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Lazarou I, Krooupa AM, Nikolopoulos S, Apostolidis L, Sarris N, Papadopoulos S, Kompatsiaris I. Cancer Patients' Perspectives and Requirements of Digital Health Technologies: A Scoping Literature Review. Cancers (Basel) 2024; 16:2293. [PMID: 39001356 PMCID: PMC11240750 DOI: 10.3390/cancers16132293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024] Open
Abstract
Digital health technologies have the potential to alleviate the increasing cancer burden. Incorporating patients' perspectives on digital health tools has been identified as a critical determinant for their successful uptake in cancer care. The main objective of this scoping review was to provide an overview of the existing evidence on cancer patients' perspectives and requirements for patient-facing digital health technologies. Three databases (CINAHL, MEDLINE, Science Direct) were searched and 128 studies were identified as eligible for inclusion. Web-based software/platforms, mobile or smartphone devices/applications, and remote sensing/wearable technologies employed for the delivery of interventions and patient monitoring were the most frequently employed technologies in cancer care. The abilities of digital tools to enable care management, user-friendliness, and facilitate patient-clinician interactions were the technological requirements predominantly considered as important by cancer patients. The findings from this review provide evidence that could inform future research on technology-associated parameters influencing cancer patients' decisions regarding the uptake and adoption of patient-facing digital health technologies.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Anna-Maria Krooupa
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Lazaros Apostolidis
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Nikos Sarris
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Symeon Papadopoulos
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute (ITI), Centre for Research and Technology Hellas (CERTH), 6th km Charilaou-Thermi Road, P.O. Box 6036, 57001 Thessaloniki, Greece
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Karim JL, Wan R, Tabet RS, Chiu DS, Talhouk A. Person-Generated Health Data in Women's Health: Scoping Review. J Med Internet Res 2024; 26:e53327. [PMID: 38754098 PMCID: PMC11140278 DOI: 10.2196/53327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The increased pervasiveness of digital health technology is producing large amounts of person-generated health data (PGHD). These data can empower people to monitor their health to promote prevention and management of disease. Women make up one of the largest groups of consumers of digital self-tracking technology. OBJECTIVE In this scoping review, we aimed to (1) identify the different areas of women's health monitored using PGHD from connected health devices, (2) explore personal metrics collected through these technologies, and (3) synthesize facilitators of and barriers to women's adoption and use of connected health devices. METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews, we searched 5 databases for articles published between January 1, 2015, and February 29, 2020. Papers were included if they targeted women or female individuals and incorporated digital health tools that collected PGHD outside a clinical setting. RESULTS We included a total of 406 papers in this review. Articles on the use of PGHD for women steadily increased from 2015 to 2020. The health areas that the articles focused on spanned several topics, with pregnancy and the postpartum period being the most prevalent followed by cancer. Types of digital health used to collect PGHD included mobile apps, wearables, websites, the Internet of Things or smart devices, 2-way messaging, interactive voice response, and implantable devices. A thematic analysis of 41.4% (168/406) of the papers revealed 6 themes regarding facilitators of and barriers to women's use of digital health technology for collecting PGHD: (1) accessibility and connectivity, (2) design and functionality, (3) accuracy and credibility, (4) audience and adoption, (5) impact on community and health service, and (6) impact on health and behavior. CONCLUSIONS Leading up to the COVID-19 pandemic, the adoption of digital health tools to address women's health concerns was on a steady rise. The prominence of tools related to pregnancy and the postpartum period reflects the strong focus on reproductive health in women's health research and highlights opportunities for digital technology development in other women's health topics. Digital health technology was most acceptable when it was relevant to the target audience, was seen as user-friendly, and considered women's personalization preferences while also ensuring accuracy of measurements and credibility of information. The integration of digital technologies into clinical care will continue to evolve, and factors such as liability and health care provider workload need to be considered. While acknowledging the diversity of individual needs, the use of PGHD can positively impact the self-care management of numerous women's health journeys. The COVID-19 pandemic has ushered in increased adoption and acceptance of digital health technology. This study could serve as a baseline comparison for how this field has evolved as a result. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/26110.
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Affiliation(s)
- Jalisa Lynn Karim
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Rachel Wan
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Rhea S Tabet
- Department of Pharmacology and Therapeutics, McGill University, Montréal, QC, Canada
| | - Derek S Chiu
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Aline Talhouk
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
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Ester M, McDonough MH, Bansal M, Dreger J, Daun JT, McNeely ML, Luu T, Culos-Reed SN. Perspectives on Ease of Use and Value of a Self-Monitoring Application to Support Physical Activity Maintenance among Individuals Living with and beyond Cancer. Curr Oncol 2024; 31:1572-1587. [PMID: 38534953 PMCID: PMC10969407 DOI: 10.3390/curroncol31030120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Physical activity (PA) can improve the physical and psychosocial health of individuals with cancer, yet PA levels remain low. Technology may address PA maintenance barriers in oncology, though the intervention effectiveness to date remains mixed. Qualitative research can reveal the nuances of using technology-based PA maintenance tools. The present study aimed to understand the perspectives of individuals with cancer on using an app to support PA maintenance. METHODS Individuals were interviewed after using a self-monitoring app for 24 weeks, asking about their app use, ease of use, and perceived value for supporting PA. Analyses were guided by an interpretive description. RESULTS Eighteen individuals were interviewed. The participants were 37-75 years old; lived in seven Canadian provinces/territories; identified as White, South Asian, or Indigenous; and had eight different cancers. Four themes were developed: some did not need the app to stay physically active, some valued the app for helping them maintain their PA, the user experience ranged from intuitive to confusing, and the time burden of app use ranged from acceptable to overwhelming. CONCLUSIONS The participants provided insights on using a self-monitoring app to improve PA maintenance in oncology. Work is needed to capture additional perspectives and apply findings to the development of technology-based PA maintenance tools.
