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Chengang H, Liping W, Shujin W, Chen C, Jiayue Y, Jingjing L, Shujie H, Jieming W, Liyan Y, Ni Z, Jinhui C, Jiaqi S. Multi-stage optimization strategy based on contextual analysis to create M-health components for case management model in breast cancer transitional care: the CMBM study as an example. BMC Nurs 2024; 23:385. [PMID: 38844982 PMCID: PMC11155158 DOI: 10.1186/s12912-024-02049-x] [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: 11/22/2023] [Accepted: 05/29/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND None of the early M-Health applications are designed for case management care services. This study aims to describe the process of developing a M-health component for the case management model in breast cancer transitional care and to highlight methods for solving the common obstacles faced during the application of M-health nursing service. METHODS We followed a four-step process: (a) Forming a cross-functional interdisciplinary development team containing two sub-teams, one for content development and the other for software development. (b) Applying self-management theory as the theoretical framework to develop the M-health application, using contextual analysis to gain a comprehensive understanding of the case management needs of oncology nursing specialists and the supportive care needs of out-of-hospital breast cancer patients. We validated the preliminary concepts of the framework and functionality of the M-health application through multiple interdisciplinary team discussions. (c) Adopting a multi-stage optimization strategy consisting of three progressive stages: screening, refining, and confirmation to develop and continually improve the WeChat mini-programs. (d) Following the user-centered principle throughout the development process and involving oncology nursing specialists and breast cancer patients at every stage. RESULTS Through a continuous, iterative development process and rigorous testing, we have developed patient-end and nurse-end program for breast cancer case management. The patient-end program contains four functional modules: "Information", "Interaction", "Management", and "My", while the nurse-end program includes three functional modules: "Consultation", "Management", and "My". The patient-end program scored 78.75 on the System Usability Scale and showed a 100% task passing rate, indicating that the programs were easy to use. CONCLUSIONS Based on the contextual analysis, multi-stage optimization strategy, and interdisciplinary team work, a WeChat mini-program has been developed tailored to the requirements of the nurses and patients. This approach leverages the expertise of professionals from multiple disciplines to create effective and evidence-based solutions that can improve patient outcomes and quality of care.
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Affiliation(s)
- Hong Chengang
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Wang Liping
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China.
| | - Wang Shujin
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Chen Chen
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Yang Jiayue
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Lu Jingjing
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Hua Shujie
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Wu Jieming
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Yao Liyan
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Zeng Ni
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Chu Jinhui
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
| | - Sun Jiaqi
- School of Nursing, Hangzhou Normal University, Hangzhou City, Zhejiang Province, 311100, China
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Villinger K, Berli C, Scholz U. App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review. Health Psychol Rev 2024:1-23. [PMID: 38755755 DOI: 10.1080/17437199.2024.2349617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/25/2024] [Indexed: 05/18/2024]
Abstract
The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms.
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Affiliation(s)
| | - Corina Berli
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Urte Scholz
- Department of Psychology, University of Zurich, Zurich, Switzerland
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Rick TJ, Sagaram S, Jewett PI, Lee HY, Sadak KT, Turcotte LM, Vogel RI, Blaes A. A pilot randomized controlled trial of an online intervention for Hodgkin lymphoma survivors to increase knowledge about late effects and recommended screening. J Cancer Surviv 2024:10.1007/s11764-024-01587-2. [PMID: 38642203 DOI: 10.1007/s11764-024-01587-2] [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: 01/31/2024] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Hodgkin lymphoma (HL) survivors who received chest radiotherapy are at risk for breast cancer and cardiovascular disease, but screening adherence is low. We assessed the acceptability/feasibility of a web-based educational intervention and its impact on knowledge of health risks and screening. METHODS HL survivors were randomized to either an interactive online educational intervention or handouts only. Surveys were completed at baseline and 3 months post-intervention. We described the acceptability/feasibility of the intervention and compared knowledge between groups. RESULTS Fifty-two HL survivors participated; 27 in the intervention group and 25 in the control group. Eighteen (66%) intervention participants completed the intervention and reported high acceptability (89-100%). At baseline, adherence to breast cancer screening was low across all participants. Post-intervention, those in the intervention group more often than controls correctly identified breast cancer and echocardiogram screening guidelines (35% vs. 28%, P = 0.02 and 82% vs. 52%, P = 0.04) and reported knowing how to address potential complications from cancer treatments (87% vs. 64%, P = 0.03). We detected no increase in screening behavior post-intervention. CONCLUSION Online education modules for high-risk HL survivors are an acceptable method to improve knowledge of health risks and screening guidelines. Future interventions should focus on improving screening uptake in this population. IMPLICATIONS FOR CANCER SURVIVORS Web-based learning can be useful in increasing cancer survivor knowledge of their unique risks and screening recommendations but does not necessarily change patient behavior. Involvement in a cancer survivorship program can help assess individual barriers and monitor uptake of screening.
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Affiliation(s)
- Tara J Rick
- Department of Medicine, Division of Hematology/Oncology, University of Minnesota, Minneapolis, USA.
- University of Minnesota Masonic Cancer Center, Minneapolis, USA.
| | | | - Patricia I Jewett
- Department of Medicine, Division of Hematology/Oncology, University of Minnesota, Minneapolis, USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, USA
| | - Karim T Sadak
- University of Minnesota Masonic Cancer Center, Minneapolis, USA
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Minnesota, Minneapolis, USA
| | - Lucie M Turcotte
- University of Minnesota Masonic Cancer Center, Minneapolis, USA
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Minnesota, Minneapolis, USA
| | - Rachel I Vogel
- University of Minnesota Masonic Cancer Center, Minneapolis, USA
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, USA
| | - Anne Blaes
- Department of Medicine, Division of Hematology/Oncology, University of Minnesota, Minneapolis, USA
- University of Minnesota Masonic Cancer Center, Minneapolis, USA
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Vardar O, Serçekuş P. The effect of a mobile application for patients living with gynaecological cancer on their physical and psychosocial adaptation. Int J Palliat Nurs 2024; 30:128-137. [PMID: 38517850 DOI: 10.12968/ijpn.2024.30.3.128] [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] [Indexed: 03/24/2024]
Abstract
BACKGROUND Education of patients with cancer and patient self-management allow better clinical outcomes using e-health or mobile health applications. AIMS To develop a mobile application to increase the physical and psychosocial adaptation for patients with gynecological cancer who are receiving chemotherapy and to investigate the effectiveness of the mobile application. METHODS This study was planned as a parallel, single-blind, pre-post test randomised controlled experimental study in which two groups (intervention-control) will be compared. A total of 52 gynecological cancer patients were planned to be included in the study. FINDINGS This study is in the protocol stage. Therefore, the results of the study have not yet been reported. CONCLUSIONS Evidence-based information within JineOnkolojik Destek provides rich data on coping with chemotherapy. In addition, the visual and auditory elements, real patient stories and videos, and the ability to ask questions and receive counselling from the research team can positively affect the physical and psychosocial health of the cancer survivors.
