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Shen S, Salehi E, White C, Chen Y, Iyengar NM. Evaluation of a mobile behavior change program for weight loss in breast cancer survivors. NPJ Breast Cancer 2024; 10:53. [PMID: 38951532 PMCID: PMC11217495 DOI: 10.1038/s41523-024-00659-x] [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: 01/02/2024] [Accepted: 06/14/2024] [Indexed: 07/03/2024] Open
Abstract
Post-diagnosis weight gain is common in early-stage breast cancer and is associated with increased risk of recurrence and mortality. Intentional weight loss is difficult to maintain, and digital lifestyle interventions may provide a scalable approach to address this challenge. In this prospective single-arm study (ClinicalTrials.gov NCT04753268; February 15, 2021), key eligibility criteria included: stage I-III breast cancer, body mass index (BMI) ≥ 27.5 kg/m2, and completion of cancer treatment ≥6 months before study enrollment. Participants were provided with a behavioral change mobile application (Noom®). The primary endpoint was a change in self-reported weight from baseline to 26 weeks. Secondary endpoints included engagement, changes in physical activity, dietary patterns, and patient-reported outcomes (PRO). In total, 31 patients were enrolled (mean age 56.8 ± 9.9, mean baseline BMI 33.5 kg/m2 ± 6.5). The mean weight change was -4.8 kg ( ± 4.4, P < 0.001), mean percent weight change was -5.6% ( ± 5.0%); 11/31 patients (35.5%) lost ≥5% of their initial weight. Metrics of digital application engagement associated with weight loss ≥5% included articles read (P = 0.012), weights logged (P = 0.006), food records logged (P = 0.001), messages sent (P = 0.001), and application open count (P = 0.014). Significant increases were seen in mean daily step count (P = 0.004), GPAQ scores (P = 0.002), and Body Image Scale scores (P < 0.001). Mean energy intake remained consistently in a calorie-restricted range of 1300-1400 kcal/day. In this study, breast cancer survivors were highly engaged with a behavioral change smartphone application which led to clinically significant weight loss, increased physical activity, maintenance of an energy-restricted diet, and improvements in body image.
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Affiliation(s)
- Sherry Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Erica Salehi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charlie White
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuan Chen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Neil M Iyengar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Weill Cornell Medicine, New York, NY, USA.
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Seid A, Fufa DD, Bitew ZW. The use of internet-based smartphone apps consistently improved consumers' healthy eating behaviors: a systematic review of randomized controlled trials. Front Digit Health 2024; 6:1282570. [PMID: 38283582 PMCID: PMC10811159 DOI: 10.3389/fdgth.2024.1282570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Digital tools, such as mobile apps and the Internet, are being increasingly used to promote healthy eating habits. However, there has been inconsistent reporting on the effectiveness of smartphones and web-based apps in influencing dietary behaviors. Moreover, previous reviews have been limited in scope, either by focusing on a specific population group or by being outdated. Therefore, the purpose of this review is to investigate the impacts of smartphone- and web-based dietary interventions on promoting healthy eating behaviors worldwide. Methods A systematic literature search of randomized controlled trials was conducted using databases such as Google Scholar, PubMed, Global Health, Informit, Web of Science, and CINAHL (EBSCO). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to prepare the entire document. EndNote (version 20) was used for reference management. The risk of bias in the articles was assessed using the "Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0)" by the Cochrane Collaboration. Narrative synthesis, using text and tables, was used to present the results. The study was registered in PROSPERO under protocol number CRD42023464315. Results This review analyzed a total of 39 articles, which consisted of 25 smartphone-based apps and 14 web-based apps. The studies involved a total of 14,966 participants. Out of the 25 studies, 13 (52%) showed that offline-capable smartphone apps are successful in promoting healthier eating habits. The impact of smartphone apps on healthy adults has been inconsistently reported. However, studies have shown their effectiveness in chronically ill patients. Likewise, internet-based mobile apps, such as social media or nutrition-specific apps, have been found to effectively promote healthy eating behaviors. These findings were consistent across 14 studies, which included healthy adults, overweight or obese adults, chronically ill patients, and pregnant mothers. Conclusion Overall, the findings suggest that smartphone apps contribute to improving healthy eating behaviors. Both nutrition-specific and social media-based mobile apps consistently prove effective in promoting long-term healthy eating habits. Therefore, policymakers in the food system should consider harnessing the potential of internet-based mobile apps and social media platforms to foster sustainable healthy eating behaviors.