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Affiliation(s)
- Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Meghan H. McDonough
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Julianna Dreger
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Julia T. Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Department of Oncology, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada
| | - Thompson Luu
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
- Department of Oncology, Cummings School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB T2N 4N2, Canada
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Hardcastle SJ, Maxwell-Smith C, Cavalheri V, Boyle T, Román ML, Platell C, Levitt M, Saunders C, Sardelic F, Nightingale S, McCormick J, Lynch C, Cohen PA, Bulsara M, Hince D. The promoting physical activity in regional and remote cancer survivors (PPARCS) trial: Physical activity maintenance. Scand J Med Sci Sports 2024; 34:e14572. [PMID: 38424471 DOI: 10.1111/sms.14572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention. METHODS PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between-group changes in PA outcomes. RESULTS The increased moderate-to-vigorous PA (MVPA) following intervention was maintained with significantly higher MVPA in the intervention group at 24 weeks (vs. controls) compared to baseline nett change of 52.5 min/week (95% CI 11.0-94.0.4). CONCLUSIONS Distance-based interventions using wearables and health coaching may produce MVPA maintenance amongst nonmetropolitan cancer survivors.
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Affiliation(s)
- Sarah J Hardcastle
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Chloe Maxwell-Smith
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Allied Health, South Metropolitan Health Service, Murdoch, Western Australia, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Marta Leyton Román
- Department of Didactics of Musical, Plastic and Body Expression, University of Extremadura, Caceres, Spain
| | - Cameron Platell
- St. John of God Subiaco Hospital, Perth, Western Australia, Australia
| | - Michael Levitt
- St. John of God Subiaco Hospital, Perth, Western Australia, Australia
| | - Christobel Saunders
- St. John of God Subiaco Hospital, Perth, Western Australia, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Frank Sardelic
- Tamara Private Hospital, Tamworth, New South Wales, Australia
| | | | - Jacob McCormick
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Craig Lynch
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Paul A Cohen
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
- St. John of God Subiaco Hospital, Perth, Western Australia, Australia
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Dana Hince
- Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
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Howe L, Husband A, Robinson‐Barella A. Prescribing pre- and post-operative physical activity interventions for people undergoing breast cancer surgery: A qualitative systematic review. Cancer Med 2024; 13:e7063. [PMID: 38457236 PMCID: PMC10923032 DOI: 10.1002/cam4.7063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/26/2023] [Accepted: 02/18/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Undertaking physical activity, pre- and post-operatively, can benefit recovery time and improve post-surgical outcomes. One cohort of patients that have reported these benefits are those undergoing surgery for breast cancer. Yet, what remains unclear is the level to which physical activity interventions are implemented into standard surgical care for patients with breast cancer. AIMS This systematic review aimed to examine existing qualitative evidence focusing on pre- and post-operative physical activity interventions to better understand the benefits and shortcomings of physical activity within the surgical journey. METHODS A systematic literature search was undertaken in November 2022, across five databases: MEDLINE, PsycINFO, Embase, CINAHL, and Scopus. Qualitative studies involving people with breast cancer who had undertaken a physical activity intervention, either pre- and/or post-operatively, were included for analysis. The review was registered on PROSPERO: CRD42022372466 and performed according to PRISMA guidelines. The Critical Appraisal Skills Programme qualitative study checklist was used to assess study quality. RESULTS Fourteen studies were included, comprising the perspectives of 418 people receiving surgery for breast cancer. One study implemented preoperative physical activity interventions; the remaining studies focused on post-operative interventions. A narrative systematic review was undertaken due to heterogeneity in reported results. Four themes were developed by thematic analysis, centring on: (1) factors promoting engagement with physical activity interventions; (2) factors preventing engagement with physical activity interventions; (3) the impact of pre- and post-operative interventions on physical and psychological health; and (4) participant recommendations for pre- and post-operative interventions. CONCLUSION Pre- and post-operative physical activity interventions were well-accepted. Patients recognised factors which promoted or prevented engagement with interventions, as well as pre- and post-operative physical and psychological benefits that arose as a result. Evidence based co-design studies may further inform successful implementation of prescribed physical activity into standard care for surgical breast cancer patients.
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Affiliation(s)
- Lauren Howe
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
| | - Andy Husband
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Anna Robinson‐Barella
- School of Pharmacy, King George VI BuildingNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
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Tjon A Joe S, Verschure-Dorsman S, Wilthagen EA, Stuiver M. Barriers and facilitators for weight management interventions in breast cancer patients: a systematic review of qualitative studies. Int J Qual Stud Health Well-being 2023; 18:2259290. [PMID: 37840321 PMCID: PMC10580791 DOI: 10.1080/17482631.2023.2259290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION This systematic review and meta-synthesis of qualitative studies provides an overview of barriers and facilitators that breast cancer patients experience in weight management interventions. METHODS We included qualitative studies describing barriers and facilitators for weight management interventions as experienced by adult breast cancer patients after the completion of initial treatment . The data was extracted and using thematic analysis. RESULTS After analysis, eleven themes were determined. Six of those themes could be linked to the Attitude, Social Influence and self Efficacy (ASE)-model. Physical and mental benefits, anticipated regret and a lack of motivation were linked to attitude. Integrating a weight management programme in daily life, stigma and fears were linked to self-efficacy. With regard to the social influence determinant, encouragement and discouragement by family members were developed as a theme. Four additional themes were conducted related to weight management behaviour; external barriers, economic barriers, cultural barriers and physical barriers. In addition, integrating weight management in cancer care was described as a separate theme. CONCLUSIONS Several disease specific issues, including feeling stigmatized after cancer treatment and treatment-related side effects and peer-support should be given specific attention to maximize adherence of weight management programmes.
