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Zhang X, Zhang S, Zhang H, Xiong Z, Li Y, Li L, Pi X, Liu H. Feasibility and Acceptability Evaluation of a Digital Therapeutic Program for Improving Cancer Prevention: A Quasi-experimental Pre-post Interventional Pilot Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02431-y. [PMID: 38898222 DOI: 10.1007/s13187-024-02431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 06/21/2024]
Abstract
Previous studies have proved that healthy behaviors hinder the onset and progression of tumors. Digital therapeutics (DTx), playing a pivotal role in facilitating behavioral adjustments through educational interventions, lifestyle support, and symptom monitoring, contribute to the goal of tumor prevention. We aim to optimize the evaluation of the feasibility and acceptability of DTx for cancer prevention. This involves assessing AITI's daily activity rates and user feedback, and comparing changes in behavioral habits and differences in SF-36 before and after the intervention. In a 4-week trial with 57 participants engaging actively, we found both the average daily activity rate and 4-week retention rate at 35 (61.4%). The USE Questionnaire scores (validity, ease of use, acquisition, and satisfaction) ranged from 68.06 to 83.10, indicating AITI's user-friendliness and acceptability. Furthermore, positive habit changes were noted among participants in exercise and diet (p < 0.0001), suggesting the effectiveness of the DTx approach in modifying behavioral habits related to physical activity and nutrition. This pilot study underscores the potential of DTx in advancing cancer prevention. However, larger and longer studies are needed to comprehensively assess its impact.
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Affiliation(s)
- Xianwei Zhang
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China
| | - Sheng Zhang
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China
| | - Haiyan Zhang
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China
| | - Ziyou Xiong
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China
| | - Yi Li
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China
| | - Lufeng Li
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Gaotan Rock, 30 Main Street, Chongqing, China.
| | - Xitian Pi
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China.
| | - Hongying Liu
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, No. 174 Shazheng Road, Shapingba District, Chongqing, 400044, China.
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Jiang X, Chen J, Yuan X, Lin Y, Chen Y, Li S, Jiang Q, Yu H, Du Q, Peng J. Feasibility of an Individualized mHealth Nutrition (iNutrition) Intervention for Post-Discharged Gastric Cancer Patients Following Gastrectomy: A Randomized Controlled Pilot Trial. Nutrients 2023; 15:nu15081883. [PMID: 37111102 PMCID: PMC10144256 DOI: 10.3390/nu15081883] [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] [Received: 03/02/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: A major challenge for post-discharged gastric cancer patients following gastrectomy is the impact of the anatomy change on decreased oral intake, nutritional status, and, ultimately, quality of life. The purpose of this study is to examine the feasibility and preliminary effects of an individualized mHealth nutrition (iNutrition) intervention in post-discharged gastric cancer patients following gastrectomy. (2) Methods: A mixed-method feasibility study with a parallel randomized controlled design was conducted. Patients were randomly assigned to either the iNutrition intervention group (n = 12) or the control group (n = 12). Participants completed measures at baseline (T0), four (T1), and twelve weeks (T2) post-randomization. (3) Results: Recruitment (33%) and retention (87.5%) rates along with high adherence and acceptability supported the feasibility of the iNutrition intervention for post-discharged gastric cancer patients following gastrectomy, echoed by the qualitative findings. The iNutrition intervention significantly improved participants' nutritional behavior (p = 0.005), energy intake (p = 0.038), compliance with energy requirements (p = 0.006), and compliance with protein requirements (p = 0.008). (4) Conclusions: The iNutrition intervention is feasible and potentially benefits post-discharged gastric cancer patients following gastrectomy. A larger trial is required to establish the efficacy of this approach. Trial Registration: 19 October 2022 Chinese Clinical Trial Registry, ChiCTR2200064807.
