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Lee H, Uhm KE, Cheong IY, Yoo JS, Chung SH, Park YH, Lee JY, Hwang JH. Patient Satisfaction with Mobile Health (mHealth) Application for Exercise Intervention in Breast Cancer Survivors. J Med Syst 2018; 42:254. [PMID: 30402781 DOI: 10.1007/s10916-018-1096-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/09/2018] [Indexed: 01/21/2023]
Abstract
This study aimed to assess user satisfaction with mobile health (mHealth) application in breast cancer survivors after a 12-week exercise program and provide developers with reference points for mHealth applications from the perspective of patients and physicians. This is a retrospective review of prospectively collected multicenter data of 88 breast cancer survivors who carried out a 12-week exercise program via smartphone application with pedometer. Personalized programs including aerobic and resistance exercise were prescribed by physiatrists. Also, telephone counseling was performed at the 3rd and 9th week. All patients completed the user satisfaction questionnaire at the end of the intervention. The mean achievement rates of aerobic and resistance exercise for 12 weeks were 78.8 and 71.3%, respectively. The mean score of overall satisfaction rated on the 5-point Likert scale was 4.22 ± 0.73. When the patients were grouped according to age, the overall satisfaction score increased significantly with age (P = 0.040). Also, the satisfaction scores of patients with radiotherapy were significantly higher than patients without radiotherapy (P = 0.001). In terms of system characteristics, the most satisfying was data transmission accuracy (4.32 ± 0.74). In addition, patients were very satisfied with telephone counseling (4.55 ± 0.62). The results suggest the direction of mHealth should go to meet the detailed requirements of the specific user group as a more targeted approach. In addition, if a mutual feedback platform can be implanted in mHealth applications, it will increase user loyalty and make mHealth a more available motivational technology in our lives.
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Affiliation(s)
- Hannah Lee
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyeong Eun Uhm
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - In Yae Cheong
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
| | - Seung Hyun Chung
- Department of Rehabilitation Medicine, National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
| | - Yong Hyun Park
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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Escriva Boulley G, Leroy T, Bernetière C, Paquienseguy F, Desfriches-Doria O, Préau M. Digital health interventions to help living with cancer: A systematic review of participants' engagement and psychosocial effects. Psychooncology 2018; 27:2677-2686. [PMID: 30152074 DOI: 10.1002/pon.4867] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/09/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Digital health interventions (DI) open the possibility for cancer patients and survivors to manage the disease and its side effects when they return home after treatment. This study aims to highlight the components of DI, investigate patient engagement with DI, and explore the effects of DI on psychosocial variables. METHODS In September 2017, we performed a systematic review of studies focusing on DI which target cancer patients or survivors. RESULTS A total of 29 articles (24 studies) were reviewed. There was considerable heterogeneity in study methods, in outcome definitions, in measures for engagement with DI and in psychosocial variables assessed. Results from the studies showed a high level of engagement. Self-efficacy, psychological symptoms, and quality of life were the most commonly assessed psychosocial variables. However, results for the effect of DI on psychosocial variables were inconsistent. Regarding pain management, results were in line with what one would expect. CONCLUSIONS The present review showed that despite the heterogeneity in the studies assessed and inconsistent results, DI may constitute an excellent means to help cancer patients and survivors cope better with the disease and with treatment side effects, as they can improve self-management and wellbeing. In order to acquire a greater understanding of the mechanisms underlying cancer patients'/survivors' psychological and behavioral changes in terms of adopting DI, direct comparison between studies is needed. However, this can only come about if methodological and conceptual standardization of DI is implemented.
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Affiliation(s)
- Géraldine Escriva Boulley
- Laboratory: Social Psychology Research Group [Groupe de Recherche en Psychologie Sociale] (EA 4163), Psychology Institute [Institut de Psychologie]-Lyon 2 University [Université Lyon 2], Bron, France
| | - Tanguy Leroy
- Laboratory: Social Psychology Research Group [Groupe de Recherche en Psychologie Sociale] (EA 4163), Psychology Institute [Institut de Psychologie]-Lyon 2 University [Université Lyon 2], Bron, France
| | - Camille Bernetière
- Laboratory: Information and Communication Sciences Lyon Research Team [Équipe de Recherche de Lyon en Sciences de l'Information et de la Communication] (EA 4147), Institute of Human Sciences [Institut des Sciences de l'Homme]-Lyon University [Université de Lyon], Lyon, France
| | - Françoise Paquienseguy
- Laboratory: Information and Communication Sciences Lyon Research Team [Équipe de Recherche de Lyon en Sciences de l'Information et de la Communication] (EA 4147), Institute of Human Sciences [Institut des Sciences de l'Homme]-Lyon University [Université de Lyon], Lyon, France
| | - Orélie Desfriches-Doria
- Laboratory: Information and Communication Sciences Lyon Research Team [Équipe de Recherche de Lyon en Sciences de l'Information et de la Communication] (EA 4147), Institute of Human Sciences [Institut des Sciences de l'Homme]-Lyon University [Université de Lyon], Lyon, France