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Affiliation(s)
- Awole Seid
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Desta Dugassa Fufa
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
- Haramaya Institute of Technology, Haramaya University, Dire Dawa, Ethiopia
| | - Zebenay Workneh Bitew
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Wang X, Sun J, Yin X, Zou C, Li H. Effects of behavioral change techniques on diet and physical activity in colorectal cancer patients: a systematic review and meta-analysis. Support Care Cancer 2022; 31:29. [PMID: 36515770 DOI: 10.1007/s00520-022-07511-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the effect of behavior change technology on diet, exercise, and sedentary behaviors in colorectal cancer over the last decade. METHODS This study systematically searched six English databases (Cochrane Library, EMBASE, APA PsycInfo, SCOPUS, PubMed, Web of Science) and three Chinese databases (CNKI, WanFang, and SINOMEd), searched for eligible clinical trials published between January 1, 2012, and December 31, 2021. Each database follows the principle of PICOS and adopts the method of subject words combined with free words to conduct literature retrieval, such as "colorectal cancer" and "behavior change intervention." Meta-analysis was performed using RevMan 5.3 software. Continuous data using the same measurement tools were analyzed using weighted mean difference (MD). Otherwise, standard mean difference (SMD) was used for analysis. The confidence interval is 95%. There was no significant statistical heterogeneity between the studies (P > 0.1, I2 < 50%), and fixed-effects model was used. There was statistical heterogeneity (P ≤ 0.1), I2 ≥ 50%), and the random effects model was used for analysis. The Cochrane risk of bias tool was used to assess the risk of bias in the included studies. RESULTS In total, 15 good-quality randomized controlled trials were identified. Six studies focused on eating habits. Twelve studies focused on physical activity. We found that behavior change techniques had significant effects on colorectal cancer survivors' eating behaviors such as frequency of fruit and vegetable intake and mastery of dietary knowledge (P < 0.05). The meta-analysis showed that the amount of physical activity in the intervention group increased by 71.76 min/w (16.27 to 127.24, P = 0.01) at 3 months after treatment compared with the control group. The meta-analysis showed that the amount of physical activity in the intervention group increased by 113.97 min/w (48.34 to 179.59, P < 0.001) at 6 months after treatment compared with the control group. The results revealed significant difference in the overall effect of the behavior change technique on the amount of exercise. Behavior change techniques were not found to have significant effects on body weight and BMI in colorectal cancer survivors, but it had a significant effect on sedentary behavior (P < 0.05). CONCLUSIONS The effects of behavioral change technique intervention on diet and physical activity may be more clinically significant at 6 months. This is the first systematic review and meta-analysis to summarize the effectiveness of a behavioral change techniques health behavior intervention in patients with colorectal cancer.
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Affiliation(s)
- Xiao Wang
- First Hospital of Jilin University, Changchun, China
| | - Jiao Sun
- Jilin University, Changchun, China
| | - Xin Yin
- First Hospital of Jilin University, Changchun, China
| | - Congcong Zou
- First Hospital of Jilin University, Changchun, China
| | - Hongyan Li
- First Hospital of Jilin University, Changchun, China.
