JMIR Publications

ABSTRACT

Background:

Long-term breast cancer survivors often continue to experience physical and psychological sequelae, despite being cancer-free; these challenges can negatively impact their quality of life and self-efficacy. Mobile health interventions (mHealth) constitute a promising strategy for providing personalized support. However, the feasibility and acceptability of these tools in long-term breast cancer survivors has not yet been sufficiently explored.

Objective:

To evaluate the feasibility and acceptability of the CUMACA-M, a digital health application designed to improve quality of life and self-efficacy in long-term breast cancer survivors.

Methods:

A single-arm feasibility pilot study was conducted with pre- and postintervention evaluations. The participants were recruited from the (Blinded for review) Association, an organization supporting individuals with breast cancer in (region and country blinded for review). The inclusion criteria included being female, being ≥18 years of age, having been diagnosed with breast cancer, and being disease-free for at least five years after primary treatment. The participants used the CUMACA-M app for three months. Feasibility was assessed through recruitment and completion rates, whereas acceptability was measured using the System Usability Scale (SUS) and open-ended qualitative questions. Changes in quality of life and self-efficacy were analysed with the Quality of Life - Cancer Survivors (QOL-CS) scale and the Self-Efficacy to Manage Chronic Disease Scale (SEMCD-S). Paired t tests were performed for pre-post comparisons.

Results:

A total of 23 women (mean age = 52.8 years, SD = 6.1) participated, with a 100% retention rate. The SUS score (mean = 80.8, SD = 15.2) indicated excellent usability. The health advice module received the highest level of satisfaction, whereas the nutrition and physical activity modules received suggestions for improvement. With respect to the clinical outcomes, no statistically significant differences were found between the pre- and postintervention scores on the QOL-CS (total score: pre = 5.96, SD = 1.08; post = 5.72, SD = 1.20; p = 0.074) or the SEMCD-S (total score: pre = 6.57, SD = 1.90; post = 6.26, SD = 1.82; p = 0.395). However, a reduction was observed in the QOL-CS spiritual well-being subscale (pre = 5.35, SD = 1.13; post = 4.93, SD = 1.22; p = 0.050).

Conclusions:

As a pioneering digital intervention for long-term breast cancer survivors, CUMACA-M proved to be a viable and acceptable intervention for this population, with a high level of usability and no dropouts. Although no significant changes were observed in quality of life or self-efficacy, the fact that it is a pilot study with a limited sample and the short duration of follow-up could have influenced these results. Studies with larger samples and longer follow-up periods are needed to assess the long-term impact of this intervention.