| | - Marie Préau
- Laboratory: Social Psychology Research Group [Groupe de Recherche en Psychologie Sociale] (EA 4163), Psychology Institute [Institut de Psychologie]-Lyon 2 University [Université Lyon 2], Bron, France
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Zhu J, Ebert L, Liu X, Wei D, Chan SWC. Mobile Breast Cancer e-Support Program for Chinese Women With Breast Cancer Undergoing Chemotherapy (Part 2): Multicenter Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e104. [PMID: 29712622 PMCID: PMC5952114 DOI: 10.2196/mhealth.9438] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 01/20/2023] Open
Abstract
Background Women undergoing chemotherapy for the treatment of breast cancer have frequently reported unmet supportive care needs. Moreover, easily accessible and innovative support is lacking. Objective The purpose of this trial was to determine the effectiveness of an app-based breast cancer e-support program to address women’s self-efficacy (primary outcome), social support, symptom distress, quality of life, anxiety, and depression. Secondary objectives included exploring the association between women’s health outcomes and the breast cancer e-support usage data. Methods A multicenter, single-blinded, randomized controlled trial was conducted. A total of 114 women with breast cancer, who were commencing chemotherapy and were able to access internet through a mobile phone, were recruited in the clinics from 2 university-affiliated hospitals in China. Women were randomized either to the intervention group (n=57) receiving breast cancer e-support plus care as usual or the control group (n=57) receiving care as usual alone. The health care team and research assistants collecting data were blinded to the women’s group allocation. Bandura’s self-efficacy theory and the social exchange theory guided the development of the breast cancer e-support program, which has 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. Moderated by an experienced health care professional, the breast cancer e-support program supported women for 12 weeks covering 4 cycles of chemotherapy. Health outcomes were self-assessed through paper questionnaires in clinics at baseline before randomization (T0), after 3 (T1), and 6 months (T2) of follow-ups. Results Fifty-five participants in the intervention group and 49 in the control group completed the follow-up assessments (response rate: 91.2%). During the 12-week intervention, the log-in frequency ranged from 0 to 774 times (mean 54.7; SD 131.4; median 11; interquartile range, IQR 5-27), and the total usage duration ranged from 0 to 9371 min (mean 1072.3; SD 2359.5; median 100; IQR 27-279). Repeated measures multivariate analysis of covariance (intention-to-treat) found that breast cancer e-support + care as usual participants had significant better health outcomes at 3 months regarding self-efficacy (21.05; 95% CI 1.87-40.22; P=.03; d=0.53), symptom interference (−0.73; 95% CI −1.35 to −.11; P=.02; d=−0.51), and quality of life (6.64; 95% CI 0.77-12.50; P=.03, d=0.46) but not regarding social support, symptom severity, anxiety, and depression compared with care as usual participants. These beneficial effects were not sustained at 6 months. Spearman rank-order correlation showed that the breast cancer e-support usage duration was positively correlated with self-efficacy (r=.290, P=.03), social support (r=.320, P=.02), and quality of life (r=.273, P=.04) at 3 months. Conclusions The breast cancer e-support program demonstrated its potential as an effective and easily accessible intervention to promote women’s self-efficacy, symptom interference, and quality of life during chemotherapy. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000639426; www.ANZCTR.org.au/ACTRN12616000639426.aspx (Archived by Webcite at http://www.webcitation.org/6v1n9hGZq)
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Affiliation(s)
- Jiemin Zhu
- Nursing Department, Medical School, Xiamen University, Xiamen, China.,School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Lyn Ebert
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Xiangyu Liu
- Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, China
| | - Di Wei
- Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, China
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Byun W, Lee JM, Kim Y, Brusseau TA. Classification Accuracy of a Wearable Activity Tracker for Assessing Sedentary Behavior and Physical Activity in 3-5-Year-Old Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E594. [PMID: 29587432 PMCID: PMC5923636 DOI: 10.3390/ijerph15040594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/19/2018] [Accepted: 03/23/2018] [Indexed: 12/25/2022]
Abstract
This study examined the accuracy of the Fitbit activity tracker (FF) for quantifying sedentary behavior (SB) and varying intensities of physical activity (PA) in 3-5-year-old children. Twenty-eight healthy preschool-aged children (Girls: 46%, Mean age: 4.8 ± 1.0 years) wore the FF and were directly observed while performing a set of various unstructured and structured free-living activities from sedentary to vigorous intensity. The classification accuracy of the FF for measuring SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and total PA (TPA) was examined calculating Pearson correlation coefficients (r), mean absolute percent error (MAPE), Cohen's kappa (k), sensitivity (Se), specificity (Sp), and area under the receiver operating curve (ROC-AUC). The classification accuracies of the FF (ROC-AUC) were 0.92, 0.63, 0.77 and 0.92 for SB, LPA, MVPA and TPA, respectively. Similarly, values of kappa, Se, Sp and percentage of correct classification were consistently high for SB and TPA, but low for LPA and MVPA. The FF demonstrated excellent classification accuracy for assessing SB and TPA, but lower accuracy for classifying LPA and MVPA. Our findings suggest that the FF should be considered as a valid instrument for assessing time spent sedentary and overall physical activity in preschool-aged children.