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Affiliation(s)
- Okan Vardar
- Lecturer, Faculty of Health Sciences, Pamukkale University, Türkiye
| | - Pınar Serçekuş
- Professor, Faculty of Health Sciences, Pamukkale University, Türkiye
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Arcan C, Hou W, Hoffman K, Reichardt A, Yang X, Clouston SAP, Bromet EJ, Luft B. Mediterranean diet intervention among World Trade Center responders with post-traumatic stress disorder: Feasibility and outcomes of a pilot randomized controlled trial. Obes Sci Pract 2024; 10:e725. [PMID: 38263989 PMCID: PMC10804354 DOI: 10.1002/osp4.725] [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: 01/25/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Responders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD). Methods WTC Health Program members (N = 62), 45-65 years, males 87%, body mass index (BMI) 27-45 kg/m2 randomized to MedDiet (n = 31) or usual nutrition counseling (n = 31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons. Results A total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17) kg, BMI 33.20 (27.50-41.75) kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62) cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p = 0.0002; Control: -1% (-13%-4%), p = 0.008 and at follow-up MedDiet: -2% (-14%-12%), p = 0.07; Control: -2% (-20%-3%), p = 0.006. The overall BMI was reduced by -0.68 kg/m2 (-4.61-2.09) kg/m2 p < 0.0001 at post-intervention and by -0.60 kg/m2 (-6.91-3.39) kg/m2, p < 0.0009 at follow-up. Overall, median WC was reduced (p < 0.0001); post-intervention -3.81 cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p = 0.019) and serum ω6/ω3 (p = 0.029) at post-intervention. Conclusion Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects.
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Affiliation(s)
- Chrisa Arcan
- Department of EpidemiologySchool of Population HealthVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Wei Hou
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Vertex Pharmaceuticals IncorporatedBostonMassachusettsUSA
| | - Kathryn Hoffman
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Amanda Reichardt
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Xiaohua Yang
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Sean A. P. Clouston
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Evelyn J. Bromet
- Neurosciences InstituteRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Benjamin Luft
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
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Frazier MC, Balis LE, Armbruster SD, Estabrooks PA, Harden SM. Adaptations to a statewide walking program: Use of iterative feedback cycles between research and delivery systems improves fit for over 10 years. Transl Behav Med 2024; 14:45-53. [PMID: 37682753 PMCID: PMC10782918 DOI: 10.1093/tbm/ibad052] [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] [Indexed: 09/10/2023] Open
Abstract
FitEx is an 8-week, group-based physical activity and fruit and vegetable consumption program co-created and implemented with the Cooperative Extension System. Effectiveness and delivery personnel perceptions of the program are promising; however, ongoing adaptations are required to continuously meet shifting needs of both researchers and delivery systems. We applied the APDER iterative cycles of implementation over 15 years to understand dynamic and ongoing adaptations as well as implications for FitEx sustainability. Each year, an IRPP between delivery (FitEx deliverers) and research (FitEx developers) systems shared feedback on program core elements and strategies for adaptation through regular team meetings, emails, and evaluations. While the core elements (delivering to groups, goal setting, feedback, and self-monitoring) of FitEx remained consistent, changes were made to address logistical factors, emergent research questions, and technological advancements. For example, program deliverers suggested decreasing training time and making program content available on demand rather than through traditional in-person training. Using APDER with a long-standing IRPP allowed the delivery system to provide feedback to program developers to co-create ongoing adaptations and data-driven decisions. Future work in response to shifting needs includes Fitbit integration and technological updates to the usability of the FitEx platform. Our aim is to report the 15+ years of applying the Assess, Plan, Do, Evaluate, Report (APDER) process with an integrated research-practice partnership (IRPP) for co-creation of ongoing adaptations of FitEx and to share methods for capturing relevant data for decision-making to integrate health promotion programs in community settings.
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Affiliation(s)
- Mary C Frazier
- Translational Biology, Medicine, and Health Program, Virginia Tech, Roanoke, VA, USA
| | - Laura E Balis
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
| | - Shannon D Armbruster
- Division of Gynecologic Oncology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Paul A Estabrooks
- Department of Health & Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
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Tagai EK, Mantia‐Smaldone GM, Belfiglio A, Chu CS, Lapitan E, Santos H, Hernandez E, Sarwer DB, Miller SM. Perceived importance of weight loss and exercise among endometrial cancer survivors with overweight or obesity: Implications for lifestyle modification interventions. Obes Sci Pract 2023; 9:661-669. [PMID: 38090692 PMCID: PMC10712408 DOI: 10.1002/osp4.701] [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: 05/02/2022] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 02/01/2024] Open
Abstract
Objective Type 1 endometrial cancer (EC) survivors who are overweight or obese are at increased risk of comorbidities and reduced quality of life. Lifestyle modification interventions (e.g., healthy eating, exercise) may help these women reduce excess weight and improve their quality of life. However, existing interventions have shown limited success. Guided by Self-Determination Theory, the proposed study sought to identify factors associated with perceived importance of weight loss and exercise as well as interest in lifestyle modification interventions (components of extrinsic and intrinsic motivation) among EC survivors with overweight or obesity to inform future intervention development. Methods One hundred type 1 EC survivors [body mass index (BMI) ≥ 25 kg/m2] completed a cross-sectional survey assessing sociodemographics, medical factors, exercise, risk perceptions and provider communication, quality of life, barriers to dieting and exercise, perceived importance of healthy lifestyles, and desired intervention content. Results EC survivors who were aware obesity is a risk factor for EC were significantly more likely to perceive weight loss as important and were interested in weight loss programs and receiving information about exercise (ps < 0.05). Additionally, EC survivors who reported their provider discussed the importance of a healthy weight after their diagnosis were significantly more likely to perceive exercise as important and were interested in receiving dieting information. Conclusions EC survivors expressed interest in lifestyle modification interventions. Increasing awareness about the risk of obesity and provider discussions about healthy weight during routine appointments may motivate EC survivors to engage in lifestyle modification interventions.
