JMIR Publications

ABSTRACT

Background:

Many newly diagnosed cancers are associated with modifiable lifestyle behaviors, such as diet, exercise, smoking cessation, and maintaining a healthy weight. Despite this, primary care providers rarely discuss cancer prevention behaviors with their patients.

Objective:

To assess the usability, acceptability and engagement of the Healthier Together mobile application, which is designed to promote cancer prevention behaviors among Non-Hispanic Black primary care patients, utilizing social network and goal setting theories of behavior change.

Methods:

In an eight-week pilot study, we enrolled primary care patients (n=41) and provided these participants with a cancer prevention mobile application that allowed them to select, track, and share progress on cancer prevention goals with other users. We assessed application usability with the System Usability Scale (SUS). We assessed app acceptability by qualitatively analyzing open-ended responses about participants’ overall experience with the app. We assessed participant engagement by analyzing the built-in data capture, including how many times participants checked in (out of a maximum of eight) during the study.

Results:

Of 41 participants, the mean age was 51 (SD: 12) and 31 (76%) were women. App use data was captured for all participants and 34 (83%) completed the exit survey and interview. The mean SUS score was 87 (SD ±12; median 90; IQR 78-95). Analysis of open-ended responses revealed several key themes, with participants complementing the application’s ease of use and health behavior promoting features, while also commenting on the need for more feedback and social interactions through the application. On average, participants checked in 5.7 times (SD: 2.7) out of eight possible opportunities. Thirty-one participants (76%) checked in during at least 4 of the 8 weeks. Secondary analyses revealed that participants often accomplished their set goal (mean: 5.1, SD: 2.7) for each week. Qualitative analysis of comments participants left within the app after each weekly check-in revealed several themes on how the app assisted participants in behavioral change, highlighting that some participants built up exercise programs, ate healthier foods, lost a significant amount of weight, and stopped smoking during the study.

Conclusions:

The implementation of a mobile cancer prevention goal setting application in a primary care setting was feasible with high usability, acceptability, and engagement from participants. User feedback revealed an influence on health behaviors. These findings suggest the promise of the HT application to facilitate behavioral change to reduce cancer risk among Non-Hispanic Black primary care patients.