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Affiliation(s)
- Wonwoo Byun
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Jung-Min Lee
- School of Physical Education, Kyung Hee University, Yongin 17104, Korea.
| | - Youngwon Kim
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CBD 0SP, UK.
| | - Timothy A Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
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McCallum C, Rooksby J, Gray CM. Evaluating the Impact of Physical Activity Apps and Wearables: Interdisciplinary Review. JMIR Mhealth Uhealth 2018; 6:e58. [PMID: 29572200 PMCID: PMC5889496 DOI: 10.2196/mhealth.9054] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/01/2018] [Accepted: 01/07/2018] [Indexed: 01/02/2023] Open
Abstract
Background Although many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work. Objectives This study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed. Method An interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis. Results A total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance). Conclusions The rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid research designs, in-device sensors and user-logs to assess effectiveness, engagement, and acceptability. Screening articles was time-consuming because reporting across health and computing sciences lacked standardization. Reporting guidelines are therefore needed to facilitate the synthesis of evidence across disciplines.
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Affiliation(s)
- Claire McCallum
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - John Rooksby
- School of Computing Science, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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56
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Short CE, Finlay A, Sanders I, Maher C. Development and pilot evaluation of a clinic-based mHealth app referral service to support adult cancer survivors increase their participation in physical activity using publicly available mobile apps. BMC Health Serv Res 2018; 18:27. [PMID: 29338722 PMCID: PMC5771037 DOI: 10.1186/s12913-017-2818-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Participation in regular physical activity holds key benefits for cancer survivors, yet few cancer survivors meet physical activity recommendations. This study aimed to develop and pilot test a mHealth app referral service aimed at assisting cancer survivors to increase their physical activity. In particular, the study sought to examine feasibility and acceptability of the service and determine preliminary efficacy for physical activity behaviour change. METHODS A systematic search identified potentially appropriate Apple (iOS) and Android mHealth apps. The apps were audited regarding the type of physical activity encouraged, evidence-based behavioural strategies and other characteristics, to help match apps to users' preferences and characteristics. A structured service was devised to deliver the apps and counselling, comprising two face-to-face appointments with a mid-week phone or email check-up. The mHealth app referral service was piloted using a pre-post design among 12 cancer survivors. Participants' feedback regarding the service's feasibility and acceptability was sought via purpose-designed questionnaire, and analysed using inductive thematic analysis and descriptive statistics. Change in physical activity was assessed using a valid and reliable self-report tool and analysed using paired t-tests. In line with recommendations for pilot studies, confidence intervals and effect sizes were reported to aid interpretation of clinical significance, with an alpha of 0.2 used to denote statistical significance. RESULTS Of 374 mHealth apps identified during the systematic search, 54 progressed to the audit (iOS = 27, Android = 27). The apps consistently scored well for aesthetics, engagement and functionality, and inconsistently for gamification, social and behaviour change features. Ten participants completed the pilot evaluation and provided positive feedback regarding the service's acceptability and feasibility. On average, participants increased their moderate-vigorous physical activity by 236 min per week (d = 0.73; 95% CI = -49 to 522; p = 0.09). CONCLUSION This study offered initial evidence that a mHealth app referral service for cancer survivors is feasible and acceptable and may increase physical activity levels. The large increase in physical activity is promising, but should be interpreted with caution given the small sample size and lack of control group. Further research is warranted on a larger scale to investigate generalisability, long-term compliance and application in clinical settings.
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Affiliation(s)
- Camille E. Short
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Amy Finlay
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Ilea Sanders
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
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Brett J, Boulton M, Watson E. Development of an e-health app to support women prescribed adjuvant endocrine therapy after treatment for breast cancer. Patient Prefer Adherence 2018; 12:2639-2647. [PMID: 30587936 PMCID: PMC6294163 DOI: 10.2147/ppa.s187692] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Adjuvant endocrine therapy (AET) is prescribed to women for 5-10 years after treatment for estrogen receptor positive (ER+ve), early-stage breast cancer. AET has proven effectiveness in reducing the risk of recurrence of breast cancer and mortality. However, adherence is known to be suboptimal with around 20% discontinuing by 2 years and up to 50% discontinuing by 5 years. Interventions are needed to support women taking AET after breast cancer. The aim of this study was to develop and pilot test an e-health app for this population. METHODS Two focus groups (n=15) and five interviews were conducted with women following treatment for early-stage breast cancer to assess the likely acceptability of an e-health app and to inform the content (Phase I). Following development of a prototype e-health app, a simple heuristic usability test was completed by five women in order to identify any design usability problems (Phase II). A further 18 women used the app for 1 month between July and August 2016, after which they were interviewed by telephone to collect their experiences and views of the app (Phase III). RESULTS The prototype e-health app included evidence-based information on effectiveness of AET, an electronic side-effects diary, a peer support forum, a repeat prescription reminder, suggested strategies for facilitating adherence and managing any side effects that occur, and a link to further evidence and useful organizations for further information and support. The app was received positively by women. Women found the app useful as it emphasized the importance of taking AET, helped them manage their side effects and provided details of support organizations, while offering empathy and exchange of suggestions for self-management strategies through the peer support forum. CONCLUSION Overall, findings suggest that this novel e-health app has potential as a feasible medium for promoting adherence to AET. Future research should evaluate the efficacy of the app in supporting women and promoting adherence.