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Affiliation(s)
- Erin K. Tagai
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Gina M. Mantia‐Smaldone
- Division of Gynecologic OncologyFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Andrew Belfiglio
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Christina S. Chu
- Division of Gynecologic OncologyFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Emmanuel Lapitan
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Heather Santos
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
- Department of Epidemiology and BiostatisticsDornsife School of Public HealthDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Enrique Hernandez
- Obstetrics, Gynecology, and Reproductive SciencesLewis Katz School of Medicine at Temple UniversityPhiladelphiaPennsylvaniaUSA
| | - David B. Sarwer
- College of Public HealthCenter for Obesity Research and EducationTemple UniversityPhiladelphiaPAUSA
| | - Suzanne M. Miller
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
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Zhu J, Niu H, Lu D, Li Y, Ding M. Research on the applicability of an exercise rehabilitation app aiming to improve the mental and physical health of breast cancer patients in the post-operative period. Front Psychol 2023; 14:1126284. [PMID: 37457078 PMCID: PMC10349282 DOI: 10.3389/fpsyg.2023.1126284] [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: 12/17/2022] [Accepted: 03/09/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Breast cancer is one of the most common malignant cancers in women, seriously endangering the physical and mental health of patients. In this study, we developed an app for breast cancer patients undergoing radiotherapy or chemotherapy with a focus on exercise interventions, supplemented by nutritional and psychological interventions, to verify the applicability of the app for these patients and its impact on their quality of life, sleep, and psychological state. We also investigated the patients' experience and perceptions of the app. Methods A total of 17 participants, aged 42-58 years, were recruited for this study using a mixed-methods design, including quantitative group pre-and post-test scores and qualitative interview results. The participants used the app for 8-18 weeks depending on their radiotherapy or chemotherapy cycle. During the radiotherapy or chemotherapy period, the participants used the "Yun Dong Ru Kang" exercise rehabilitation app to perform aerobic exercises twice a week, as well as rehabilitation exercises appropriate to their radiotherapy or chemotherapy stage, and used the app on their own the rest of the time. The primary results included their scores on the PSSUQ overall assessment usability questionnaire, the users' use of the app, and the results of the interviews; the secondary indicators were quality of life, sleep status, and anxiety and depression status. Results An overall score of 6.2 (out of 7 points) on the PSSUQ questionnaire indicates the high usability; the average use time per subject per week was 97.69 ± 11.82 min, which exceeds the minimum use time, but the average use time tended to decrease as the use time was postponed. Promoted articles on nutritional diets received the most hits. The results of the interviews were consistent with the questionnaire scores, with the majority of participants believing that the means of exercise should be enriched and the interface optimized, while the reduction in the length of use was related to the participants' own state of learning about calisthenics. In the results of the Breast Cancer-Specific Scale FACT-B, there was a significant increase (p < 0.05) in the Emotional Status dimension score and a significant decrease (p < 0.05) on the Additional Concerns dimension score. In the results of the Pittsburgh Sleep Quality Inventory PSQI, there was a non-significant improvement in all items except for a significant increase (p < 0.05) for the Hypnotic Medication item. In the Hospital Anxiety and Depression Scale (HADS), there was no significant improvement in any of the anxiety and depression factors. Conclusions The "Yun Dong Ru Kang "app has certain applicability, and the use of the exercise rehabilitation app may effectively reduce the negative impact of chemotherapy side effects on the quality of life, sleep and depression of breast cancer patients in the chemotherapy or radiotherapy phase. Before it is put into use in the future, the app should be enriched with exercise tools, the interface should be optimized, and articles on nutrition and diet should be promoted.
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Affiliation(s)
- Jiaxin Zhu
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Hu Niu
- Department of Breast and Thyroid Surgery, Jinan Central Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Dianjie Lu
- School of Information Science and Engineering, Shandong Normal University, Jinan, China
| | - Yuqi Li
- Jinan Zhensheng School, Jinan, China
| | - Meng Ding
- College of Physical Education, Shandong Normal University, Jinan, China
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Kim JS, Kim M, Seo Y. User evaluation of a mobile education application for the management of metabolic syndrome among cancer survivors. Eur J Oncol Nurs 2023; 63:102276. [PMID: 36898267 DOI: 10.1016/j.ejon.2023.102276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE This study aimed to develop a smartphone education application for managing metabolic syndrome among cancer survivors and obtain user evaluation based on quantitative and qualitative data. METHODS Ten cancer survivors and 10 oncology nurse specialists responded to a structured usability evaluation tool (Mobile Application Rating Scale: MARS). Quantitative data analysis was performed through descriptive statistics using SPSS version 25.0. We conducted semi-structured interviews of the cancer survivors and oncology nurse specialists. Qualitative data of interview responses were coded as the app's strengths and weaknesses, information, motivation, and behavioral change. RESULTS The overall usability evaluation score of the app was 3.66 ± 0.39 for cancer survivors and 3.79 ± 0.20 for oncology nurse specialists. Both cancer survivors and oncology nurse specialists scored the area of functionality as the highest and engagement as the lowest. Additionally, the qualitative usability evaluation suggested that the app should be visually improved by including figures and tables to enhance readability and providing videos and more specific guidelines to directly elicit behavioral change. CONCLUSIONS Metabolic syndrome in cancer survivors can be effectively managed by using the educational application developed in this study by improving the shortcomings of the app for cancer survivors.
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Affiliation(s)
- Ji-Su Kim
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, 06974, Seoul, Republic of Korea.
| | - Minhae Kim
- Department of Nursing, National Cancer Center, Gyeonggi-do, Republic of Korea.
| | - Yeji Seo
- Department of Nursing, Semyung University, 65 Semyeong-ro, Jecheon-si, Chungcheongbuk-do, Republic of Korea.
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Feasibility of Investigational Procedures and Efficacy of a Personalized Omega-3 Dietary Intervention in Alleviating Pain and Psychoneurological Symptoms in Breast Cancer Survivors. Pain Manag Nurs 2023; 24:78-88. [PMID: 35450801 DOI: 10.1016/j.pmn.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) are at risk for psychoneurological symptoms (PNS) and inflammation for years following cancer treatment. Fish, particularly salmon, provides a rich source of omega-3 long chain fatty acids (omega-3LC), which has an anti-inflammatory effect. However, the benefit of omega-3LC on PNS is not well-known. AIMS This study evaluated the feasibility and the initial efficacy of a personalized meal plan with dietary omega-3LC in reducing PNS. METHODS A prospective, randomized controlled trial design (n = 46) was used to evaluate the feasibility of a personalized meal plan using two omega-3LC dose levels (high and low omega-3LC) in reducing PNS including pain, depression, fatigue, sleep, and stress. RESULTS The recruitment rate was 4.9% with overall retention rate of 74% and 67.1% adherence to personalized meal plan and dietary procedures. Of participants who completed the investigation, 94% completed fish adherence logs and consumed ≥70% of the assigned quantity of fish. Saliva collection was 97.8% at baseline and 100% at follow-up. BCS in the high omega-3LC group had a significant decrease in pain (p < .01), perceived stress (p < .05), sleep (p < .001), depression (p < .001), and fatigue (p < .01) over the course of intervention. There were trends of PNS improvement in the low omega-3LC group but the differences did not reach statistical significance. CONCLUSION Our results support the feasibility of our investigational design, procedures, and intervention. The outcomes provide preliminary support for an expanded research effort using fish as a source of omega-3LC and personalized dietary planning as a vehicle for symptom self-management in BCS.
