JMIR Publications

ABSTRACT

Background:

COVID-19 has had significant health and behavioral impacts on populations worldwide. Cancer survivors are at particular risk of changes in behavioral patterns, as they were encouraged to be more vigilant and observe stricter social distancing guidelines.

Objective:

We explored 1) changes in physical activity/sedentary behaviors since COVID-19, and mental health status, 2) alternative strategies to support the survivors’ physical activity and social support during and after COVID-19 including the role of digital health.

Methods:

A survey was distributed to cancer survivors participating (currently or in the past) in a community-based physical activity program, LIVESTRONG at the Y. Questions addressed pre-COVID vs. current changes in physical activity and sedentary time. Anxiety and depression were assessed using the GAD-2 and PHQ-2 with scores ≥3 classified as clinically diagnosed anxiety/depression. Digital health preferences were assessed using closed ended questions. Descriptive statistics were calculated. Open-ended responses addressing other preferences for physical activity programs and social support were analyzed, coded and categorized into themes.

Results:

Of the 61 participants, (mean age=62 ± 10.4; female=83.6%), 67.2% reported performing less physical activity and 67.2% reported sitting more since COVID-19 began. For the GAD-2 and PHQ-2, 24.6% and 26.2% met the criteria for clinical anxiety and depression, respectively. All participants (100%) reported having a cellphone; 90% had a smartphone. Preferences reported for physical activity programming (n=28) included three themes: 1) Use of digital/remote platforms (Zoom, online, videos), 2) Specific activities and locations (e.g. outdoors, walking, gardening, biking, YMCA, senior centers) and 3) Social support is important regardless of the type of activity (e.g. family, friends, peers and coaches). Participants reported a mean score of 71.8 ± 21.4 (scale 0-100) for importance of social support during physical activity programs. Social support preferences (n=15) included three themes: 1) Support from remote platforms (e.g. text messaging, Zoom, phone calls, emails and Facebook), 2) Tangible support in person (YMCA, Senior Center), and 3) Social support with no specific platform (e.g. small groups and family/friend visits).

Conclusions:

Since the start of COVID-19, cancer survivors in our study have experienced decreased physical activity and increased sedentary time. Depression and anxiety were reported by one-quarter of respondents. Both physical activity and mental health are critical factors in survivor’s quality of life, and interventions tailored to survivors’ preferences for activity are necessary. Digital remote physical activity programs with added social support may be a promising way to address ongoing needs during and after the pandemic.