JMIR Publications

ABSTRACT

Background:

Breast cancer, the most commonly diagnosed cancer and second leading cause of cancer-related death in women in the U.S., disproportionately impacts women from minoritized or low socioeconomic backgrounds. The average woman has an approximate 12% lifetime risk of developing breast cancer. Lifetime risk nearly doubles if a woman has a first-degree relative with breast cancer, and the risk increases as multiple family members are affected. Decreasing sedentary behaviors through moving more and sitting less is associated with a reduction in breast cancer risk and improved outcomes for both cancer survivors and healthy adults. Digital health solutions, such as mobile applications that are culturally appropriate, designed with input from the target audience, and including social support, are effective at improving health behaviors.

Objective:

To develop and evaluate the usability and acceptability of a prototype app designed with a user-centered approach to promote moving more and sitting less in Black breast cancer survivors and their first-degree relatives (parent, child, sibling).

Methods:

This three phase study consisted of 1) development; 2) user testing; and 3) evaluation of user engagement and usability. Key community stakeholders were engaged in the first two (qualitative) phases to provide input into the development of the prototype application (MoveTogether). After development and user testing, a usability pilot was conducted. Participants were adult breast cancer survivors who identified as Black and agreed to participate with a relative. Participants used the app and a step tracking watch for four weeks. App components included goal setting and reporting, reminders, dyad messaging, and educational resources. Usability and acceptability were assessed with a questionnaire which included the System Usability Scale (SUS), and semi-structured interviews. Data were analyzed with descriptive statistics and content analysis.

Results:

Participants in the usability pilot (n=10) were female, ages 30-50 (60%), not married (80%), and college graduates (50%). The app was used on average 17 of 28 days, SUS score of 72 (range 55-95), and at least 70% agreed the app was acceptable, helpful, and gave new ideas. Ninety percent found the dyad component useful and would recommend the app to a friend. Qualitative findings suggest that the goal setting feature was helpful and the dyad partner (“buddy”) provided accountability. Participants were neutral on cultural appropriateness of the app.

Conclusions:

The MoveTogether App appeared to be acceptable to promote moving more in dyads of breast cancer survivors and their relatives. Connecting with a buddy, setting goals, and tracking activity were the highest rated components. Future work should be done to further develop the intervention based on findings and then test efficacy to improve sedentary behavior, while considering culturally informed strategies for adoption and implementation within the community. Clinical Trial: NCT05011279