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König LM, Van Emmenis M, Nurmi J, Kassavou A, Sutton S. Characteristics of smartphone-based dietary assessment tools: a systematic review. Health Psychol Rev 2022; 16:526-550. [PMID: 34875978 DOI: 10.1080/17437199.2021.2016066] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.
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Affiliation(s)
- Laura M König
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.,Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Miranda Van Emmenis
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Johanna Nurmi
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aikaterini Kassavou
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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12
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Smits A, Galaal K, Winnan S, Lopes A, Bekkers RLM. Feasibility and Effectiveness of the Exercise Program in Endometrial Cancer; Feasibility and Acceptability Survivorship Trial (EPEC-FAST). Cancers (Basel) 2022; 14:cancers14225579. [PMID: 36428675 PMCID: PMC9688636 DOI: 10.3390/cancers14225579] [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: 10/12/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
To evaluate the feasibility of an individualized exercise program in the standard care for endometrial cancer patients aimed to improve quality of life and other health outcomes. This was a single-arm prospective intervention trial to assess the feasibility of an individualized exercise intervention in endometrial cancer patients after treatment. The exercise intervention consisted of weekly individualized training sessions, for 10 weeks, at a local gym facility. The program started six weeks post-operatively. Primary outcomes were feasibility aspects including number of eligible patients, recruitment and adherence rates. Secondary outcomes included quality of life outcomes and anthropometric measures. A total of 54 women were eligible for participation, of which 22 (41%) consented to the study. Overall attendance was 86%, and there were no adverse events. There was a significant improvement in quality of life outcomes, including role (p = 0.02), emotional (p = 0.02) and cognitive functioning (p = 0.04). In addition, there was a significant improvement in visceral fat percentage (p = 0.039) and physical fitness (six-minute walk test p < 0.001). The maximum weight loss achieved was 6.0 kg after 3 months and 8.4 kg after 6 months. An individualized one-to-one exercise intervention in endometrial cancer patients is feasible in terms of recruitment, adherence and safety.
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Affiliation(s)
- Anke Smits
- Gynecological Oncology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-24-309-79-58
| | - Khadra Galaal
- Gynecological Oncology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Seeb 999046, Oman
| | - Steve Winnan
- Royal Cornwall Hospital Trust, Penryn TR10 9FE, UK
| | - Alberto Lopes
- Gynecological Oncology, Royal Cornwall Hospital Trust, Truro TR1 3HD, UK
| | - Ruud L. M. Bekkers
- Gynecological Oncology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Gynecological Oncology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands
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13
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Mohammadzadeh Z, Eghtedar S, Ayatollahi H, Jebraeily M. Effectiveness of a self-management mobile app on the quality of life of women with breast cancer: a study in a developing country. BMC Womens Health 2022; 22:446. [PMID: 36368982 PMCID: PMC9652046 DOI: 10.1186/s12905-022-02020-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Self-management involves taking responsibility for personal health and taking the initiative to do so. This can be accomplished by learning information and skills that will help consider the difficulties may encounter during and after cancer treatment. With this perspective, we have aimed to develop a self-management mobile app for women with breast cancer in Iran and evaluate its impact on the quality of life of patients. Method This study is a methodological study in 2021. We developed the app during three phases. The first phase aimed at identifying educational content and designing user experience, the second phase aimed at developing and implementing the app, and the third phase aimed at evaluating pre-and post-implementation. Result In this study, an Android app for self-management women with breast cancer was developed. According to the results of the pre-and post-implementations among the most significant changes were in the quality of life level, highest respectively: social avoidance (Pre: 6.41–Post: 3.56), negative feelings (Pre: 5.93 - Post: 3.40), sexual function (Pre: 6.80 - Post: 5.04), sexual interest (Pre: 6.41 - Post: 4.75) and pain (Pre: 6.37 - Post: 4.97). And least the changes respectively: distress-family (Pre: 7 - Post: 7), distress-recurrence (Pre: 4.49 - Post: 4.38), benefits (Pre: 2.47 - Post: 3.12), appearance (Pre: 4.10 - Post: 3.32). Also, we calculated the usability evaluation of this app with the system usability scale (SUS); the overall rating score was 83/100, an excellent level (> 80.3), and a grade A. Conclusion The study shows that a breast cancer self-management app can support and improve the quality of life of women with breast cancer. We conducted this study to show that by developing a self-management app, women with breast cancer can improve their quality of life, − by increasing their self-management skills. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-02020-5.
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14
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McKenzie ND, Ahmad S. Impact of Lifestyle Interventions on Gynecologic Cancers: Beyond Diet and Exercise. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221123764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A Lifestyle Medicine approach to compliment cancer care is less commonly researched or implemented for women with gynecologic cancers as compared to better funded malignancies such as breast, prostate, and colorectal. Yet, several gynecologic malignancies are linked to obesity, estrogen/metabolic signaling pathways, and altered tumor microenvironment which could benefit greatly from a lifestyle medicine program. Lifestyle medicine, an evidenced-based branch of science, has expanded to the prevention and treatment of disorders caused by lifestyle factors (including cancer). Modifiable lifestyle factors such as obesity, lack of physical activity/nutrient density, microbial dysbiosis, sleep disturbance, and chronic stressors contribute greatly to cancer morbidity and mortality worldwide. This overarching area of research is evolving with some subtopics in their infancy requiring further investigation. Modern tools have allowed for better understanding of mechanisms by which adiposity and inactivity affect tumor promoting signaling pathways as well as the local tumor environment. Through the evolving use of these sophisticated techniques, novel prognostic biomarkers have emerged to explore efficacy of pharmacologic and lifestyle interventions in cancer. This state-of-the-art review article appraises recent evidence for a lifestyle medicine approach, beyond diet and exercise, to optimize survivorship and quality of life for patients with gynecologic cancers and introduces the 8-week web-based comprehensive HEAL-GYN program.
