doi.org/10.1002/pbc.26660.

26.

Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, et al. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591–602.PubMedPubMedCentral

27.

Choi L, Liu Z, Matthews CE, Buchowski MS. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357–64.PubMedPubMedCentral

28.

Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.PubMed

29.

Ayala GX, Elder JP. Qualitative methods to ensure acceptability of behavioral and social interventions to the target population. J Public Health Dent. 2011;71(Suppl 1):S69–79.PubMedPubMedCentral

30.

Krueger R. Developing questions for focus groups: focus group kit #3. Thousand Oaks: Sage Publications; 1998.

31.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.

32.

Centers for Disease Control and Prevention. Physical activity for everyone. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html. Accessed 1 July 2020.

33.

Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, et al. From ideas to efficacy: the ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2015;34(10):971–82.PubMedPubMedCentral

34.

Chow EJ, Mueller BA, Baker KS, Cushing-Haugen KL, Flowers ME, Martin PJ, et al. Cardiovascular hospitalizations and mortality among recipients of hematopoietic stem cell transplantation. Ann Intern Med. 2011;155(1):21–32.PubMed

35.

Armenian SH, Sun CL, Vase T, Ness KK, Blum E, Francisco L, et al. Cardiovascular risk factors in hematopoietic cell transplantation survivors: role in development of subsequent cardiovascular disease. Blood. 2012;120(23):4505–12.PubMedPubMedCentral

36.

van Nimwegen FA, Schaapveld M, Janus CP, Krol AD, Petersen EJ, Raemaekers JM, et al. Cardiovascular disease after Hodgkin lymphoma treatment: 40-year disease risk. JAMA Intern Med. 2015;175(6):1007–17.PubMed

37.

Patnode CD, Evans CV, Senger CA, Redmond N, Lin JS. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017;318(2):175–93.PubMed

38.

LeFevre ML. Force USPST. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(8):587–93.PubMed

39.

Turner RR, Steed L, Quirk H, Greasley RU, Saxton JM, Taylor SJ, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2018;9:CD010192. https://doi.org/10.1002/14651858.CD010192.pub3.CrossRefPubMed

40.

Burden S, Jones DJ, Sremanakova J, Sowerbutts AM, Lal S, Pilling M, et al. Dietary interventions for adult cancer survivors. Cochrane Database Syst Rev. 2019;2019(11). https://doi.org/10.1002/14651858.CD011287.pub2.

41.

Demark-Wahnefried W, Morey MC, Sloane R, Snyder DC, Miller PE, Hartman TJ, et al. Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol. 2012;30(19):2354–61.PubMedPubMedCentral

42.

Courneya KS, Vardy JL, O'Callaghan CJ, Friedenreich CM, Campbell KL, Prapavessis H, et al. Effects of a structured exercise program on physical activity and fitness in colon cancer survivors: one year feasibility results from the CHALLENGE trial. Cancer Epidemiol Biomark Prev. 2016;25(6):969–77.

43.

Perrin A, Turner E. Smartphones help blacks, Hispanics bridge some - but not all - digital gaps with whites. Pew Research Center https://www.pewresearch.org/fact-tank/2019/08/20/smartphones-help-blacks-hispanics-bridge-some-but-not-all-digital-gaps-with-whites/. Accessed 1 July 2020.

44.

Direito A, Carraca E, Rawstorn J, Whittaker R, Maddison R. mHealth technologies to influence physical activity and sedentary behaviors: behavior change techniques, systematic review and meta-analysis of randomized controlled trials. Ann Behav Med. 2017;51(2):226–39.PubMed

45.

Haberlin C, O'Dwyer T, Mockler D, Moran J, O’Donnell DM, Broderick J. The use of eHealth to promote physical activity in cancer survivors: a systematic review. Support Care Cancer. 2018;26(10):3323–36.PubMed

46.

Wong JN, McAuley E, Trinh L. Physical activity programming and counseling preferences among cancer survivors: a systematic review. Int J Behav Nutr Phys Act. 2018;15(1):48.PubMedPubMedCentral

47.

Vargas AJ, Schully SD, Villani J, Ganoza Caballero L, Murray DM. Assessment of prevention research measuring leading risk factors and causes of mortality and disability supported by the US National Institutes of Health. JAMA Netw Open. 2019;2(11):e1914718.PubMedPubMedCentral

48.

McNulty J, Kim W, Thurston T, Kim J, Larkey L. Interventions to improve quality of life, well-being, and care in Latino cancer survivors: a systematic literature review. Oncol Nurs Forum. 2016;43(3):374–84.PubMed

49.

Amireault S, Fong AJ, Sabiston CM. Promoting healthy eating and physical activity behaviors: a systematic review of multiple health behavior change interventions among cancer survivors. Am J Lifestyle Med. 2018;12(3):184–99.PubMed

50.

US Preventive Services Task Force, Grossman DC, Bibbins-Domingo K, Curry SJ, Barry MJ, Davidson KW, et al. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without cardiovascular risk factors: US Preventive Services Task Force recommendation statement. JAMA. 2017;318(2):167–74.

51.

Tollosa DN, Tavener M, Hure A, James EL. Adherence to multiple health behaviours in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2019;13(3):327–43.PubMed

52.

Ligibel JA, Jones LW, Brewster AM, Clinton SK, Korde LA, Oeffinger KC, et al. Oncologists’ attitudes and practice of addressing diet, physical activity, and weight management with patients with cancer: findings of an ASCO survey of the oncology workforce. J Oncol Pract. 2019;15(6):e520–e8.PubMedPubMedCentral

Titel: Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial
verfasst von: Eric J. Chow
David R. Doody
Chongzhi Di
Saro H. Armenian
K. Scott Baker
Jonathan B. Bricker
Ajay K. Gopal
Anna M. Hagen
Tyler G. Ketterl
Stephanie J. Lee
Kerryn W. Reding
Jeannette M. Schenk
Karen L. Syrjala
Sarah A. Taylor
Guangxing Wang
Marian L. Neuhouser
Jason A. Mendoza
Publikationsdatum: 10.10.2020
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 4/2021
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-020-00949-w

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Feasibility of a behavioral intervention using mobile health applications to reduce cardiovascular risk factors in cancer survivors: a pilot randomized controlled trial