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Affiliation(s)
- Xiaohan Jiang
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
| | - Jiamin Chen
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
- Department of Clinical Nutrition, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Xiuhong Yuan
- Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510006, China
| | - Yijia Lin
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Yingliang Chen
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Sijia Li
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Qiuxiang Jiang
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Hong Yu
- Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510006, China
| | - Qianqian Du
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
| | - Junsheng Peng
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
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Tu W, Yan S, Yin T, Zhang S, Xu W, Zhang P, Xu G. Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study. Digit Health 2023; 9:20552076231205741. [PMID: 37829613 PMCID: PMC10566283 DOI: 10.1177/20552076231205741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background Dietary management plays a crucial role in the treatment of patients with ulcerative colitis (UC). While various e-services provide dietary advice, the long-term dietary management requires continuous monitoring and dynamic adjustment to accommodate the evolving nature of the disease and meet the patients' nutritional needs. Consequently, the development of a novel dietary management tool that incorporates diet tracking, personalized nutritional feedback, and evidence-based advice becomes imperative. This study aims to address this need by developing a WeChat applet called "HealthyGut" specifically designed for the dietary management of UC patients, and evaluate its feasibility, acceptability, and preliminary efficacy. Methods A total of 134 UC patients were equally allocated into the intervention group (receiving a 12-week mobile-based dietary management via HealthyGut) and control group (receiving a paper-based food diary and routine advice). The feasibility outcomes were recruitment, retention, engagement, satisfaction, and acceptability in the intervention group. Dietary intakes were effective outcomes. Results Both groups had satisfactory retention rates (89.6% and 77.6%, respectively). The System Usability Scale in the intervention group yielded "good usability" with a mean score of 79.63 (SD 7.39), and all participants reported good user experiences and perceived benefits after using HealthyGut. At week 12, intervention responders reported significantly higher daily energy intake than control group (Z = -3.089, p = 0.002). Conclusions and Implications The results display that HealthyGut as a dietary management tool is feasible and accepted by UC patients, and it may help them make healthier food choices. Larger sample studies should be considered in the future.
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Affiliation(s)
- Wenjing Tu
- Nursing School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shuxia Yan
- Nursing School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tingting Yin
- Nursing School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Sumin Zhang
- Anorectal Department, Nanjing City Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Wenjing Xu
- Nursing School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ping Zhang
- Gastroenterology Department, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Guihua Xu
- Nursing School, Nanjing University of Chinese Medicine, Nanjing, China
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Gudmundsson GH, Mészáros J, Björnsdóttir ÁE, Ámundadóttir ML, Thorvardardottir GE, Magnusdottir E, Helgadottir H, Oddsson S. Feasibility of a Digital Therapeutic Program for Cancer Patients During Active Treatment: Analysis of Engagement, Retention and Quality of Life (Preprint). JMIR Form Res 2022; 6:e39764. [PMID: 36227639 PMCID: PMC9614627 DOI: 10.2196/39764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2022] Open
Abstract
Background Increasing evidence shows that lifestyle interventions can improve the symptoms, quality of life (QoL), and even overall survival of patients with cancer. Digital therapeutics (DTx) can help implement behavioral modifications and empower patients through education, lifestyle support, and remote symptom monitoring. Objective We aimed to test the feasibility of a DTx program for patients with cancer, as measured by engagement, retention, and acceptability. In addition, we explored the effects of the program on cancer-related QoL. Methods We conducted a 4-week single-arm trial in Iceland, where DTx was delivered through a smartphone app. The intervention consisted of patient education about mindfulness, sleep, stress, and nutrition; lifestyle coaching; and the completion of daily missions for tracking physical activity and exercise, reporting patient-reported outcomes (PROs), practicing mindfulness, and logging healthy food intake. Information on program engagement and retention, step goal attainment, as well as PROs were collected throughout the study. QoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 at baseline and follow-up. Results In total, 30 patients with cancer undergoing active therapy were enrolled, and 29 registered in the app (23 female, 18 with breast cancer; mean age 52.6, SD 11.5 years). Overall, 97% (28/29) of participants were active in 3 of the 4 weeks and completed the pre- and postprogram questionnaires. The weekly active days (median) were 6.8 (IQR 5.8-6.8), and 72% (21/29) of participants were active at least 5 days a week. Users interacted with the app on average 7.7 (SD 1.9) times per day. On week 1, all 29 participants used the step counter and logged an average of 20,306 steps; 21 (72%) participants reached their step goals of at least 3000 steps per day. On week 4, of the 28 active users, 27 (96%) were still logging their steps, with 19 (68%) reaching their step goals. Of the 28 participants who completed the satisfaction questionnaire, 25 (89%) were likely to recommend the program, 23 (82%) said the program helped them deal with the disease, and 24 (86%) said it helped them remember their medication. QoL assessment showed that the average global health status, functioning, and symptom burden remained stable from baseline to follow-up. In all, 50% (14/28) of participants reported less pain, and the average pain score decreased from 31 (SD 20.1) to 22.6 (SD 23.2; P=.16). There was no significant change in PROs on the quality of sleep, energy, and stress levels from the first to the last week. Conclusions The high retention, engagement, and acceptability found in this study demonstrate that multidisciplinary DTx is feasible for patients with cancer. A longer, full-scale randomized controlled trial is currently being planned to evaluate the efficacy of the intervention.