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Affiliation(s)
| | - Sarfraz Ahmad
- Gynecologic Oncology Program, AdventHealth Cancer Institute, Orlando, FL, USA
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15
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Rezaee R, Asadi S, Yazdani A, Rezvani A, Kazeroon AM. Development, usability and quality evaluation of the resilient mobile application for women with breast cancer. Health Sci Rep 2022; 5:e708. [PMID: 35782301 PMCID: PMC9234476 DOI: 10.1002/hsr2.708] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Mental health problems as a consequence of cancer lower the quality of life of cancer patients. Despite increasing studies of breast cancer‐focused mobile health applications (m‐Health apps), there is less research on breast cancer patients' quality of life or well‐being. The purpose of this study is to develop and evaluate the usability and quality of an educational m‐Health app aimed at improving the resilience of breast cancer in women. Methods This study was conducted in four phases. It included extracting the requirements of the app through the nominal group technique. Based on these results, an m‐Health app was developed and evaluated in terms of usability and quality by two scales, System Usability Scale and Mobile App Rating Scale questionnaires, respectively. Finally, the role of patients' age and educational backgrounds in the use of the app was assessed. The relationship between learnability and usability of the app was measured by the T‐Test. Results The app was developed with three user interfaces. Its usability developed from the patient's point of view scored a remarkable score of 83.20 with a 95% confidence interval. This value was too indicative of high satisfaction with the usefulness and the possibility of recommending it to other cancer survivors. The results of the quality evaluation from an expert's point of view showed that this app had good functionality. Evaluation of the role of demographic information in the use of the app showed that it can be used for all age groups with different levels of education. The app did not differ significantly between learnability and usability. Conclusion The development of m‐Health apps, based on usability principles that are suitable for all age groups with different levels of education, is welcomed by cancer patients.
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Affiliation(s)
- Rita Rezaee
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran
| | - Sima Asadi
- Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
| | - Azita Yazdani
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran
| | - Alireza Rezvani
- Department of Internal Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
| | - Arash Mani Kazeroon
- Department of Psychiatry, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
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16
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An-m-Health Intervention Using Smartphone App to Improve Physical Activity in College Students: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127228. [PMID: 35742477 PMCID: PMC9223541 DOI: 10.3390/ijerph19127228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
Abstract
Using m-Health apps can provide researchers and others with an effective way for improving physical activity (PA) and healthy lifestyle behaviors. The promotion of health should move from a model focused on the physical and biological basis of illness and towards a focus on the behavioral changes that support health. Therefore, the aims of the current study were to improve PA (step-counts) and body weight using a theory-based m-Health app. A 12-week randomized treatment trial was carried out at Texas A&M University, Texas, college station. College students (n = 130) were recruited. They were randomized in an equal ratio of 1:1 to intervention (m-Health app) (n = 65) and control (n = 65) conditions. The response rate was (87.6%). Both groups utilized a Smartphone app. The intervention group received PA goals of (10,000 steps/day), using an m-Health app. The control group was provided with information related to daily recommended PA levels. The primary change was daily step count between the baseline and follow-up. The secondary outcome was the body mass index (BMI). Descriptive statistics were used to summarize the baseline differences between the control and intervention groups. Independent sample t-test were used for comparison between the intervention and control groups. Post-intervention PAs were higher for the intervention group (mean = 54,896.) vs. control group (mean = 45,530.12; p < 0.05). The intervention group’s step-counts increased significantly (pre-mean = 40,320.38 steps per week; post-mean = 54,896.27 steps per week, p < 0.05). The body-weight changes were significant among the intervention group (p < 0.05). m-Health apps can increase PA and improve body weight, with goal setting and feedback as key intervention components. Future studies should personalize PA goals and feedback.
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17
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Briggs LG, Labban M, Alkhatib K, Nguyen DD, Cole AP, Trinh QD. Digital technologies in cancer care: a review from the clinician's perspective. J Comp Eff Res 2022; 11:533-544. [PMID: 35416050 DOI: 10.2217/cer-2021-0263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Physicians are increasingly utilizing digital health technologies (DHT) such as smartphone applications, network-enabled wearable devices, web-based communication platforms, videoconferencing, chatbots, artificial intelligence and virtual reality to improve access to, and quality of, care. DHT aid in cancer screening, patient education, shared decision-making, promotion of positive health habits, symptom monitoring and intervention, patient-provider communication, provision of psychological support and delivery of effective survivorship care. This narrative review outlines how physicians may utilize digital health to improve or augment their delivery of cancer care. For the full potential of DHT to be realized, experts must develop appropriate solutions to issues surrounding the regulation, liability, quality, security, equity and reimbursement of DHT.
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Affiliation(s)
- Logan G Briggs
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Muhieddine Labban
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Khalid Alkhatib
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - David-Dan Nguyen
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alexander P Cole
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Quoc-Dien Trinh
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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18
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Błajda J, Barnaś E, Kucab A. Application of Personalized Education in the Mobile Medical App for Breast Self-Examination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4482. [PMID: 35457349 PMCID: PMC9032731 DOI: 10.3390/ijerph19084482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 12/15/2022]
Abstract
Introduction. Mobile apps are considered intelligent tools useful in various areas of public health. The social dimension of breast cancer and the current epidemic situation require tools that may increase knowledge and improve the skills in the field of breast self-examination. The study aims to assess the use of personalized education based on algorithms with conditions in the mobile medical app for breast self-examination. Materials and methods. In total, 500 women from the Podkarpackie Province were enrolled in the study, which was a representative group for the inhabitants of this province. The subjects were randomly divided into two groups (group I: the study group including 250 people; group II: the controls of 250 people). The study group was subjected to intervention, which was personalized education on breast cancer. The method was a proprietary mobile medical app based on algorithms with conditions. The study was carried out from March 2018 to February 2019. Results. The majority of women, 77.8% (N = 389), were under 30 years of age. Only a small amount of the breast area was marked in the tactile test in both groups. In the study group, the average number of selected points was 14.86 (7.43% of the area to be examined), while in the control group it amounted to 9.14 (4.57%). The area most commonly examined in Test I in both groups was the central area of the mammary gland with the nipple. After the intervention in Test II, women from the study group marked a significantly greater area in the tactile test than women from the control group (χ2 = 99.733; df = 6; p < 0.0001). The mean result in the study group was 22.10, while in the control group it amounted to 9.10. It was found that the breast area marked in both tests depended solely on the women’s knowledge about breast cancer (p < 0.001). It was also found that the higher the risk of developing breast cancer, the more points in Test I were indicated by the women in the tactile test (p = 0.0122). Conclusions. Educational mobile medical apps for breast cancer prevention may help to deal with breast cancer, which is an important public health issue. It is also important to broaden the possibilities of medical apps for breast self-examination with elements verifying the skills of the three-stage compression of the examined breast.
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Affiliation(s)
- Joanna Błajda
- Institute of Health Sciences, Medical College of University of Rzeszów, Kopisto 2a, 35-959 Rzeszow, Poland; (E.B.); (A.K.)
