Currently accepted at: JMIR Formative Research
Date Submitted: May 10, 2025
Date Accepted: Feb 2, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/77255
The final accepted version (not copyedited yet) is in this tab.
Effect of WeChat Intervention Based on the Common-Sense Model on Breast Cancer-Related Lymphedema Preventive Behaviors: A Quasi-Experimental Study
ABSTRACT
Background:
Breast cancer-related lymphedema is the most prevalent postoperative complication among breast cancer survivors. Although mobile health tools are increasingly used for patient education, evidence supporting their efficacy in lymphedema prevention remains limited.
Objective:
To evaluate the effectiveness of a WeChat-based intervention grounded in the Common-Sense Model in improving preventive behaviors, modifying illness perceptions, and reducing lymphedema incidence among breast cancer survivors, and to validate the targets of the intervention.
Methods:
This study employed a quasi-experimental design. Participants (N=192) were recruited from the breast cancer department of a cancer hospital in Guangzhou, China. The control group (n=98) received routine care. The intervention group (n=94) participated in a 3-month CSM-guided WeChat mini-program (“Nantian e-Care”) delivering tailored educational articles, exercise tutorials, arm circumference monitoring, and real-time nurse consultations. Outcomes, including preventive behaviors, illness perceptions, and lymphedema incidence, were assessed 1, 3, and 6 months post-surgery. Generalized estimating equations were used in the analysis.
Results:
The intervention group exhibited significant improvements in lifestyle adjustments (Wald χ2=6.927, P=0.031) and physical exercise adherence (Wald χ2=6.927, P=0.031) compared with the control group. Illness perception including identity (Wald χ2=8.076, P=0.044), timeline cyclical (Wald χ2=8.452, P=0.038), personal control (Wald χ2=9.283, P=0.026), and illness coherence (Wald χ2=29.784, P<0.001), behavioral (Wald χ2=19.492, P<0.001) and physical factors (Wald χ2=24.073, P<0.001) were markedly enhanced. Mechanistically, skincare improvements were driven by intervention effects, personal control, illness coherence, and behavioral attribution. Lifestyle changes were correlated with intervention and illness coherence. Adherence to physical exercise was marginally affected by intervention and personal control. Critically, the intervention group demonstrated a lower incidence of lymphedema at six months (6.38% vs. 15.31%, χ2=3.922, P=0.048).
Conclusions:
The Common-Sense Model-guided WeChat intervention effectively promoted preventive behaviors, optimized illness perceptions, and reduced lymphedema risk. These findings underscore the value of integrating theory-driven mHealth tools into postoperative care, and highlight scalable strategies for chronic disease management in resource-limited settings. Clinical Trial: ChiCTR2100048798.
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