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Affiliation(s)
- Jo Brett
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
| | - Mary Boulton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK,
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Tokosi TO, Fortuin J, Douglas TS. The Impact of mHealth Interventions on Breast Cancer Awareness and Screening: Systematic Review Protocol. JMIR Res Protoc 2017; 6:e246. [PMID: 29269341 PMCID: PMC5754564 DOI: 10.2196/resprot.8043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 09/01/2017] [Accepted: 10/05/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) is the use of mobile communication technologies to promote health by supporting health care practices (eg, health data collection, delivery of health care information). mHealth technologies (such as mobile phones) can be used effectively by health care practitioners in the distribution of health information and have the potential to improve access to and quality of health care, as well as reduce the cost of health services. Current literature shows limited scientific evidence related to the benefits of mHealth interventions for breast cancer, which is the leading cause of cancer deaths in women worldwide and contributes a large proportion of all cancer deaths, especially in developing countries. Women, especially in low- and middle-income countries (LMICs), are faced with low odds of surviving breast cancer. This finding is likely due to multiple factors related to health systems: low priority of women's health and cancer on national health agendas; lack of awareness that breast cancer can be effectively treated if detected early; and societal, cultural, and religious factors that are prevalent in LMICs. The proposed systematic review will examine the impact of mHealth interventions on breast cancer awareness and screening among women aged 18 years and older. OBJECTIVE The objectives of this study are to identify and describe the various mHealth intervention strategies that are used for breast cancer, and assess the impact of mHealth strategies on breast cancer awareness and screening. METHODS Literature from various databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials will be examined. Trial registers, reports, and unpublished theses will also be included. All mobile technologies such as cell phones, personal digital assistants, and tablets that have short message service, multimedia message service, video, and audio capabilities will be included. mHealth is the primary intervention. The search strategy will include keywords such as "mHealth," "breast cancer," "awareness," and "screening," among other medical subject heading terms. Articles published from January 1, 1964 to December 31, 2016 will be eligible for inclusion. Two authors will independently screen and select studies, extract data, and assess the risk of bias, with discrepancies resolved by dialogue involving a third author. We will assess statistical heterogeneity by examining the types of participants, interventions, study designs, and outcomes in each study, and pool studies judged to be statistically homogeneous. In the assessment of heterogeneity, a sensitivity analysis will be considered to explore statistical heterogeneity. Statistical heterogeneity will be investigated using the Chi-square test of homogeneity on Cochrane's Q statistic and quantified using the I-squared statistic. RESULTS The search strategy will be refined with the assistance of an information specialist from November 1, 2017 to January 31, 2018. Literature searches will take place from February 2018 to April 2018. Data extraction and capturing in Review Manager (RevMan, Version 5.3) will take place from May 1, 2018 to July 31, 2018. The final stages will include analyses and writing, which is anticipated occur between August 2018 and October 2018. CONCLUSIONS The knowledge derived from this study will inform health care stakeholders, including researchers, policy makers, investors, health professionals, technologists, and engineers, on the impact of mHealth interventions on breast cancer screening and awareness. TRIAL REGISTRATION Prospero registration number CRD42016050202.
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Affiliation(s)
- Temitope O Tokosi
- Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Jill Fortuin
- Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Tania S Douglas
- Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa
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Ryu B, Kim N, Heo E, Yoo S, Lee K, Hwang H, Kim JW, Kim Y, Lee J, Jung SY. Impact of an Electronic Health Record-Integrated Personal Health Record on Patient Participation in Health Care: Development and Randomized Controlled Trial of MyHealthKeeper. J Med Internet Res 2017; 19:e401. [PMID: 29217503 PMCID: PMC5740264 DOI: 10.2196/jmir.8867] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/20/2017] [Accepted: 10/31/2017] [Indexed: 12/18/2022] Open
Abstract
Background Personal health record (PHR)–based health care management systems can improve patient engagement and data-driven medical diagnosis in a clinical setting. Objective The purpose of this study was (1) to demonstrate the development of an electronic health record (EHR)–tethered PHR app named MyHealthKeeper, which can retrieve data from a wearable device and deliver these data to a hospital EHR system, and (2) to study the effectiveness of a PHR data-driven clinical intervention with clinical trial results. Methods To improve the conventional EHR-tethered PHR, we ascertained clinicians’ unmet needs regarding PHR functionality and the data frequently used in the field through a cocreation workshop. We incorporated the requirements into the system design and architecture of the MyHealthKeeper PHR module. We constructed the app and validated the effectiveness of the PHR module by conducting a 4-week clinical trial. We used a commercially available activity tracker (Misfit) to collect individual physical activity data, and developed the MyHealthKeeper mobile phone app to record participants’ patterns of daily food intake and activity logs. We randomly assigned 80 participants to either the PHR-based intervention group (n=51) or the control group (n=29). All of the study participants completed a paper-based survey, a laboratory test, a physical examination, and an opinion interview. During the 4-week study period, we collected health-related mobile data, and study participants visited the outpatient clinic twice and received PHR-based clinical diagnosis and recommendations. Results A total of 68 participants (44 in the intervention group and 24 in the control group) completed the study. The PHR intervention group showed significantly higher weight loss than the control group (mean 1.4 kg, 95% CI 0.9-1.9; P<.001) at the final week (week 4). In addition, triglyceride levels were significantly lower by the end of the study period (mean 2.59 mmol/L, 95% CI 17.6-75.8; P=.002). Conclusions We developed an innovative EHR-tethered PHR system that allowed clinicians and patients to share lifelog data. This study shows the effectiveness of a patient-managed and clinician-guided health tracker system and its potential to improve patient clinical profiles. Trial Registration ClinicalTrials.gov NCT03200119; https://clinicaltrials.gov/ct2/show/NCT03200119 (Archived by WebCite at http://www.webcitation.org/6v01HaCdd)