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Affiliation(s)
- Sheena Tjon A Joe
- clinical dietitian, The Netherlands Cancer Institute, Department of dietetics, Amsterdam, The Netherlands
| | - Sara Verschure-Dorsman
- clinical dietitian, The Netherlands Cancer Institute, Department of dietetics, Amsterdam, The Netherlands
| | - Erica A. Wilthagen
- medical information specialist, Scientific Information Service, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martijn Stuiver
- Department of Epidemiology and Data Science, CCA, AmsterdamUMC, University of Amsterdam, Amsterdam, The Netherlands
- Associate group leader of the Cancer Survivorship group, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Hardcastle SJ, Douglass E, Wilson B, Maxwell-Smith C. Experiences and facilitators of physical activity engagement amongst colorectal and endometrial cancer survivors: the Wearable Activity Technology and Action-Planning (WATAAP) trial. Support Care Cancer 2023; 31:662. [PMID: 37914916 PMCID: PMC10620246 DOI: 10.1007/s00520-023-08137-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE This study explored colorectal and endometrial cancer survivors' experiences of participation in a wearable intervention and the dimensions that influenced intervention engagement and physical activity behaviour change. METHODS Semi-structured interviews (n= 23) were conducted with intervention participants (mean age 65.8 (SD ±7.1) and analysed using thematic analysis. RESULTS Four main themes were identified: (i) commitment, (ii) accountability and monitoring, (iii) routine, (iv) Fitbit as health coach. Those that assigned a higher priority to PA were more likely to schedule PA and be successful in PA change. Those less successful presented more barriers to change and engaged in more incidental PA. The Fitbit acting as health coach was the active ingredient of the intervention. CONCLUSIONS Commitment evidenced through prioritising PA was the foundational dimension that influenced PA engagement. Interventions that foster commitment to PA through increasing the value and importance of PA would be worthwhile. Wearables holds great promise in PA promotion and harnessing the technique of discrepancy between behaviour and goals is likely a valuable behaviour change technique.
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Affiliation(s)
- Sarah J Hardcastle
- Department of Sport and Physical Activity, Sheffield Hallam University, Broomhall, Sheffield, UK.
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
| | - Emma Douglass
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Bree Wilson
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Chloe Maxwell-Smith
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Optimising Health and Wellbeing Domain, Enable Institute, Curtin University, Perth, Western Australia, Australia
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Brick R, Lyons KD, Bender C, Eilers R, Ferguson R, Pergolotti M, Toto P, Skidmore E, Leland NE. Preferences on Delivery of Cancer Rehabilitation Services for Cancer-Related Disability Among Older Individuals Surviving Breast Cancer: A Qualitative Study. REHABILITATION ONCOLOGY 2023; 41:139-148. [PMID: 37841364 PMCID: PMC10574708 DOI: 10.1097/01.reo.0000000000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Older individuals surviving breast cancer often encounter cancer-related disability as a short-term or long-term effect of cancer and related treatment. Cancer rehabilitation interventions have the potential to prevent, mitigate, or remediate cancer-related disability. However, use of these services remains limited. Understanding the priorities and perspectives of older individuals surviving breast cancer is key to developing effective and implementable cancer rehabilitation interventions. This qualitative descriptive study examined individuals' preferred and valued methods of cancer rehabilitation intervention delivery. Methods Using a qualitative descriptive design, older individuals surviving breast cancer (n=14) completed a single telephone-based semi-structure interview. Interviews explored survivors' preferences for cancer rehabilitation service delivery. Interview transcriptions were thematically analyzed. Open codes were inductively generated and reviewed for agreement by an independent reviewer. The codes were deductively organized. Differences were resolved through consensus meetings. Results Findings revealed preferred intervention delivery characteristics for intervention setting, mode of delivery, format, and timing. Participants predominantly preferred interventions delivered in community-based settings, with both in-person and remote components. Participants also appeared to value one-on-one interventions and those delivered post-treatment. Survivors' overarching preferences were based on desire for patient-centric care, one-on-one therapist time, complex medical schedules, and financial concerns. Discussion Study findings provide guidance on the modification of existing and creation of new cancer rehabilitation interventions addressing cancer-related disability in older individuals surviving breast cancer. Adoption of stakeholder-driven intervention delivery characteristics may improve value and acceptability of interventions. Future intervention research should incorporate and test these characteristics to ensure their effectiveness in real-world settings.