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Yen HY, Jin G, Chiu HL. Smartphone app-based interventions targeting physical activity for weight management: a meta-analysis of randomized controlled trials. Int J Nurs Stud 2022; 137:104384. [DOI: 10.1016/j.ijnurstu.2022.104384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
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Ho AS, Behr H, Mitchell ES, Yang Q, Lee J, May CN, Michaelides A. Goal language is associated with attrition and weight loss on a digital program: Observational study. PLOS DIGITAL HEALTH 2022; 1:e0000050. [PMID: 36812521 PMCID: PMC9931249 DOI: 10.1371/journal.pdig.0000050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/24/2022] [Indexed: 06/18/2023]
Abstract
Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals' written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals' written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals' natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.
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Affiliation(s)
- Annabell Suh Ho
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Heather Behr
- Academic Research, Noom, Inc., New York, New York, United States of America
- Department of Integrative Health, Saybrook University, Pasadena, California, United States of America
| | | | - Qiuchen Yang
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Jihye Lee
- Department of Communication, Stanford University, Stanford, California, United States of America
| | - Christine N. May
- Academic Research, Noom, Inc., New York, New York, United States of America
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Ang SM, Chen J, Liew JH, Johal J, Dan YY, Allman-Farinelli M, Lim SL. Efficacy of Interventions That Incorporate Mobile Apps in Facilitating Weight Loss and Health Behavior Change in the Asian Population: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e28185. [PMID: 34783674 PMCID: PMC8663646 DOI: 10.2196/28185] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/10/2021] [Accepted: 09/23/2021] [Indexed: 12/20/2022] Open
Abstract
Background Smartphone apps have shown potential in enhancing weight management in Western populations in the short to medium term. With a rapidly growing obesity burden in Asian populations, researchers are turning to apps as a service delivery platform to reach a larger target audience to efficiently address the problem. Objective This systematic review and meta-analysis aims to determine the efficacy of interventions that incorporate apps in facilitating weight loss and health behavior change in the Asian population. Methods A total of 6 databases were searched in June 2020. The eligible studies included controlled trials in which an app was used in the intervention. The participants were aged 18 years or older and were of Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses, and post hoc analyses was conducted to determine the effects of adding an app to usual care and study duration. The primary outcome was absolute or percentage weight change, whereas the secondary outcomes were changes to lifestyle behaviors. Results A total of 21 studies were included in this review, and 17 (81%) were selected for the meta-analysis. The pooled effect size across 82% (14/17) of the randomized controlled trials for weight change was small to moderate (Hedges g=–0.26; 95% CI –0.41 to –0.11), indicating slightly greater weight loss achieved in the intervention group; however, this may not be representative of long-term studies (lasting for more than a year). Supplementing multicomponent usual care with an app led to greater weight loss (Hedges g=–0.28; 95% CI –0.47 to –0.09). Asian apps were largely culturally adapted and multifunctional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. Conclusions More evidence is required to determine the efficacy of apps in the long term and address the low uptake of apps to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multicomponent intervention to facilitate the designing of studies that are most effective and cost-efficient for weight management. Trial Registration PROSPERO CRD42020165240; https://tinyurl.com/2db4tvn6
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Affiliation(s)
- Siew Min Ang
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Juliana Chen
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Jia Huan Liew
- Science Unit, Lingnan University, Hong Kong, Hong Kong
| | - Jolyn Johal
- Joanna Briggs Institute, University of Adelaide, Adelaide, Australia
| | - Yock Young Dan
- Department of Medicine, National University Hospital, Singapore, Singapore
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore, Singapore