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Affiliation(s)
- Borim Ryu
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Nari Kim
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Eunyoung Heo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Keehyuck Lee
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea.,Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Hee Hwang
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Yoojung Kim
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic Of Korea
| | - Joongseek Lee
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic Of Korea
| | - Se Young Jung
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea.,Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
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60
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Rincon E, Monteiro-Guerra F, Rivera-Romero O, Dorronzoro-Zubiete E, Sanchez-Bocanegra CL, Gabarron E. Mobile Phone Apps for Quality of Life and Well-Being Assessment in Breast and Prostate Cancer Patients: Systematic Review. JMIR Mhealth Uhealth 2017; 5:e187. [PMID: 29203459 PMCID: PMC5735250 DOI: 10.2196/mhealth.8741] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/26/2017] [Accepted: 10/29/2017] [Indexed: 11/13/2022] Open
Abstract
Background Mobile phone health apps are increasingly gaining attention in oncological care as potential tools for supporting cancer patients. Although the number of publications and health apps focusing on cancer is increasing, there are still few specifically designed for the most prevalent cancers diagnosed: breast and prostate cancers. There is a need to review the effect of these apps on breast and prostate cancer patients’ quality of life (QoL) and well-being. Objective The purposes of this study were to review the scientific literature on mobile phone apps targeting breast or prostate cancer patients and involving QoL and well-being (anxiety and depression symptoms) and analyze the clinical and technological characteristics, strengths, and weaknesses of these apps, as well as patients’ user experience with them. Methods We conducted a systematic review of peer-reviewed literature from The Cochrane Library, Excerpta Medica Database, PsycINFO, PubMed, Scopus, and MEDLINE to identify studies involving apps focused on breast and/or prostate cancer patients and QoL and/or well-being published between January 1, 2000, and July 12, 2017. Only trial studies which met the inclusion criteria were selected. The systematic review was completed with a critical analysis of the apps previously identified in the health literature research that were available from the official app stores. Results The systematic review of the literature yielded 3862 articles. After removal of duplicates, 3229 remained and were evaluated on the basis of title and abstract. Of these, 3211 were discarded as not meeting the inclusion criteria, and 18 records were selected for full text screening. Finally, 5 citations were included in this review, with a total of 644 patients, mean age 52.16 years. Four studies targeted breast cancer patients and 1 focused on prostate cancer patients. Four studies referred to apps that assessed QoL. Only 1 among the 5 analyzed apps was available from the official app store. In 3 studies, an app-related intervention was carried out, and 2 of them reported an improvement on QoL. The lengths of the app-related interventions varied from 4 to 12 weeks. Because 2 of the studies only tracked use of the app, no effect on QoL or well-being was found. Conclusions Despite the existence of hundreds of studies involving cancer-focused mobile phone apps, there is a lack of rigorous trials regarding the QoL and/or well-being assessment in breast and/or prostate cancer patients. A strong and collective effort should be made by all health care providers to determine those cancer-focused apps that effectively represent useful, accurate, and reliable tools for cancer patients’ disease management. Trial Registration PROSPERO CRD42017073069; https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID= CRD42017073069 (Archived by WebCite at http://www.webcitation.org/6v38Clb9T)
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Affiliation(s)
- Esther Rincon
- Department of Psychology and Pedagogy, Universidad San Pablo Centro de Estudios Universitarios, Alcorcón (Madrid), Spain
| | | | | | | | | | - Elia Gabarron
- Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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61
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Novel approaches to support breast cancer survivorship care models. Breast 2017; 36:1-13. [DOI: 10.1016/j.breast.2017.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/04/2017] [Accepted: 08/11/2017] [Indexed: 12/21/2022] Open
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Stewart JL, Besenyi GB, Williams LB, Burt V, Anglin JC, Ghamande SA, Coughlin SS. Healthy lifestyle intervention for African American uterine cancer survivors: Study protocol. Contemp Clin Trials Commun 2017; 8:11-17. [PMID: 29075673 PMCID: PMC5653315 DOI: 10.1016/j.conctc.2017.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/03/2017] [Accepted: 08/15/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cancer of the uterine corpus is the most common gynecologic malignancy and the fourth most common cancer in U.S. women. There is a racial disparity in the survival from endometrial cancer and this may be addressed by culturally-tailored lifestyle interventions to help African American (AA) endometrial cancer survivors lose weight or maintain a healthy weight. OBJECTIVE The overall purpose of this pilot study is to develop and evaluate a culturally-tailored lifestyle intervention to help AA uterine cancer survivors reduce their risk of cancer recurrence and improve their quality of life through healthy eating, physical activity, and weight management. While many interventions have been evaluated to assist cancer survivors through diet and physical activity, few have focused on AA women with a uterine cancer diagnosis. METHODS Community-engaged research principles are being followed. This study was developed with input from the Augusta University (AU) College of Nursing Community Advisory Board (CAB) and the Division of Gynecologic Oncology at the Georgia Cancer Center at AU. Weekly sessions throughout a 12-week intervention will include physical activity and lectures on improving nutritional status. The pre/post-test design includes baseline and 6-month follow-up, where participants will complete a questionnaire that assesses knowledge and attitudes about physical activity, nutrition, uterine cancer, social support, and quality of life. CONCLUSIONS From this pilot study, we will learn more about the feasibility and integration of healthy lifestyle interventions in this patient population, and the results can provide an opportunity for a larger-scale, multi-center study with a randomized controlled design.