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Affiliation(s)
- Rachelle Brick
- University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA, USA
| | - Kathleen Doyle Lyons
- Massachusetts General Hospital Institute of Health Professions, Department of Occupational Therapy, Boston, MA US
| | - Catherine Bender
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Rachel Eilers
- University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA, USA
| | - Robert Ferguson
- University of Pittsburgh, School of Medicine, Division of Hematology/Oncology, Pittsburgh, PA, USA
| | | | - Pamela Toto
- University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA, USA
| | - Elizabeth Skidmore
- University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA, USA
| | - Natalie E Leland
- University of Pittsburgh, Department of Occupational Therapy, Pittsburgh, PA, USA
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Teo NR, Siew LED, Ang WHD, Lau Y. Wearable-Technology-Assisted Interventions for Breast-Cancer Survivors: A Meta-Analysis and Meta-Regression. Semin Oncol Nurs 2023; 39:151403. [PMID: 36894449 DOI: 10.1016/j.soncn.2023.151403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/17/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES This review, meta-analysis, and meta-regression aimed to (1) evaluate the effect of wearable-technology-assisted interventions on the physical activity and weight of breast cancer survivors, (2) identify the essential features of wearable-technology-assisted interventions, and (3) explore the covariates of the treatment effect. DATA SOURCES Randomized controlled trials were obtained from 10 databases and trial registries from inception until December 21, 2021. Trials that examined the effects of wearable-technology-assisted interventions for individuals with breast cancer were included. The mean and standard deviation scores were used to compute the effect sizes. CONCLUSION The meta-analyses revealed significantly improved in moderate-to-vigorous activity, total physical activity, and weight control. The findings from this review suggest that wearable-technology-assisted interventions may be a potential solution to improve physical activity and weight in breast cancer survivors. Future studies should include high-quality trials with large sample sizes. IMPLICATIONS FOR NURSING PRACTICE Wearable technology has promising effects on physical activity and could be incorporated into routine care for breast cancer survivors.
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Affiliation(s)
- Neil Russell Teo
- Staff Nurse, Nursing Department, Singapore General Hospital, Singapore
| | - Li En Dana Siew
- Staff Nurse, Nursing Department, Singapore General Hospital, Singapore
| | - Wei How Darryl Ang
- PhD Candidate, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore
| | - Ying Lau
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore.
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Muhsen IN, Rasheed OW, Habib EA, Alsaad RK, Maghrabi MK, Rahman MA, Sicker D, Wood WA, Beg MS, Sung AD, Hashmi SK. Current Status and Future Perspectives on the Internet of Things in Oncology. Hematol Oncol Stem Cell Ther 2023; 16:102-109. [PMID: 34687614 DOI: 10.1016/j.hemonc.2021.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/04/2021] [Accepted: 09/24/2021] [Indexed: 01/31/2023] Open
Abstract
The Internet of Things (IoT) has penetrated many aspects of everyday human life. The use of IoT in healthcare has been expanding over the past few years. In this review, we highlighted the current applications of IoT in the medical literature, along with the challenges and opportunities. IoT use mainly involves sensors and wearables, with potential applications in improving the quality of life, personal health monitoring, and diagnosis of diseases. Our literature review highlights that the current main application studied in the literature is physical activity tracking. In addition, we discuss the current technologies that would help IoT-enabled devices achieve safe, quick, and meaningful data transfer. These technologies include machine learning/artificial intelligence, 5G, and blockchain. Data on current IoT-enabled devices are still limited, and future research should address these devices' effect on patients' outcomes and the methods by which their integration in healthcare will avoid increasing costs.
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Affiliation(s)
- Ibrahim N Muhsen
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Omar W Rasheed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Eiad A Habib
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Rakan K Alsaad
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Md A Rahman
- Department of Cyber Security and Forensic Computing, University of Prince Mugrin, Medina, Saudi Arabia
| | - Douglas Sicker
- School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Muhammad S Beg
- Division of Hematology/Medical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Anthony D Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, NC, USA
| | - Shahrukh K Hashmi
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Medicine, Sheikh Shakbout Medical City, Abu Dhabi, United Arab Emirates
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Robinson A, Husband A, Slight R, Slight SP. Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change. JMIR Hum Factors 2022; 9:e29782. [PMID: 35254271 PMCID: PMC8933804 DOI: 10.2196/29782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/05/2021] [Accepted: 11/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background A patient’s capability, motivation, and opportunity to change their lifestyle are determinants of successful outcomes following bariatric surgery. Lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been associated with greater postsurgical weight loss and improved long-term health. Integrating patient-centered digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviors, and provide holistic patient support, to improve surgical success. Previous research focused on implementing digital technologies and measuring effectiveness in surgical cohorts. However, there is limited work concerning the desires, suggestions, and reflections of patients undergoing bariatric surgery. This qualitative investigation explores patients’ perspectives on technology features that would support behavior changes during the pre- and postoperative periods, to potentially maintain long-term healthy lifestyles following surgery. Objective This study aims to understand how digital technologies can be used to support patient care during the perioperative journey to improve weight loss outcomes and surgical success, focusing on what patients want from digital technologies, how they want to use them, and when they would be of most benefit during their surgical journey. Methods Patients attending bariatric surgery