Feasibility and acceptability of a physical activity tracker and text messages to promote physical activity during chemotherapy for colorectal cancer: a pilot randomized controlled trial (Smart Pace II)
ABSTRACT
Background:
We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate to vigorous physical activity (MVPA) among colorectal cancer (CRC) patients during chemotherapy.
Objective:
To determine whether a digital heath physical activity intervention was feasible and acceptable during chemotherapy for CRC.
Methods:
Potentially eligible CRC patients expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco and online through advertising. Eligible patients were randomized 1:1 to a 12-week (wk) intervention (Fitbit Flex, automated text messages) vs. usual care. At 0- and 12-wks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-min walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-min walk test outcomes were masked. Primary outcomes were adherence (e.g., Fitbit wear, text response rate) and self-assessed acceptability of the intervention. A priori, the intervention would be considered feasible if we observed 80% complete follow-up and 70% adherence and satisfaction.
Results:
In 2018 to 2020, we screened 240 patients; 53.3% (128/240) were ineligible and 26.7% (64/240) declined. Forty-four patients were randomized to intervention (n=22) or control (n=22). These patients were 57% female (25/44); 68% identified as white race (30/44) and 25% identified as Asian American/Pacific Islander (11/44); 77% (34/44) had a 4-year college degree. Median age at enrollment was 54 years (interquartile range: 45, 62). Follow-up at 12-weeks was 91% complete (40/44). In the intervention arm, patients wore Fitbits a median of 67 of 84 study days (80%) and responded to a median 17 out of 27 questions sent via text message (63%). Among the 19 of 22 intervention patients who completed the feedback survey, 89% were satisfied with the Fitbit (17/19) and 63% were satisfied with the text messages (12/19); 68% said the text messages motivated them to exercise (13/19); 74% said the frequency of text messages (1-3 days) was ideal (14/19); 79% said receiving text messages in the morning and evening was ideal (15/19).
Conclusions:
This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored text message content. Studies with more socioeconomically diverse CRC patients are needed. Clinical Trial: NCT03524716
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.