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Affiliation(s)
- Jessica Lynn Stewart
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Gina B. Besenyi
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Lovoria B. Williams
- College of Nursing, Biobehavioral Nursing Department, Augusta University, Augusta, GA, United States
| | - Victoria Burt
- College of Nursing Community Advisory Board, Augusta University, Augusta, GA, United States
| | - Judith C. Anglin
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Sharad A. Ghamande
- Division of Gynecologic Oncology, Georgia Cancer Center, Augusta University, GA, United States
| | - Steven Scott Coughlin
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
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63
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Zhu J, Ebert L, Xue Z, Shen Q, Chan SWC. Development of a mobile application of Breast Cancer e-Support program for women with breast cancer undergoing chemotherapy. Technol Health Care 2017; 25:377-382. [PMID: 28085020 DOI: 10.3233/thc-161292] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women with breast cancer undergoing chemotherapy experience a variety of physical and psychosocial symptoms, which have negative effect on women's quality of life and psychological well-being. Although M-health technologies provides innovative and easily accessible option to provide psychosocial support, mobile phone based interventions remain limited for these women in China. OBJECTIVE To develop a new mobile application to offer information as well as social and emotional support to women with breast cancer undergoing chemotherapy to promote their self-efficacy and social support, thus improving symptom management strategies. METHODS Basing on previous theoretical framework which incorporated Bandura's self-efficacy theory and the social exchange theory, a new mobile application, called Breast Cancer e-Support Program (BCS) was designed, with the content and functionality being validated by the expert panel and women with breast cancer. RESULTS BCS App program has four modules: 1) Learning forum; 2) Discussion forum; 3) Ask-the-Expert forum; and 4) Personal Stories forum. BCS program can be applied on both android mobile phones and iPhones to reach more women. CONCLUSIONS This is the first of its kind developed in China for women with breast cancer undergoing chemotherapy. A randomized controlled trial is undertaking to test the effectiveness of BCS program.
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Affiliation(s)
- Jiemin Zhu
- Nursing Department, Medical School, Xiamen University, Xiamen, Fujian, China.,Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
| | - Lyn Ebert
- Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
| | - Zhimin Xue
- Breast Surgery, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China
| | - Qu Shen
- Nursing Department, Medical School, Xiamen University, Xiamen, Fujian, China
| | - Sally Wai-Chi Chan
- Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
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Cox M, Basen-Engquist K, Carmack CL, Blalock J, Li Y, Murray J, Pisters L, Rodriguez-Bigas M, Song J, Cox-Martin E, Demark-Wahnefried W. Comparison of Internet and Telephone Interventions for Weight Loss Among Cancer Survivors: Randomized Controlled Trial and Feasibility Study. JMIR Cancer 2017; 3:e16. [PMID: 28954716 PMCID: PMC5637068 DOI: 10.2196/cancer.7166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 06/14/2017] [Accepted: 07/01/2017] [Indexed: 01/23/2023] Open
Abstract
Background Weight loss interventions have been successfully delivered via several modalities, but recent research has focused on more disseminable and sustainable means such as telephone- or Internet-based platforms. Objective The aim of this study was to compare an Internet-delivered weight loss intervention to a comparable telephone-delivered weight loss intervention. Methods This randomized pilot study examined the effects of 6-month telephone- and Internet-delivered social cognitive theory–based weight loss interventions among 37 cancer survivors. Measures of body composition, physical activity, diet, and physical performance were the outcomes of interest. Results Participants in the telephone intervention (n=13) showed greater decreases in waist circumference (–0.75 cm for telephone vs –0.09 cm for Internet, P=.03) than the Internet condition (n=24), and several other outcomes trended in the same direction. Measures of engagement (eg, number of telephone sessions completed and number of log-ins) suggest differences between groups which may account for the difference in outcomes. Conclusions Cancer survivors in the telephone group evidenced better health outcomes than the Internet group. Group differences may be due to higher engagement in the telephone group. Incorporating a telephone-based component into existing weight loss programs for cancer survivors may help enhance the reach of the intervention while minimizing costs. More research is needed on how to combine Internet and telephone weight loss intervention components so as to maximize engagement and outcomes. Trial Registration ClinicalTrials.gov NCT01311856; https://clinicaltrials.gov/ct2/show/NCT01311856 (Archived by WebCite at http://www.webcitation.org/6tKdklShY)
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Affiliation(s)
- Matthew Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Karen Basen-Engquist
- Center for Energy Balance In Cancer Prevention and Survivorship, Department of Behavioral Science, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Cindy L Carmack
- Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Janice Blalock
- Tobacco Treatment Program, Department of Behavioral, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Yisheng Li
- Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - James Murray
- Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Louis Pisters
- Department of Urology, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Miguel Rodriguez-Bigas
- Department of Surgical Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Jaejoon Song
- Center for Energy Balance In Cancer Prevention and Survivorship, Department of Behavioral Science, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Emily Cox-Martin
- Division of Medical Oncology, University of Colorado, Aurora, CO, United States
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Harvey J, Dittus K, Mench E. eHealth and behavioral weight loss interventions for female cancer survivors: A review. ACTA ACUST UNITED AC 2017; 13:80-88. [PMID: 28905688 PMCID: PMC7789030 DOI: 10.1177/1745505717731012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cancer survivors are at increased risk of chronic disease and diminished quality
of life. The presence of overweight and obesity can exacerbate these health
risks. Fortunately, even small weight losses have been found to produce
clinically meaningful health outcomes. However, effective obesity treatment is
difficult to access, and recently, efforts have been made to disseminate
interventions using eHealth or distantly delivered technology. This review aims
to focus on the efficacy and limitations of these technologies for female cancer
survivors. Suggestions are also provided to encourage further meaningful work in
this area.