clinics in one hospital in the North of England were invited to participate. Semistructured interviews were conducted with purposively sampled pre- and postoperative patients to discuss lifestyle changes and the use of digital technologies to complement their care. The interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 20 patients were interviewed (preoperative phase: 40% (8/20); postoperative phase: 60% (12/20). A total of 4 overarching themes were developed and related to the optimization of technology functionality. These centered on providing tailored content and support; facilitating self-monitoring and goal setting; delivering information in an accessible, trusted, and usable manner; and meeting patient information-seeking and engagement needs during the surgical pathway. Functionalities that delivered personalized feedback and postoperative follow-up were considered beneficial. Individualized goal setting functionality could support a generation of digitally engaged patients with bariatric conditions as working toward achievable targets was deemed an effective strategy for motivating behavior change. The creation of digital package of care checklists between patients and clinicians was a novel finding from this study. Conclusions Perceptions of patients undergoing bariatric surgery validated the integration of digital technologies within the surgical pathway, offering enhanced connectedness and support. Recommendations are made relating to the design, content, and functionality of digital interventions to best address the needs of this cohort. These findings have the potential to influence the co-design and integration of person-centered, perioperative technologies.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Robert Slight
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sarah P Slight
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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12
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De La Torre S, Spruijt-Metz D, Farias AJ. Survivors' health competence mediates the association between wearable activity tracker use and self-rated health: HINTS analysis. J Cancer Surviv 2022; 16:1268-1278. [PMID: 35001258 DOI: 10.1007/s11764-021-01112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Physical activity (PA) plays an important role in achieving positive self-rated health (SRH) among cancer survivors. Wearable activity trackers (WATs) can be effective for self-monitoring and tracking PA. Studies have shown that survivors who use WATs are more likely to engage in more PA. However, few studies have examined the direct and indirect associations between WAT use, PA, and SRH mediated by constructs derived from self-determination theory, perceived health competence, and perceived social relatedness for health. METHODS Data on survivors were analyzed from National Cancer Institute's Health Information National Trend Survey (HINTS) Cycle 1-3 (n = 1,421). Path analysis was used to test the total, direct, and indirect associations. RESULTS Previous WAT use was directly associated with PA level (standardized beta (SB): 0.07, p = 0.005) and indirectly associated with SRH (SB: 0.04, p = 0.005), mediated by perceived health competence and PA. Perceived health competence was directly associated with SRH (SB: 0.51, p < .0001) and PA (SB: 0.20, p < .0001), and perceived social relatedness for health was not significantly associated with PA (SB: 0.005, p = 0.8) or SRH (SB: 0.02, p = 0.31). CONCLUSIONS Overall, these results indicate that perceived health competence significantly mediated the associations between WAT use and SRH; however, WAT use was only directly associated with PA and was not mediated. IMPLICATIONS FOR CANCER SURVIVORS These findings support the notion that WATs may play a role in addressing SRH among cancer survivors through fostering perceived health competence by providing real-time feedback, goal setting, and opportunities for self-monitoring.
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Affiliation(s)
- Steven De La Torre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna Spruijt-Metz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Dornsife Center for Economic and Social Research, Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Albert J Farias
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. .,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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13
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Alberts NM, Leisenring WM, Flynn JS, Whitton J, Gibson TM, Jibb L, McDonald A, Ford J, Moraveji N, Dear BF, Krull KR, Robison LL, Stinson JN, Armstrong GT. Wearable Respiratory Monitoring and Feedback for Chronic Pain in Adult Survivors of Childhood Cancer: A Feasibility Randomized Controlled Trial From the Childhood Cancer Survivor Study. JCO Clin Cancer Inform 2021; 4:1014-1026. [PMID: 33147073 DOI: 10.1200/cci.20.00070] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Approximately 40% of childhood cancer survivors experience chronic pain, with many also reporting pain-related disability. Given associations established in the general population among respiration, anxiety, and pain, continuous tracking and feedback of respiration may help survivors manage pain. METHODS A feasibility, nonblinded, randomized controlled trial (RCT) comparing wearable respiratory monitoring with a control group examined feasibility, acceptability, and preliminary efficacy among survivors of childhood cancer with chronic pain who were ≥ 18 years of age, able to speak and read English, lived in the United States, and had access to a smartphone and the Internet. The primary outcomes were pain interference, pain severity, anxiety, negative affect, and perceived stress. The intervention group (n = 32) received a wearable respiratory monitor, used the device, and completed an in-application breathing exercise daily for 30 days. The control group (n = 33) received psychoeducation after completion of the study. RESULTS Almost all participants in the intervention group (n = 31 of 32) and control group (n = 32 of 33) completed the study. Of those who completed the intervention, 90.3% wore the device for ≥ 50% of the trial. Posttreatment improvement for negative affect (Cohen d = 0.59; 95% CI, 0.09 to 1.10) was significantly greater in the intervention group compared with the control group. A follow-up study (n = 24) examined acceptability and feasibility of a second-generation device among those who completed the RCT. Most survivors (81.0%) wore the device daily during the trial and 85.7% reported satisfaction with the device and the application. CONCLUSION The results of this pilot study support the acceptability and feasibility of wearable respiratory monitoring among survivors of childhood cancer. Larger randomized trials are needed to assess efficacy and maintenance of this intervention for chronic pain.
