JMIR Publications

ABSTRACT

Background:

Web-based lifestyle interventions to promote healthy diet and physical activity behaviors among cancer survivors and their partners are recent developments. Thus, few studies have reported patterns of website use, and whether it is associated with behavior change.

Objective:

The study’s primary aim was to describe website use in the DUET (Daughters, dUdes, mothers and othErs Together) trial and examine the associations between website use and changes in diet quality, moderate-to-vigorous physical activity (MVPA), and body weight.

Methods:

This secondary analysis utilized data from 28 survivor-partner dyads (with BMI ≥ 25) randomized to the 6-month DUET web-based weight loss intervention. The intervention released serialized e-learning sessions on diet and exercise each week. Website use was quantified as the number of weeks participants accessed the website, time spent on the website, and frequency of pageviews. Diet quality was assessed from 2-day dietary recalls, and MVPA from the Godin Leisure-Time Exercise Questionnaire and accelerometry. Weight was measured on a digital scale. Website use was summarized descriptively; associations were examined using Spearman partial correlations.

Results:

The study sample had a mean age of 58 (SD±12.5) years; 78.6% identified as female, 66.1% were non-Hispanic White, and 86% were breast cancer survivors. On average, participants viewed 11.2 weeks (SD±7.4) of the 24-week intervention, or a total of 312.9 (SD±255.7) minutes per participant. Sessions (2736), Home Page (975), and Tools (967) features showed the highest pageview activity (total of 5885 pageviews). Website use was significantly higher among adults aged 65 years or older compared to younger participants, showcased by duration of use (14.4 vs. 9.2 weeks), time spent per week (17.0 vs. 10.5 minutes), and total number of pageviews (135.7 vs. 85.3) (P <.05); higher website use was also reported among women versus men in terms of duration of use (12.8 vs. 5.6 weeks), time spent per week (14.6 vs. 7.4 minutes), and total number of pageviews (120 vs. 50.3) (P <.05). Diet quality was positively associated with website use: weeks (r = 0.50, P < .001), time (r = 0.45, P < .001), total pageviews (r = 0.46, P < .001), and sessions pageviews (r = 0.39, P =.005). Self-reported MVPA was also positively associated with website use: weeks (r = 0.37, P =.007), time (r = 0.36, P =.009), total pageviews (r = 0.36, P =.010), and sessions pageviews (r = 0.35, P =.01). However, no statistically significant associations were detected for accelerometry-measured MVPA or weight.

Conclusions:

Findings suggest that cancer survivors and their partners engage with web-based lifestyle interventions that promote diet and physical activity behaviors (with use particularly high among older adults and females), and that website use was significantly associated with improvements in diet quality and self-reported MVPA. Clinical Trial: ClinicalTrials.gov Identifier: NCT04132219