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Affiliation(s)
- Jean Harvey
- 1 Department of Nutrition and Food Sciences, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Kim Dittus
- 2 Department of Internal Medicine, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Elise Mench
- 3 Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, USA
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66
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Beg MS, Gupta A, Stewart T, Rethorst CD. Promise of Wearable Physical Activity Monitors in Oncology Practice. J Oncol Pract 2017; 13:82-89. [PMID: 28387544 DOI: 10.1200/jop.2016.016857] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Commercially available physical activity monitors provide clinicians an opportunity to obtain oncology patient health measures to an unprecedented degree. These devices can provide objective and quantifiable measures of physical activity, which are not subject to errors or bias of self-reporting or shorter duration of formal testing. Prior work on so-called quantified-self data was based on older-generation, research-grade accelerometers, which laid the foundation for consumer-based physical activity monitoring devices to be validated as a feasible and reliable tool in patients with cancer. Physical activity monitors are being used in chronic conditions including chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus, and obesity. Differing demographics, compounded with higher symptom and treatment burdens in patients with cancer, imply that additional work is needed to understand the unique strengths and weaknesses of physical activity monitors in this population. Oncology programs can systematically implement these tools into their workflows in an adaptable and iterative manner. Translating large amounts of data collected from an individual physical activity monitoring device into clinically relevant information requires sophisticated data compilation and reduction. In this article, we summarize the characteristics of older- and newer-generation physical activity monitors, review the validation of physical activity monitors with respect to health-related quality-of-life assessments, and describe the current role of these devices for the practicing oncologist. We also highlight the challenges and next steps needed for physical activity monitors to provide relevant information that can change the current state of oncology practice.
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Affiliation(s)
- Muhammad S Beg
- University of Texas Southwestern Medical Center; Harold C. Simmons Cancer Center, Dallas, TX; and Yale University, New Haven, CT
| | - Arjun Gupta
- University of Texas Southwestern Medical Center; Harold C. Simmons Cancer Center, Dallas, TX; and Yale University, New Haven, CT
| | - Tyler Stewart
- University of Texas Southwestern Medical Center; Harold C. Simmons Cancer Center, Dallas, TX; and Yale University, New Haven, CT
| | - Chad D Rethorst
- University of Texas Southwestern Medical Center; Harold C. Simmons Cancer Center, Dallas, TX; and Yale University, New Haven, CT
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67
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Roberts AL, Fisher A, Smith L, Heinrich M, Potts HWW. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2017; 11:704-719. [PMID: 28779220 PMCID: PMC5671545 DOI: 10.1007/s11764-017-0632-1] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 07/14/2017] [Indexed: 12/21/2022]
Abstract
Purpose The number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors. Methods We conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included. Results Fifteen studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (seven studies; mean difference (MD) = 41 min per week; 95% CI 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = −0.23; 95% CI −0.41, −0.05). There was a trend towards significance for reduced fatigue and no significant change in cancer-specific measures of quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL measures and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality. Conclusions DBCIs may improve PA and BMI among cancer survivors, and there is mixed evidence for diet. The number of included studies is small, and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time. Implications for cancer survivors Digital technologies offer a promising approach to encourage health behaviour change among cancer survivors. Electronic supplementary material The online version of this article (doi:10.1007/s11764-017-0632-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna L Roberts
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Abigail Fisher
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, UK
| | - Malgorzata Heinrich
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
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Lima ICVD, Galvão MTG, Pedrosa SC, Silva CAC, Pereira MLD. Validação de mensagens telefônicas para promoção da saúde de pessoas com HIV. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a opinião de experts sobre o conteúdo de mensagens telefônicas para a promoção da saúde de pessoas vivendo com HIV. Métodos Estudo de desenvolvimento metodológico direcionado à validação de dez mensagens telefônicas, com participação de 11 experts que avaliaram sua clareza e grau de relevância. O índice de validade de conteúdo relativo a cada mensagem foi calculado e estabeleceu-se uma concordância mínima de 75%. Resultados Foram consideradas mensagens claras (79,1%) e muito relevantes (98,2%). O índice de validade de conteúdo geral foi 0,98. Principais alterações sugeridas: inclusão de um questionamento sobre o tema no início de cada mensagem; adequação para uma linguagem mais simples e interativa; substituição de termos específicos e exclusão de palavras ou expressões relacionadas ao HIV. Conclusão Os experts consideraram as mensagens claras e relevantes para a promoção da saúde das pessoas vivendo com HIV.