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19
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Win H, Russell S, Wertheim BC, Maizes V, Crocker R, Brooks AJ, Mesa R, Huberty J, Geyer H, Eckert R, Larsen A, Gowin K. Mobile App Intervention on Reducing the Myeloproliferative Neoplasm Symptom Burden: Pilot Feasibility and Acceptability Study. JMIR Form Res 2022; 6:e33581. [PMID: 35357315 PMCID: PMC9015738 DOI: 10.2196/33581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Myeloproliferative neoplasms (MPNs) are a group of myeloid malignancies associated with significant symptom burden. Despite pharmacological advances in therapies, inadequate management of MPN symptoms results in reduced quality of life. Objective This study aims to determine the feasibility of a 12-week global wellness mobile app intervention in decreasing MPN symptom burden. The University of Arizona Andrew Weil Center for Integrative Medicine’s global wellness mobile app, My Wellness Coach (MWC), guides patients to improve their health and well-being through facilitating behavior changes. Methods Of the 30 patients enrolled in a 12-week intervention, 16 (53%) were retained through the final assessment. Feasibility was assessed by the ease of recruitment, participant adherence, and mobile app acceptability. App acceptability was measured using the user version of the Mobile Application Rating Scale. MPN symptom burden was measured at baseline and 12 weeks after the intervention. Results Recruitment was efficient, with the participant goal reached within a 60-day period, suggestive of a demand for such an intervention. Adherence was less than the target within study design (75%), although similar to mobile device app use in other studies (53%). The app was deemed acceptable based on the mean user version of the Mobile Application Rating Scale 3-star rating by participants. Finally, there were statistically significant improvements in several MPN symptoms, quality of life, and total score on the Myeloproliferative Neoplasm Symptom Assessment Form surveys. Conclusions Our 12-week intervention with the MWC app was feasible and was associated with a decrease in MPN symptom burden. Further investigation of the MWC app for use as a self-management strategy to reduce the symptom burden in patients with MPN is warranted.
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Affiliation(s)
- Hninyee Win
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Samantha Russell
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | | | - Victoria Maizes
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Robert Crocker
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Audrey J Brooks
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, AZ, United States
| | - Ruben Mesa
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Jennifer Huberty
- Department of Hematology, University of Arizona, Tucson, AZ, United States
| | - Holly Geyer
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Ryan Eckert
- Mays Cancer Center, University of Texas, San Antonio, TX, United States
| | - Ashley Larsen
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Krisstina Gowin
- Department of Hematology, University of Arizona, Tucson, AZ, United States
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20
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Williams V, Brown N, Moore JX, Farrell D, Perumean-Chaney S, Schleicher E, Fontaine K, Demark-Wahnefried W, Pekmezi D. Web-Based Lifestyle Interventions for Survivors of Cancer: Usability Study. JMIR Form Res 2022; 6:e30974. [PMID: 35188468 PMCID: PMC8902653 DOI: 10.2196/30974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/04/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Internet-based lifestyle programs are increasingly being used to deliver health behavior change interventions to survivors of cancer. However, little is known about website use in this population or its association with healthy lifestyle changes. OBJECTIVE The aim of this study is to describe lifestyle intervention website use (log-ins, time on website, and page views) among survivors of cancer and patterns of use by participant characteristics. In addition, associations were explored between website use and changes in healthy lifestyle knowledge and practice. METHODS A total of 35 survivors of cancer were recruited between August 2017 and 2018 to participate in a 2-week, single-arm pilot test of the SurvivorSHINE lifestyle intervention website. Knowledge and practices related to healthy diet and physical activity behaviors were measured at baseline and follow-up. Website use (eg, time spent on the website, frequency of log-ins, and page views) were collected from the SurvivorSHINE administrative site during the intervention period. Patterns of use were examined by participants' gender and race. Correlations between website use and changes in healthy lifestyle knowledge, physical activity, diet, and weight were explored. Mann-Whitney U tests were used to compare demographic factors on website use. RESULTS Participants logged into the SurvivorSHINE intervention website an average of 3.2 (SD 2) times over the 2-week period and spent a total average of 94 (SD 56) minutes viewing the website during the intervention. Examining website activity, 1905 page views were logged. The User Profile (344 page views) and Home sections (301 page views) were the most frequently visited components. No associations were observed between the frequency of log-ins or the total time on the website, improvements in knowledge related to healthy lifestyles, or changes in body weight or dietary intake. However, the total time on the website was positively correlated with improvements in accelerometer-measured physical activity (r=0.74; P=.02) and self-reported physical activity (r=0.35; P=.04). CONCLUSIONS Survivors of cancer demonstrated clear interest in a diet and exercise intervention website, as evidenced by their frequency of log-ins, page views on numerous features, and total viewing time. Moreover, increased website use was correlated with improvements in physical activity.
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Affiliation(s)
- Victoria Williams
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nashira Brown
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Justin Xavier Moore
- Department of Population Health Sciences, Augusta University, Augusta, GA, United States
| | | | - Suzanne Perumean-Chaney
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erica Schleicher
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Wendy Demark-Wahnefried
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
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21
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Developing a lifestyle intervention program for overweight or obese preconception, pregnant and postpartum women using qualitative methods. Sci Rep 2022; 12:2511. [PMID: 35169236 PMCID: PMC8847557 DOI: 10.1038/s41598-022-06564-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/02/2022] [Indexed: 11/18/2022] Open
Abstract
The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. Barrier factors include time constraints, poor baseline knowledge, family culture, food accessibility, and lack of relevant data sources. Enabling factors were motivation to be healthy for themselves and their offspring, family and social support, a holistic delivery platform providing desired information delivered at appropriate times, regular feedback, goal setting, and nudges. From the findings of this study, we propose components of an idealized lifestyle intervention including (i) taking a holistic life-course approach to education, (ii) using mobile health platforms to reduce barriers, provide personalized feedback and promote goal-setting, and (iii) health nudges to cultivate sustained lifestyle habits.
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22
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Edbrooke L, Khaw P, Freimund A, Carpenter D, McNally O, Joubert L, Loeliger J, Traill A, Gough K, Mileshkin L, Denehy L. ENhAncing Lifestyle Behaviors in EndometriaL CancEr (ENABLE): A Pilot Randomized Controlled Trial. Integr Cancer Ther 2022; 21:15347354211069885. [PMID: 35045735 PMCID: PMC8785429 DOI: 10.1177/15347354211069885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Endometrial cancer is associated with the highest comorbid disease burden of any cancer. The aim of this trial was to assess the feasibility and safety of an allied health intervention during adjuvant treatment. METHODS A mixed-methods pilot randomized (2:1) controlled trial with concealed allocation and assessor-blinding. Eligibility criteria: adjuvant endometrial cancer treatment scheduled, disease stage I-IIIC1, ECOG 0-2 and able to perform unsupervised physical activity (PA). Participants received usual care and 8 sessions of weekly, individualized, lifestyle education (diet and PA) with behavior change and social support (intervention group), delivered predominantly by telehealth, or usual care alone. Feasibility outcomes: recruitment and consent rates, decline reasons, program acceptability, intervention adherence and retention. RESULTS 22/44 eligible patients (50%, 95%CI: 36%, 64%) were recruited over 10 months (14 intervention, 8 usual care). The recruitment rate was 2.2 patients/month (95%CI: 1.4, 3.3). Patients who declined had too much going on (7/22, 32%) or were not interested (6/22, 27%). Mean (SD) age and BMI were 63.2 years (6.8) and 31.9 kg/m2 (6.7). A majority were FIGO stage I (15/22, 68%) and received vaginal brachytherapy (14/22, 64%). Adherence was high, 11/14 (79%, 95%CI: 52%, 92%) participants attended >70% of scheduled sessions. Retention was 100% (95%CI: 85%, 100%) at 9 weeks, however completion of objective measures was impacted by COVID-19 restrictions. Telehealth and online questionnaires enabled participation. No serious adverse events occurred. CONCLUSION The intervention was acceptable to participants with high levels of adherence and retention. Trial findings will be used to design a future RCT. TRIAL REGISTRATION The trial was registered on www.anzctr.org.au (ACTRN12619000631101) 29/04/2019.