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Affiliation(s)
- Nicole M Alberts
- St Jude Children's Research Hospital, Memphis, TN.,Concordia University, Montréal, Quebec, Canada
| | | | | | | | | | - Lindsay Jibb
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - James Ford
- St Jude Children's Research Hospital, Memphis, TN
| | | | - Blake F Dear
- Macquarie University, Sydney, New South Wales, Australia
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14
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Karim JL, Talhouk A. Person-Generated Health Data in Women's Health: Protocol for a Scoping Review. JMIR Res Protoc 2021; 10:e26110. [PMID: 34047708 PMCID: PMC8196349 DOI: 10.2196/26110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/25/2021] [Accepted: 04/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background Due to their ability to collect person-generated health data, digital tools and connected health devices may hold great utility in disease prevention, chronic disease self-monitoring and self-tracking, as well as in tailoring information and educational content to fit individual needs. Facilitators and barriers to the use of digital health technologies vary across demographics, including sex. The “femtech” market is growing rapidly, and women are some of the largest adopters of digital health technologies. Objective This paper aims to provide the background and methods for conducting a scoping review on the use of person-generated health data from connected devices in women’s health. The objectives of the scoping review are to identify the various contexts of digital technologies in women’s health and to consolidate women’s views on the usability and acceptability of the devices. Methods Searches were conducted in the following databases: Medline, Embase, APA PsycInfo, CINAHL Complete, and Web of Science Core Collection. We included articles from January 2015 to February 2020. Screening of articles was done independently by at least two authors in two stages. Data charting is being conducted in duplicate. Results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. Results Our search identified 9102 articles after deduplication. As of November 2020, the full-text screening stage is almost complete and data charting is in progress. The scoping review is expected to be completed by Fall 2021. Conclusions This scoping review will broadly map the literature regarding the contexts and acceptability of digital health tools for women. The results from this review will be useful in guiding future digital health and women’s health research. International Registered Report Identifier (IRRID) DERR1-10.2196/26110
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Affiliation(s)
- Jalisa Lynn Karim
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada.,Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Aline Talhouk
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
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15
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Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021; 10:jcm10092015. [PMID: 34066752 PMCID: PMC8125804 DOI: 10.3390/jcm10092015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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16
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Blount DS, McDonough DJ, Gao Z. Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021. [PMID: 34066752 DOI: 10.3390/jcm10092015.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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Affiliation(s)
- Daphne S Blount
- College of Biological Science, University of Minnesota-Twin Cities, 1445 Gortner Ave, Saint Paul, MN 55108, USA
| | - Daniel J McDonough
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
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17
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De La Torre S, Spruijt-Metz D, Farias AJ. Associations Among Wearable Activity Tracker Use, Exercise Motivation, and Physical Activity in a Cohort of Cancer Survivors: Secondary Data Analysis of the Health Information National Trends Survey. JMIR Cancer 2021; 7:e24828. [PMID: 33843595 PMCID: PMC8076994 DOI: 10.2196/24828] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/17/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background Cancer survivors who meet physical activity (PA) recommendations (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week) experience better health outcomes. With the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates survivors to use these devices. Objective The aim of this study is to investigate the associations among motivations for exercise, previous WAT use for tracking a health goal or activity, and meeting the recommended amount of PA among a cohort of cancer survivors. Methods Data on WAT users who reported having a previous cancer diagnosis were analyzed from the National Cancer Institute’s Health Information National Trends Survey 5 Cycle 3. All survivors with complete information on demographics, exercise motivations (internal guilt, external pressure, physical appearance, and exercise enjoyment), previous WAT use (yes or no), and minutes of MVPA per week (N=608) were included. Multivariate logistic regression models were used to test these associations. A separate cluster analysis was conducted to identify the profiles of exercise motivation that were associated with reporting WAT use. Results The mean age of the cohort was 66.9 years (SD 12.1). The majority were non-Hispanic White (473/608, 78.8%) and female (322/608, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (154/608, 27.8%). Survivors who reported using WATs to track a health goal or activity were 1.6 times more likely to meet MVPA recommendations than those who did not use WATs (odds ratio [OR] 1.65, 95% CI 1.03-2.65; P=.04). When exercise motivations were assessed independently, survivors who reported not feeling any internal guilt as an exercise motivation were 73% less likely to report having used a WAT than those who felt any internal guilt (OR 0.27, 95% CI 0.14-0.54; P<.001). A total of 3 distinct motivational profiles emerged from the cluster analysis. WAT users had an increased probability of membership in profile 3, which was characterized as being strongly motivated to exercise by internal guilt, physical appearance, and exercise enjoyment (OR 4.5, 95% CI 2.1-9.7; P<.001). Conclusions Among this cohort, survivors who reported using WATs to track a health goal or activity were significantly more likely to report meeting PA recommendations. Survivors who reported feeling internal guilt as an exercise motivation were significantly more likely to report using WATs to track a health goal or activity. When examining clusters of motivation, survivors who reported previous WAT use were more likely to report being motivated to exercise by a mix of intrinsic and extrinsic motivations, including internal guilt, exercise enjoyment, and physical appearance. Given the health benefits of PA for cancer survivors, technology-focused interventions that use WATs and target exercise motivation may aid in cancer survivors meeting the level of recommended PA.
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Affiliation(s)
- Steven De La Torre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donna Spruijt-Metz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Albert J Farias
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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18
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Ortega MA, Fraile-Martínez O, García-Montero C, Pekarek L, Guijarro LG, Castellanos AJ, Sanchez-Trujillo L, García-Honduvilla N, Álvarez-Mon M, Buján J, Zapico Á, Lahera G, Álvarez-Mon MA. Physical Activity as an Imperative Support in Breast Cancer Management. Cancers (Basel) 2020; 13:E55. [PMID: 33379177 PMCID: PMC7796347 DOI: 10.3390/cancers13010055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is the most common malignancy and the second cause of cancer-related death among women. It is estimated that 9 in 10 cases of BC are due to non-genetic factors, and approximately 25% to 30% of total breast cancer cases should be preventable only by lifestyle interventions. In this context, physical activity represents an excellent and accessible approach not only for the prevention, but also for being a potential support in the management of breast cancer. The present review will collect the current knowledge of physical activity in the background of breast cancer, exploring its systemic and molecular effects, considering important variables in the training of these women and the evidence regarding the benefits of exercise on breast cancer survival and prognosis. We will also summarize the various effects of physical activity as a co-adjuvant therapy in women receiving different treatments to deal with its adverse effects. Finally, we will reveal the impact of physical activity in the enhancement of quality of life of these patients, to conclude the central role that exercise must occupy in breast cancer management, in an adequate context of a healthy lifestyle.