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69
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Chung BY, Oh EH, Song SJ. Mobile Health for Breast Cancer Patients: A Systematic Review. ASIAN ONCOLOGY NURSING 2017. [DOI: 10.5388/aon.2017.17.3.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bok Yae Chung
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University. Daegu, Korea
| | - Eun Hee Oh
- Department of Nursing, Kyungpook National University Hospital, Daegu, Korea
| | - Su Jeong Song
- Graduate School of Nursing, Kyungpook National University, Daegu, Korea
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70
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Coughlin SS, Besenyi GM, Bowen D, De Leo G. Development of the Physical activity and Your Nutrition for Cancer (PYNC) smartphone app for preventing breast cancer in women. Mhealth 2017; 3:5. [PMID: 28293621 PMCID: PMC5344121 DOI: 10.21037/mhealth.2017.02.02] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 01/20/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In the U.S., breast cancer accounts for more cancer deaths in women than any site other than lung cancer. Based upon attributable risks, about 30-35% of breast cancers could potentially be prevented by addressing obesity, physical inactivity, increased alcohol consumption, and carcinogenic exposures such as hormone replacement therapy (HRT). We need methods of reducing women's risks of this disease that are attractive and easy to use, widely accessible to diverse women, and able to be easily amended to account for new research. METHODS The overall objective of this 12-month project is to develop and test a smartphone app to provide women with information about how they can reduce their risk of breast cancer through healthy behaviors such as physical activity, weight management, restricting caloric intake, consuming a healthy diet and proper nutrition, engaging in regular physical activity, and avoiding carcinogenic exposures such as HRT and alcohol. The specific aims are: (I) to develop a smartphone app for breast cancer prevention using a behavioral framework; (II) to ensure interconnectivity with commercially available products (Fitbit device for monitoring physical activity and the LoseIt! smartphone app for monitoring and tracking diet and nutrition); and (III) to ensure that the mHealth intervention is suitable for women with varying levels of health literacy and eHealth literacy. RESULTS The app, referred to as Physical activity and Your Nutrition for Cancer (PYNC), is being coded on an iOS platform. Users will be able to access the breast cancer prevention app using their smartphone or tablet. The app's design will ensure interconnectivity with commercially available products for monitoring and tracking physical activity, caloric intake, diet and nutrition. Using the app, it will be feasible for users to connect and sync their Fitbit and LoseIt! accounts so that information collected about physical activity, caloric intake, diet, and nutrition can be conveniently assessed from one portal. The Fitbit device and app provides reminders and allows users to set physical activity goals. Users will be able to access health education information about breast cancer risk-reduction with attractive graphics and visual displays. CONCLUSIONS Future directions will include testing the efficacy of the mHealth intervention in increasing physical activity, improving diet and nutrition, and weight management through a randomized controlled trial, and widespread dissemination and implementation research.
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Affiliation(s)
- Steven S. Coughlin
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Gina M. Besenyi
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Deborah Bowen
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA
| | - Gianluca De Leo
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
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Uhm KE, Yoo JS, Chung SH, Lee JD, Lee I, Kim JI, Lee SK, Nam SJ, Park YH, Lee JY, Hwang JH. Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res Treat 2016; 161:443-452. [PMID: 27933450 DOI: 10.1007/s10549-016-4065-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/22/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Kyeong Eun Uhm
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Ilwon-ro, Gangnam-gu, Seoul, 06351, Korea
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, National Cancer Center, Gyeonggi-do, Korea
| | - Seung Hyun Chung
- Department of Rehabilitation Medicine, National Cancer Center, Gyeonggi-do, Korea
| | - Jong Doo Lee
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Ilkyun Lee
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
- Department of Surgery, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Joong Il Kim
- Institute for Integrative Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Hyun Park
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Ilwon-ro, Gangnam-gu, Seoul, 06351, Korea.
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Price K, Bird SR, Lythgo N, Raj IS, Wong JYL, Lynch C. Validation of the Fitbit One, Garmin Vivofit and Jawbone UP activity tracker in estimation of energy expenditure during treadmill walking and running. J Med Eng Technol 2016; 41:208-215. [DOI: 10.1080/03091902.2016.1253795] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Kym Price
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Stephen R. Bird
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Noel Lythgo
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Isaac S. Raj
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Jason Y. L. Wong
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Chris Lynch
- Deparment of Exercise Sciences, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
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Coughlin SS, Stewart J. Use of Consumer Wearable Devices to Promote Physical Activity: A Review of Health Intervention Studies. ACTA ACUST UNITED AC 2016; 2. [PMID: 28428979 PMCID: PMC5395205 DOI: 10.15436/2378-6841.16.1123] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although many wearable devices for monitoring and tracking physical activity are available to consumers, relatively few research studies have been conducted to determine their efficacy in promoting health. METHODS In this article, data on the use of consumer wearable devices in promoting healthy behaviors are summarized based upon bibliographic searches in PubMed and Psychology and Behavioral Sciences Collection with relevant search terms through September 2016. RESULTS A total of 274 articles were identified in the bibliographic searches. By screening abstracts or full-text articles, six pre/post test trials and seven randomized controlled trials were identified. In initial trials, consumer wearable devices have been shown to increase physical activity and help users lose weight. However, the number of studies completed to date is small and limited by small sample sizes, short study durations, and uncertain generalizability of the findings. CONCLUSIONS Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the efficacy of wearable devices in promoting physical activity. Additional research is needed to determine the feasibility and effectiveness of wearable devices in promoting physical activity and weight loss in community settings including communities affected by health disparities. Studies focusing on children and adolescents are also needed.
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Affiliation(s)
- Steven S Coughlin
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA
| | - Jessica Stewart
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA
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