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Affiliation(s)
- Lara Edbrooke
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Pearly Khaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Alison Freimund
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Orla McNally
- The University of Melbourne, Parkville, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - Lynette Joubert
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Anya Traill
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Denehy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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Bell M, Reed V, Wernisch J, Papini NM, Herrmann SD. Effectiveness of profile by Sanford behavioral weight loss program for weight loss following endometrial cancer treatment. Gynecol Oncol Rep 2021; 38:100897. [PMID: 34926775 PMCID: PMC8648818 DOI: 10.1016/j.gore.2021.100897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
Patients lost greater body weight (15.3%) over 12 months with a behavioral weight management program vs. standard care (2.3%). Health coach utilization was high with patients averaging 28.3 health coaching appointments over 12 months. This behavioral weight management program should be evaluated for reducing risk of endometrial cancer recurrence.
Objective To examine differences in weight change and Body Mass Index (BMI) at 12 months among women in remission from endometrial cancer who enrolled in a behavioral weight loss (BWL) program and a matched patient control group. Methods Women (n = 22) were enrolled into the BWL program and were compared against a control group (n = 28) that accounted for age, BMI, cancer type, cancer stage, and treatment dates. The BWL program included weekly health coaching meetings that targeted nutrition, activity, and behavior change topics. Results Women enrolled in the BWL program completed 28.3 ± 14.1 appointments over 12 months resulting in an average weight change of −14.2 ± 7.8 kg (−13.3 ± 7.4%) at 6 months and −16.4 ± 12.5 kg (−15.3 ± 11.4%) at 12 months (all p < 0.001). Women in the control group had a weight change of −1.7 ± 8.4 kg (−2.3 ± 7.6%) at 12 months which was significantly different than the BWL condition (p < 0.001). BMI was significantly reduced in the BWL group at 6 months (−4.8 ± 4.5, p < 0.001) and 12 months (−5.2 ± 5.9, p < 0.001) and significantly different than in the control group at 12 months (−0.9 ± 3.2, p = 0.007). Conclusions The BWL program yielded clinically significant weight loss for endometrial cancer survivors. Future work should include longer follow up periods and include additional behavioral and psychosocial outcomes.
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Affiliation(s)
- Maria Bell
- Sanford Health, Sioux Falls, SD, United States
| | - Valerie Reed
- Sanford Research, Sioux Falls, SD, United States
| | | | | | - Stephen D. Herrmann
- Sanford Research, Sioux Falls, SD, United States
- Profile by Sanford, Sioux Falls, SD, United States
- Corresponding author at: Sanford Research, Sioux Falls, SD, United States.
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24
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Bouabida K, Malas K, Talbot A, Desrosiers MÈ, Lavoie F, Lebouché B, Taguemout M, Rafie E, Lessard D, Pomey MP. Remote Patient Monitoring Program for COVID-19 Patients Following Hospital Discharge: A Cross-Sectional Study. Front Digit Health 2021; 3:721044. [PMID: 34859244 PMCID: PMC8630581 DOI: 10.3389/fdgth.2021.721044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions. Objective: The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective. The first platform is focused on telecare phone calls (Telecare-Covid), and the second is a telemonitoring app (CareSimple-Covid). Methods: We performed a cross-sectional study. The data were collected through a phone survey from May to August 2020. Data were analyzed using descriptive statistics and t-test analysis. Participants' responses and comments on open-ended questions were analyzed using content analysis to identify certain issues and challenges and potential avenues for improving the platforms. Results: Fifty one patients participated in the study. Eighteen participants used the CareSimple-Covid platform and 33 participants used the Telecare-Covid platform. Overall, the satisfaction rate for quality and safety of care for the two platforms was 80%. Over 88% of the users on each platform considered the platforms' services to be engaging, useful, user-friendly, and appropriate to their needs. The survey identified a few significant differences in users' perceptions of each platform: empathy toward users and the quality and safety of the care received were rated significantly higher on the CareSimple-Covid platform than on the Telecare-Covid platform. Users appreciated four aspects of these telehealth approaches: (1) the ease of access to services and the availability of care team members; (2) the user-friendliness of the platforms; (3) the continuity of care provided, and (4) the wide range of services delivered. Users identified some technical limitations and raised certain issues, such as the importance of maintaining human contact, data security, and confidentiality. Improvement suggestions include promoting access to connected devices; enhancing communications between institutions, healthcare users, and the public on confidentiality and personal data protection standards; and integrating a participatory approach to telehealth platform development and deployment efforts. Conclusion: This study provides preliminary evidence that the two remote monitoring platforms are well-received by users, with very few significant differences between them concerning users' experiences and views. This type of program could be considered for use in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be addressed with a patient-centered approach.
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Affiliation(s)
- Khayreddine Bouabida
- University of Montreal Hospital Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Montreal, QC, Canada.,École de Santé publique, Département de Gestion, Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Excutive Office, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, QC, Canada.,Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada
| | - Annie Talbot
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Marie-Ève Desrosiers
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Frédéric Lavoie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Bertrand Lebouché
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Melissa Taguemout
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - Edmond Rafie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada.,Center of Excellence of Patient Partnership and the Public, Montreal, QC, Canada.,Department of Health Management, Evaluation, and Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada
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25
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Cruz C, Prado CM, Punja S, Tandon P. Use of digital technologies in the nutritional management of catabolism-prone chronic diseases: A rapid review. Clin Nutr ESPEN 2021; 46:152-166. [PMID: 34857190 DOI: 10.1016/j.clnesp.2021.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/12/2021] [Accepted: 10/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Diet and nutrition applications (apps) have become more readily accessible as smartphone ownership increases. These apps have the potential to improve nutritional outcomes, but it remains unclear whether they are effective in patients with catabolism-prone conditions and specialized nutritional needs. AIMS The primary aim of this rapid review was to determine if delivery of a nutrition intervention via an app was more effective than standard care in improving nutritional outcomes in patients with a selected set of catabolism-prone chronic diseases. Secondary aims included summarizing intervention components and reviewing adherence and acceptance. METHODS The research question was developed using the Population, Intervention, Comparison, Outcomes (PICO) framework. Comprehensive literature searches were conducted across three databases. Screening, study selection, extraction, and risk of bias (RoB) assessment were conducted for the included randomized controlled trials (RCTs). RESULTS 15 articles were included, including 5 RCTs; 3/5 RCTs were judged to be at high RoB. The study aims, measured outcomes, and intervention components were diverse. Adherence and acceptance to the app interventions were encouraging. CONCLUSIONS Due to the heterogeneity of study design, nutrition interventions, outcomes, and reporting across studies, we were unable to aggregate data regarding the impact on nutritional outcomes. Reassuringly though, the available evidence suggests high adherence and acceptance, which needs to be interpreted in light of the associated personnel support provided within each study. The use of digital technology to deliver diet and nutrition interventions in catabolism-prone conditions is feasible, easy to adhere to, and well-accepted by participants.