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Payne JE, Turk MT, Kalarchian MA, Pellegrini CA. Adherence to mobile‐app‐based dietary self‐monitoring—Impact on weight loss in adults. Obes Sci Pract 2021; 8:279-288. [PMID: 35664248 PMCID: PMC9159560 DOI: 10.1002/osp4.566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/23/2021] [Accepted: 08/28/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives Greater dietary self‐monitoring adherence is associated with weight loss, however, the dietary self‐monitoring adherence criteria that predict weight loss are unknown. The criteria used to define adherence to dietary self‐monitoring in obesity treatment tend to vary, particularly in studies that include dietary self‐monitoring via mobile applications (apps). The objectives of this study were to (a) determine weight change outcomes related to app‐based dietary self‐monitoring and (b) determine the associations between the frequency, consistency, and completeness of dietary self‐monitoring and weight change. Methods In this single‐arm uncontrolled prospective study, employees at a large, urban health system who had overweight or obesity self‐monitored dietary intake for 8 weeks using the Calorie Counter by FatSecret app. A paired sample t‐test examined the association of app‐based dietary self‐monitoring and weight change; linear regression examined the associations of frequent, consistent, and complete dietary self‐monitoring and weight change. Results A significant mean difference [t (89) = 6.59, p < 0.001] was found between baseline and 8‐week weight (M = −1.5 ± 2.1 kg) in the sample (N = 90). Linear regression revealed a significant association [F (1, 88) = 7.18, p = 0.009] between total weeks of consistent dietary self‐monitoring (M = 4.4 ± 2.8) and percent weight loss (M = −1.54% ± 2.26%), and a significant association [F (1, 88) = 6.42, p = 0.013] between dietary self‐monitoring frequency (M = 50.1% ± 33.3%) and percent weight loss. The total weeks of complete dietary self‐monitoring (M = 3.42 ± 2.87) was not associated [F (1, 88) = 3.57, p = 0.062] with percent weight loss. Conclusions Consistent and frequent app‐based dietary self‐monitoring were associated with short‐term weight loss. Emphasizing these aspects of self‐monitoring may be an avenue for decreasing the burden of self‐monitoring.
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Affiliation(s)
- Jason E. Payne
- School of Nursing College of Health & Human Services University of North Carolina Wilmington Wilmington North Carolina USA
| | - Melanie T. Turk
- School of Nursing Duquesne University Pittsburgh Pennsylvania USA
| | | | - Christine A. Pellegrini
- Department of Exercise Science Arnold School of Public Health University of South Carolina Columbia South Carolina USA
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Lim SY, Lee KW, Seow WL, Mohamed NA, Devaraj NK, Amin-Nordin S. Effectiveness of Integrated Technology Apps for Supporting Healthy Food Purchasing and Consumption: A Systematic Review. Foods 2021; 10:1861. [PMID: 34441638 PMCID: PMC8392602 DOI: 10.3390/foods10081861] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/01/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
A healthy diet is essential for good health and nutrition, though literature showed that there are various factors affecting the intention to purchase and consume healthy food. Technology integration is known to be useful in various aspects, but findings from studies on the efficacy of technology integration to improve healthy food consumption and purchase have largely been inconsistent. Therefore, we aimed to examine the efficacy of interventions that use technology apps to improve healthy food purchasing and consumption in adults. Relevant studies were identified through PubMed, Scopus, CINAHL, SportDiscuss and ACM Digital Library. Twenty studies were included in the systematic review. The majority of studies (n = 18) used a smartphone in the intervention, and only two studies used a personal digital assistant. The results showed that technology integration-based intervention favoured healthy changes in household food purchases, and increased consumption of healthy food and healthy eating outcomes - albeit to different extents. Overall, technology apps are convenient and user-friendly tools to encourage a change in healthy food purchase and consumption among people.
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Affiliation(s)
- Sook Yee Lim
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (S.Y.L.); (W.-L.S.)
- Faculty of Applied Sciences, UCSI University, Cheras 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Kai Wei Lee
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia;
| | - Wen-Li Seow
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (S.Y.L.); (W.-L.S.)
| | - Nurul Azmawati Mohamed
- Department of Basic Medical Sciences 2, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia;
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | - Syafinaz Amin-Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; (S.Y.L.); (W.-L.S.)