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Affiliation(s)
- Miguel A. Ortega
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Oscar Fraile-Martínez
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Cielo García-Montero
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Leonel Pekarek
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Luis G. Guijarro
- Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Alejandro J. Castellanos
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Lara Sanchez-Trujillo
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Natalio García-Honduvilla
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Melchor Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain
| | - Julia Buján
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
| | - Álvaro Zapico
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
- Obstetrics and Gynecology Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Guillermo Lahera
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Miguel A. Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Medical Psychology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
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19
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Robinson A, Oksuz U, Slight R, Slight S, Husband A. Digital and Mobile Technologies to Promote Physical Health Behavior Change and Provide Psychological Support for Patients Undergoing Elective Surgery: Meta-Ethnography and Systematic Review. JMIR Mhealth Uhealth 2020; 8:e19237. [PMID: 33258787 PMCID: PMC7738263 DOI: 10.2196/19237] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/22/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Digital technology has influenced many aspects of modern living, including health care. In the context of elective surgeries, there is a strong association between preoperative physical and psychological preparedness, and improved postoperative outcomes. Health behavior changes made in the pre- and postoperative periods can be fundamental in determining the outcomes and success of elective surgeries. Understanding the potential unmet needs of patients undergoing elective surgery is central to motivating health behavior change. Integrating digital and mobile health technologies within the elective surgical pathway could be a strategy to remotely deliver this support to patients. OBJECTIVE This meta-ethnographic systematic review explores digital interventions supporting patients undergoing elective surgery with health behavior changes, specifically physical activity, weight loss, dietary intake, and psychological support. METHODS A literature search was conducted in October 2019 across 6 electronic databases (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42020157813). Qualitative studies were included if they evaluated the use of digital technologies supporting behavior change in adult patients undergoing elective surgery during the pre- or postoperative period. Study quality was assessed using the Critical Appraisal Skills Programme tool. A meta-ethnographic approach was used to synthesize existing qualitative data, using the 7 phases of meta-ethnography by Noblit and Hare. Using this approach, along with reciprocal translation, enabled the development of 4 themes from the data. RESULTS A total of 18 studies were included covering bariatric (n=2, 11%), cancer (n=13, 72%), and orthopedic (n=3, 17%) surgeries. The 4 overarching themes appear to be key in understanding and determining the effectiveness of digital and mobile interventions to support surgical patients. To successfully motivate health behavior change, technologies should provide motivation and support, enable patient engagement, facilitate peer networking, and meet individualized patient needs. Self-regulatory features such as goal setting heightened patient motivation. The personalization of difficulty levels in virtual reality-based rehabilitation was positively received. Internet-based cognitive behavioral therapy reduced depression and distress in patients undergoing cancer surgery. Peer networking provided emotional support beyond that of patient-provider relationships, improving quality of life and care satisfaction. Patients expressed the desire for digital interventions to be individually tailored according to their physical and psychological needs, before and after surgery. CONCLUSIONS These findings have the potential to influence the future design of patient-centered digital and mobile health technologies and demonstrate a multipurpose role for digital technologies in the elective surgical pathway by motivating health behavior change and offering psychological support. Through the synthesis of patient suggestions, we highlight areas for digital technology optimization and emphasize the importance of content tailored to suit individual patients and surgical procedures. There is a significant rationale for involving patients in the cocreation of digital health technologies to enhance engagement, better support behavior change, and improve surgical outcomes.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Umay Oksuz
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Robert Slight
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sarah Slight
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Andrew Husband
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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20
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Behzadnia B, Kiani A, Babaei S. Autonomy-supportive exercise behaviors promote breast cancer survivors' well-being. Health Promot Perspect 2020; 10:409-417. [PMID: 33312937 PMCID: PMC7722990 DOI: 10.34172/hpp.2020.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors. Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions. Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions. Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.
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Affiliation(s)
- Behzad Behzadnia
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.,Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Arezou Kiani
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Solmaz Babaei
- Faculty of Humanities, University of Maragheh, Maragheh, Iran
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21
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Avancini A, Trestini I, Tregnago D, Wiskemann J, Lanza M, Milella M, Pilotto S. Physical Activity for Oncological Patients in COVID-19 Era: No Time to Relax. JNCI Cancer Spectr 2020; 4:pkaa071. [PMID: 33385107 PMCID: PMC7499670 DOI: 10.1093/jncics/pkaa071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/30/2020] [Accepted: 08/01/2020] [Indexed: 01/09/2023] Open
Abstract
Whereas the coronavirus disease 2019 (COVID-19) storm is relentlessly progressing worldwide, a great effort from scientific societies has been made to give recommendations for safely continuing oncological care, prioritizing the interventions according to patients' condition and type and stage of tumor. Nevertheless, to date no specific suggestions regarding physical activity and exercise in cancer patients during the COVID-19 era have been released, neglecting the potential deleterious effects of quarantine and sedentary behaviour (imposed as containment measures against COVID-19), particularly in these subjects. Moreover, literature is constantly consolidating the crucial impact of regular physical activity in cancer in reducing recurrence and mortality risk. In this commentary, we discuss possible adaptations of the recently published exercise guidelines to the current pandemic emergency, proposing various modalities to prevent or mitigate the physical inactivity risk in cancer patients.