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Affiliation(s)
| | - Judit Mészáros
- Medical and Research Department, Sidekick Health, Berlin, Germany
| | | | | | | | | | - Halla Helgadottir
- Medical and Research Department, Sidekick Health, Kopavogur, Iceland
| | - Saemundur Oddsson
- Medical and Research Department, Sidekick Health, Kopavogur, Iceland
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Hoenemeyer TW, Cole WW, Oster RA, Pekmezi DW, Pye A, Demark-Wahnefried W. Test/Retest Reliability and Validity of Remote vs. In-Person Anthropometric and Physical Performance Assessments in Cancer Survivors and Supportive Partners. Cancers (Basel) 2022; 14:1075. [PMID: 35205823 PMCID: PMC8869803 DOI: 10.3390/cancers14041075] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Anthropometric and physical performance testing is commonly done in lifestyle research and is traditionally performed in-person. To expand the scalability of lifestyle interventions among cancer survivors, in-person assessments were adapted to remote means and evaluated for feasibility, safety, validity, and reliability. (2) Methods: Cancer survivors and supportive partners were approached to participate in three anthropometric and physical performance testing sessions (two remote/one in-person). Correlations, concordance, and differences between testing modes were evaluated. (3) Results: 110-of-112 individuals approached for testing participated (98% uptake); the sample was 78% female, 64% non-Hispanic White, of mean age 58 years and body mass index = 32.4 kg/m2. ICCs for remote assessments ranged from moderate (8' walk = 0.47), to strong (8' get-up-and-go = 0.74), to very strong (30 s chair stand = 0.80; sit-and-reach = 0.86; 2 min step test = 0.87; back scratch = 0.90; weight = 0.93; waist circumference = 0.98) (p-values < 0.001). Perfect concordance (100%) was found for side-by-side and semi-tandem balance, and 87.5-90.3% for tandem balance. No significant differences between remote and in-person assessments were found for weight, 8' walk, and 8' get-up-and-go. No adverse events occurred and 75% indicated no preference or preferred virtual testing to in-person. (4) Conclusions: Remote anthropometric and physical performance assessments are reliable, valid, acceptable, and safe among cancer survivors and supportive partners.
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Affiliation(s)
- Teri W. Hoenemeyer
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, USA; (W.W.C.); (A.P.); (W.D.-W.)
| | - William W. Cole
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, USA; (W.W.C.); (A.P.); (W.D.-W.)
| | - Robert A. Oster
- O’Neal Comprehensive Cancer Center at UAB, Birmingham, AL 35233, USA; (R.A.O.); (D.W.P.)
- Department of Preventive Medicine, UAB School of Medicine, Birmingham, AL 35233, USA
| | - Dorothy W. Pekmezi
- O’Neal Comprehensive Cancer Center at UAB, Birmingham, AL 35233, USA; (R.A.O.); (D.W.P.)
- Department of Health Behavior, UAB School of Public Health, Birmingham, AL 35233, USA
| | - Andrea Pye
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, USA; (W.W.C.); (A.P.); (W.D.-W.)
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35233, USA; (W.W.C.); (A.P.); (W.D.-W.)
- O’Neal Comprehensive Cancer Center at UAB, Birmingham, AL 35233, USA; (R.A.O.); (D.W.P.)
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Ting G, Nursing MI, Hui-Lin C, Yee Mimi TM. A Systematic Review of Nurse-led Dietary Interventions for Cancer Patients and Survivors. Asia Pac J Oncol Nurs 2021; 9:81-87. [PMID: 35529414 PMCID: PMC9072171 DOI: 10.1016/j.apjon.2021.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/17/2021] [Indexed: 11/02/2022] Open
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