Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: JMIR Cancer

Date Submitted: Jan 29, 2022
Date Accepted: Jul 4, 2022

The final, peer-reviewed published version of this preprint can be found here:

Feasibility and Acceptability of an Active Video Game–Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial

Swartz MC, Lewis ZH, Deer RR, Stahl AL, Swartz MD, Christopherson U, Basen-Engquist K, Wells SJ, Silva HC, Lyons EJ

Feasibility and Acceptability of an Active Video Game–Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial

JMIR Cancer 2022;8(3):e36889

DOI: 10.2196/36889

PMID: 35994321

PMCID: 9446134

Feasibility and Acceptability of an Active Video Game-Based Physical Activity Support Group (Pink Warrior) for Breast Cancer Survivors: A Randomized Controlled Pilot Trial

  • Maria C. Swartz; 
  • Zakkoyya H. Lewis; 
  • Rachel R. Deer; 
  • Anna L. Stahl; 
  • Michael D. Swartz; 
  • Ursela Christopherson; 
  • Karen Basen-Engquist; 
  • Stephanie J. Wells; 
  • H. Colleen Silva; 
  • Elizabeth J. Lyons

ABSTRACT

Background:

Breast cancer survivors with functional limitations have a 40% higher mortality rate than those without functional limitations. Despite the known benefits of physical activity (PA), fewer than 40% of breast cancer survivors meet the recommendations for PA. The combination of active video games (AVGs) and group-based PA counseling may hold potential for motivating PA adoption and improving physical function. However, such a method has not been widely studied in breast cancer survivors.

Objective:

We aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and to estimate the effect size and variability of the intervention on PA and physical function in female breast cancer survivors in a clinic setting.

Methods:

Female breast cancer survivors (N=60) were randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated in weekly group AVG sessions, PA behavioral coaching, and survivorship navigation discussions. A participant manual with weekly reflection worksheets was provided to reinforce coaching lessons and promote self-led PA. The control group received conventional pedometers and participated in an existing breast cancer support group. Feasibility was assessed by enrollment rate (≥50%), retention rate (≥80%), group attendance rate (≥9 sessions for intervention), and numbers of technological issues and adverse events. Acceptability was measured by participants’ attitudes (from strongly disagree, 1, to strongly agree, 5) toward the use of AVGs and the overall program. Outcomes included PA (accelerometers) and physical function (Short Physical Performance Battery and gait speed). Analysis of covariance was used to determine differences in PA and physical function between groups. Cohen’s d and its 95% CI determined effect size and variability, respectively. All analyses followed the intent-to-treat principle.

Results:

Participants were 57.4±10.5 years old, 70% white, and 58% off treatment. Our enrollment rate was 56%. Despite substantial long-term hurricane-related disruptions, we achieved 80% retention. The intervention group’s attendance rate was 77%, while the control group’s attendance rate was 56%. Of the 26 game-based pedometers, 3 were damaged or lost. No study-related adverse events occurred. Acceptability items were highly rated. Steps (β=1621.64, P=0.01; d=0.72), Short Physical Performance Battery (β=0.47, P=0.01; d=0.25), and gait speed (β=0.12, P=0.004; d=0.48) had a significant intervention effect.

Conclusions:

The intervention was feasible and acceptable in this population despite the occurrence of a natural disaster. Pilot results indicate that group AVG sessions, PA coaching, and survivorship navigation produced moderate effects on PA and physical functioning. AVGs with PA counseling can potentially be used in existing breast cancer support groups to encourage PA and improve physical function. Clinical Trial: Clinicaltrials.gov NCT02750241; https://clinicaltrials.gov/ct2/show/NCT02750241


 Citation

Please cite as:

Swartz MC, Lewis ZH, Deer RR, Stahl AL, Swartz MD, Christopherson U, Basen-Engquist K, Wells SJ, Silva HC, Lyons EJ

Feasibility and Acceptability of an Active Video Game–Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial

JMIR Cancer 2022;8(3):e36889

DOI: 10.2196/36889

PMID: 35994321

PMCID: 9446134

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.