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Affiliation(s)
- Alice Avancini
- Department of Medicine, Biomedical, Clinical and Experimental Sciences, University of Verona, Verona, Italy
| | - Ilaria Trestini
- Department of Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Daniela Tregnago
- Department of Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Heidelberg, Germany
| | - Massimo Lanza
- Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Milella
- Department of Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sara Pilotto
- Department of Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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22
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Brennan L, Kessie T, Caulfield B. Patient Experiences of Rehabilitation and the Potential for an mHealth System with Biofeedback After Breast Cancer Surgery: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e19721. [PMID: 32687476 PMCID: PMC7424492 DOI: 10.2196/19721] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/26/2020] [Accepted: 06/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background Physiotherapy-led home rehabilitation after breast cancer surgery can protect against the development of upper limb dysfunction and other disabling consequences of surgery. A variety of barriers can limit physical rehabilitation outcomes, and patients may benefit from more support during this time. Mobile health (mHealth) systems can assist patients during rehabilitation by providing exercise support, biofeedback, and information. Before designing mHealth systems for a specific population, developers must first engage with users to understand their experiences and needs. Objective The aims of this study were to explore patients’ rehabilitation experiences and unmet needs during home rehabilitation after breast cancer surgery and to understand their experiences of mHealth technology and the requirements they desire from an mHealth system. Methods This was the first stage of a user-centered design process for an mHealth system. We interviewed 10 breast cancer survivors under the two main topics of “Rehabilitation” and “Technology” and performed a thematic analysis on the interview data. Results Discussions regarding rehabilitation focused on the acute and long-term consequences of surgery; unmet needs and lack of support; self-driven rehabilitation; and visions for high-quality rehabilitation. Regarding technology, participants reported a lack of mHealth options for this clinical context and using non-cancer–specific applications and wearables. Participants requested an mHealth tool from a reliable source that provides exercise support. Conclusions There are unmet needs surrounding access to physiotherapy, information, and support during home rehabilitation after breast cancer surgery that could be addressed with an mHealth system. Breast cancer survivors are open to using an mHealth system and require that it comes from a reliable source and focuses on supporting exercise performance.
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Affiliation(s)
- Louise Brennan
- Physiotherapy Department, Beacon Hospital, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Threase Kessie
- Maynooth University Innovation Lab, Maynooth University, Kildare, Ireland
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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23
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Gandhi A, Samuel SR, Kumar KV, Saxena PP, Mithra P. Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy. Asian Pac J Cancer Prev 2020; 21:1813-1818. [PMID: 32592382 PMCID: PMC7568901 DOI: 10.31557/apjcp.2020.21.6.1813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer amongst Indian women. Cancer treatments leads to various side effects out of which Cancer-Related fatigue (CRF) is one of the most under-addressed side-effects. It is experienced the most in patients receiving chemotherapy. Exercise has been proven to be a beneficial intervention to manage CRF but the benefits of pedometer-based exercise programs is under-studied in patients with breast cancer. Hence, we set out to investigate the effects of a pedometer-based exercise program for patients with breast receiving chemotherapy. METHODS The current study was a non-randomized controlled trial with 22 patients each in exercise and control group. The exercise group received a pedometer-based walking program, whereas the control group received standard physical activity advice. Fatigue, quality of life, functional capacity and body composition were assessed at baseline, 3rd week and 7th week. RESULTS At the end of 7 weeks intervention, functional capacity, quality of life and skeletal mass were found to have improved with statistical significance, while the fatigue and changes in total fat did improve but were not statistically significant. CONCLUSION A 7-week pedometer-based exercise program improved functional capacity, quality of life and percentage of skeletal mass and also shows to have prevented deterioration in fatigue levels in patients with breast cancer receiving chemotherapy.
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Affiliation(s)
- Aagna Gandhi
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - Stephen Rajan Samuel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - K Vijaya Kumar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, India
| | - Pu Prakash Saxena
- Department of Radiation oncology, Kasturba Medical College, Manipal Academy of Higher education, Mangalore, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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24
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Kokts-Porietis RL, Stone CR, Friedenreich CM, Froese A, McDonough M, McNeil J. Reply to a letter to the editor referencing "Breast cancer survivors' perspectives on a home-based physical activity intervention utilizing wearable technology". Support Care Cancer 2020; 28:1543. [PMID: 31912361 DOI: 10.1007/s00520-019-05282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Renee L Kokts-Porietis
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210 2nd SW, Calgary, Alberta, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210 2nd SW, Calgary, Alberta, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210 2nd SW, Calgary, Alberta, T2S 3C3, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Alyssa Froese
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210 2nd SW, Calgary, Alberta, T2S 3C3, Canada
| | - Meghan McDonough
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, 2210 2nd SW, Calgary, Alberta, T2S 3C3, Canada.
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25
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Kajiwara K, Kako J, Noto H, Oosono Y, Kobayashi M. Reply to: Breast cancer survivors' perspectives on a home-based physical activity intervention utilizing wearable technology. Support Care Cancer 2019; 28:1541-1542. [PMID: 31712954 DOI: 10.1007/s00520-019-05125-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/02/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Kohei Kajiwara
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Jun Kako
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hiroko Noto
- Department of Health Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasufumi Oosono
- Community Health Nursing, National Defense Medical College, Tokorozawa, Japan
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