JMIR Publications

ABSTRACT

Background:

Latina breast cancer survivors (BCS) experience worse health-related quality of life (HRQOL), greater symptom burden, and more psychosocial needs compared to non-Latina BCS. E-health platforms such as smartphone applications are increasingly being used to deliver psychosocial interventions to cancer survivors. However, few psychosocial e-health interventions have been developed specifically for Latina BCS. Also, little is known about how Latinas in general engage with e-health interventions and whether participant characteristics or study outcomes are associated with application use among this population. As such, we evaluated application use of two culturally informed, evidence-based smartphone applications for Latina BCS, one that was designed to improve HRQOL and reduce symptom burden (My Guide) and the other to promote healthy lifestyle behaviors (My Health).

Objective:

The objectives of our study were to describe patterns of e-health use of the My Guide intervention application and My Health attention-control application over the six-week study period, and explore whether application use was related to intervention effects among Latina BCS.

Methods:

Eighty Latina BCS were randomized to use the My Guide or My Health application for six weeks. Assessments were collected at baseline (T1), immediately after the six-week intervention (T2), and two-weeks post-T2 (T3). The primary outcome for this paper was application use, and how it affected the intervention effects on study outcomes (i.e., subdomains of HRQOL, symptom burden, cancer-specific distress, cancer-relevant self-efficacy, and breast cancer knowledge).

Results:

On average, participants used their assigned application for more than one hour per week. No sociodemographic or psychological characteristics were associated with e-health use of either application. At T3, greater use of My Guide was related to worse physical and breast cancer well-being, greater symptom burden, and improved breast cancer knowledge; while greater use of My Health was related to better emotional well-being and less symptom burden.

Conclusions:

These preliminary findings suggest that the six-week, self-guided psychosocial intervention may not have been long enough to significantly improve psychosocial outcomes among Latina BCS. Future research should evaluate the optimal length of intervention delivery as it relates to the hypothesized effects, and include other objective and comprehensive measures of engagement or e-health use with a larger, more diverse sample of Latina BCS over a longer study period. Clinical Trial: NCT03645005