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Yang Q, Mitchell ES, Ho AS, DeLuca L, Behr H, Michaelides A. Cross-National Outcomes of a Digital Weight Loss Intervention in the United States, Canada, United Kingdom and Ireland, and Australia and New Zealand: A Retrospective Analysis. Front Public Health 2021; 9:604937. [PMID: 34178911 PMCID: PMC8222510 DOI: 10.3389/fpubh.2021.604937] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 05/07/2021] [Indexed: 11/30/2022] Open
Abstract
Mobile health (mHealth) interventions are ubiquitous and effective treatment options for obesity. There is a widespread assumption that the mHealth interventions will be equally effective in other locations. In an initial test of this assumption, this retrospective study assesses weight loss and engagement with an mHealth behavior change weight loss intervention developed in the United States (US) in four English-speaking regions: the US, Australia and New Zealand (AU/NZ), Canada (CA), and the United Kingdom and Ireland (UK/IE). Data for 18,459 participants were extracted from the database of Noom's Healthy Weight Program. Self-reported weight was collected every week until program end (week 16). Engagement was measured using user-logged and automatically recorded actions. Linear mixed models were used to evaluate change in weight over time, and ANOVAs evaluated differences in engagement. In all regions, 27.2–33.2% of participants achieved at least 5% weight loss by week 16, with an average of 3–3.7% weight loss. Linear mixed models revealed similar weight outcomes in each region compared to the US, with a few differences. Engagement, however, significantly differed across regions (P < 0.001 on 5 of 6 factors). Depending on the level of engagement, the rate of weight loss over time differed for AU/NZ and UK/IE compared to the US. Our findings have important implications for the use and understanding of digital weight loss interventions worldwide. Future research should investigate the determinants of cross-country engagement differences and their long-term effects on intervention outcomes.
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Affiliation(s)
| | | | | | - Laura DeLuca
- Noom Inc., New York, NY, United States.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Heather Behr
- Noom Inc., New York, NY, United States.,Department of Integrative Health, Saybrook University, Pasadena, CA, United States
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McFerran E, Boeri M, Kee F. Patient Preferences in Surveillance: Findings From a Discrete Choice Experiment in the "My Follow-Up" Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:1373-1383. [PMID: 33032782 DOI: 10.1016/j.jval.2020.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 04/26/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Approximately 800 000 people die globally from colorectal cancer (CRC) every year. Prevention programs promote early detection, but for people with precancerous lesions, tailoring surveillance to include lifestyle-change programs could enhance prevention potential and improve outcomes. METHODS Those with intermediate or high-risk polyps removed during CRC screening colonoscopy within the Northern Ireland CRC Screening Programme were invited to complete 8 discrete choice questions about tailored surveillance, analyzed using random-parameters logit and a latent class modeling approach. RESULTS A total of 231 participants (77% male) self-reported comorbid hypertension (53%), high cholesterol (48%), and mean body mass index of 28.7 (overweight). Although 39% of participants were unaware of their CRC risk status, 30.9% indicated they were already making changes to reduce their risk. Although all respondents were significantly risk- and cost-averse, the latent class analysis identified 3 segments (classes): 1. Class 1 (26.8%) significantly favored phone or email support for a lifestyle change, a 17-month testing interval, and noninvasive testing. 2. Class 2 (48.4%) preferred the status quo. 3. Class 3 (24.7%) significantly favored further risk reduction and invasive testing. CONCLUSIONS This is the first documented preference study focusing on postpolypectomy surveillance offering lifestyle interventions. Although current care is strongly preferred, risk and cost aversion are important for participants. Latent class analysis shows that some respondents are willing to change diet and lifestyle behaviors, reflecting a teachable moment, with opportunities to personalize and optimize surveillance. Significant discordance between perceived and known risk of recurrence and limited recall of risk information provided within current practice suggest necessary improvements to surveillance programs.
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Affiliation(s)
- Ethna McFerran
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
| | - Marco Boeri
- RTI Health Solutions, Belfast, Northern Ireland, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK
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