JMIR Publications

ABSTRACT

Background:

Despite the known benefits of physical activity, cancer survivors remain insufficiently active. Prior trials have adopted digital health methods, though several have been pedometer-based and enrolled mainly female, non-Hispanic White, and more highly educated survivors of breast cancer.

Objective:

The objective of this study was to test a previously developed mobile health system consisting of a Fitbit activity tracker and the MyDataHelps smartphone app for feasibility in a diverse group of cancer survivors, with the goal of refining the program and setting the stage for a larger future trial.

Methods:

Participants were identified from one academic medical center’s electronic health record, referred by a clinician, or self-referred to participate in the study. Participants were screened for eligibility, enrolled, provided a Fitbit activity tracker, and instructed to download the Fitbit: Health & Wellness and MyDataHelps apps. They completed usability surveys at 1-, and 3-months. Interviews were conducted at the end of the 3-month intervention with participants and cancer care clinicians to assess acceptability of the intervention and implementation of the intervention into clinical practice, respectively. Descriptive statistics were calculated for demographics, usability surveys, and Fitbit adherence and step counts. Rapid qualitative analysis was used to identify key findings from interview transcriptions.

Results:

Of the 100 patients screened for eligibility, 31 enrolled in the trial (mean age=64.8 years, female=54.8%, Hispanic/Latino=22.6%, non-white=35.5%, less than a bachelor’s degree=45.2%, household income <$75,000=48%). The mean years since diagnosis was 7.1 and the two most frequent cancer diagnoses were prostate (29%) and breast (13%) cancer. Participants provided positive feedback on the MyDataHelps app usability; the overall app quality received a mean score of 3.79 (SD 0.82) on a Likert scale from 1 to 5, (1 = worst, 5 = best). Overall, participants felt the Fitbit activity tracker and MyDataHelps app were easy to use, but also benefited from the technical assistance of the research team. Clinicians appreciated the idea of having an objective measure of physical activity data but expressed a desire to receive training on using Fitbit data, as well as having a standard workflow in place for prescribing the Fitbit activity tracker for physical activity.

Conclusions:

Implementing a remotely-delivered, light-intensity physical activity program was feasible and acceptable in a sample of diverse cancer survivors. Future studies should consider registry-based methods and work with clinicians to engage hard-to-reach survivor populations who have low physical activity levels and disproportionately high adverse health outcomes. Clinical Trial: Clinicaltrials.gov NCT05417438 https://clinicaltrials.gov/study/NCT05417438?term=SURVIVOR%20MHEALTH&rank=1