JMIR Publications

ABSTRACT

Background:

Childhood cancer survivors are at increased risk of cardiometabolic complications which are exacerbated by poor health behaviours. Critically, many survivors do not meet physical activity guidelines.

Objective:

The primary aim was to evaluate the feasibility and acceptability of “iBounce”: a digital health intervention to educate and engage survivors in physical activity. Our secondary aims were to assess the change in survivors’ physical activity levels and behaviours, aerobic fitness, and health-related quality of life (HRQOL) after participating in iBounce.

Methods:

We recruited 8–13-year-old survivors who were ≥12 months post-cancer treatment completion. The 12-week self-guided online program (adapted from iEngage©) involved 10 educational modules, goal-setting, and home-based physical activities monitored using an activity tracker (Misfit Ray©). We assessed objective physical activity levels (GeneActiv accelerometer) and behaviours using cluster analysis, aerobic fitness (6-minute walk test), and HRQOL (EQ-5D-Y-5L) at baseline and post-intervention (week 12). Parents were trained to reassess aerobic fitness at home at follow-up (week 24).

Results:

Thirty participants opted in, 27 completed baseline assessments and 23 commenced iBounce. Our opt-in rate was 59% and most survivors (n=19/23; 83%) completed the program. We achieved high retention rate (70%), program completion (median 10/10 modules completed), activity tracker compliance (79%) and no intervention-related adverse events. Survivors reported high satisfaction with iBounce (median enjoyment score=75%; ease of use score=86%). Parents reported the program activites to be acceptable (median score was 70%) and identified benefits of the program including iBounce serving as a reminder for their child to exercise and motivation for the parent to promote physical activity for their child. Parents’ satisfaction with the program was 60% potentially due to technological difficulties which disjointed the program. We did not observe any significant changes in physical activity levels or HRQOL at week 12. Our sub-group analysis for changes in physical activity behaviours in 11 participants revealed five cluster groups: ‘most active’, ‘active’, ‘moderately active’, ‘occasionally active’, and ‘least active’. Three survivors moved to a more active cluster group highlighting their increased engagement in more frequent and sustained bouts of MVPA throughout the week. Six survivors stayed in the same cluster after completing iBounce and two moved to a less active cluster. Survivors’ mean aerobic fitness percentiles increased from pre- to post-intervention (change +17, 95% CI +1.7 to +32.1, P = .03), but not at follow-up (P = .39).

Conclusions:

We have demonstrated iBounce to be feasible to deliver and acceptable among survivors, despite some technical difficulties. The distance-delivered format provides an opportunity to engage survivors in physical activity at home and may address barriers to care, particularly for regional or remote families. We will use these pilot findings to enhance and evaluate an updated version of iBounce. Clinical Trial: ACTRN12621000259842