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Affiliation(s)
| | - Carla M Prado
- University of Alberta, Department of Agricultural, Food and Nutritional Science - Division of Human Nutrition, Canada
| | - Salima Punja
- University of Alberta, Department of Pediatrics, Canada
| | - Puneeta Tandon
- University of Alberta, Department of Medicine - Division of Gastroenterology (Liver Unit), Canada.
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26
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Seo SJ, Nho JH, Park Y. The development of a lifestyle modification mobile application, “Health for You” for overweight and obese breast cancer survivors in Korea. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:243-255. [PMID: 36311982 PMCID: PMC9328594 DOI: 10.4069/kjwhn.2021.09.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study aimed to develop a lifestyle modification (LSM) mobile application based on the Android operating system for overweight and obese breast cancer survivors (BCS) in Korea and evaluate its usability. Methods The content analysis, design, development, implementation, and evaluation of the LSM intervention mobile application for overweight and obese BCS was conducted by identifying survivors’ needs, searching the literature, and reviewing existing mobile applications. The survey was conducted from June 1 to December 28, 2020 at Jeonju city, Korea. Results The mobile application for BCS included dietary and exercise information, weight logs, as well as distress and daily achievement check. It also included information and videos on the prevention of breast cancer recurrence and used a communication bulletin board. Expert and user usability evaluation of its content and functions confirmed that it was appropriate and satisfactory for overweight and obese BCS. Conclusion This LSM mobile application developed for overweight and obese BCS was found to be appropriate for use. It can be applied for further study of effectiveness on improving their health and maintaining a healthy lifestyle, to ultimately improve quality of life.
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Affiliation(s)
- Su-Jin Seo
- Department of Nursing, Kunjang University College, Gunsan, Korea
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
- Corresponding author: Ju-Hee Nho College of Nursing, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Korea Tel: +82-63-270-3108 E-mail:
| | - Youngsam Park
- Department of General Surgery, Presbyterian Medical Center, Jeonju, Korea
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27
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Ester M, Eisele M, Wurz A, McDonough MH, McNeely M, Culos-Reed SN. Current Evidence and Directions for Future Research in eHealth Physical Activity Interventions for Adults Affected by Cancer: Systematic Review. JMIR Cancer 2021; 7:e28852. [PMID: 34542415 PMCID: PMC8491123 DOI: 10.2196/28852] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/29/2021] [Accepted: 07/26/2021] [Indexed: 12/13/2022] Open
Abstract
Background Physical activity (PA) interventions can increase PA and improve well-being among adults affected by cancer; however, most adults do not meet cancer-specific PA recommendations. Lack of time, facility access, and travel distances are barriers to participation in PA interventions. eHealth technologies may address some of these barriers, serving as a viable way to promote PA behavior change in this population. However, no review from July 2018 has synthesized available evidence across eHealth and cancer types or examined the use of behavioral theory and behavior change techniques (BCTs), leaving important gaps in knowledge. Objective This review aims to provide a comprehensive, updated overview of evidence on eHealth PA interventions for adults with cancer by describing the current state of the literature, exploring associations between intervention characteristics and effectiveness, and identifying future research needs. Methods MEDLINE, Embase, CINAHL, SportDiscus, Scopus, and CENTRAL were searched for eHealth PA interventions for adults affected by cancer. Study selection and data extraction were performed in duplicate, with consultation from the senior author (NCR). BCT coding, risk of bias, and completeness of reporting were performed using standardized tools. Results were summarized via narrative synthesis and harvest plots. Weight analyses were conducted to explore the associations between intervention characteristics and effectiveness. Results A total of 71 articles (67 studies) involving 6655 participants (mean age 56.7 years, SD 8.2) were included. Nearly 50% (32/67) of the articles were published after July 2018. Significant postintervention PA increases were noted in 52% (35/67) of the studies, and PA maintenance was noted in 41% (5/12) of the studies that included a follow-up. Study duration, primary objectives, and eHealth modality (eg, websites, activity trackers, and SMS text messaging) varied widely. Social cognitive theory (23/67, 34%) was the most used theory. The mean number of BCTs used across the studies was 13.5 (SD 5.5), with self-monitoring, credible sources, and goal setting being used in >90% of studies. Weight analyses showed the greatest associations between increased PA levels and PA as a primary outcome (0.621), interventions using websites (0.656) or mobile apps (0.563), interventions integrating multiple behavioral theories (0.750), and interventions using BCTs of problem solving (0.657) and action planning (0.645). All studies had concerns with high risk of bias, mostly because of the risk of confounding, measurement bias, and incomplete reporting. Conclusions A range of eHealth PA interventions may increase PA levels among adults affected by cancer, and specific components (eg, websites, use of theory, and action planning) may be linked to greater effectiveness. However, more work is needed to ascertain and optimize effectiveness, measure long-term effects, and address concerns with bias and incomplete reporting. This evidence is required to support arguments for integrating eHealth within PA promotion in oncology.
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Affiliation(s)
- Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Margaret McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.,Department of Oncology, University of Alberta, Edmonton, AB, Canada.,Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care - Alberta Health Services, Calgary, AB, Canada
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28
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Comparing Outcomes of a Digital Commercial Weight Loss Program in Adult Cancer Survivors and Matched Controls with Overweight or Obesity: Retrospective Analysis. Nutrients 2021; 13:nu13092908. [PMID: 34578787 PMCID: PMC8470305 DOI: 10.3390/nu13092908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Maintaining a healthy weight is beneficial for cancer survivors. However, weight loss program effectiveness studies have primarily been in highly controlled settings. This is a retrospective study exploring real-world outcomes (weight loss and program engagement) after use of a digital commercial weight loss program (Noom) in cancer survivors and matched controls. All participants had voluntarily self-enrolled in Noom. Weight and engagement data were extracted from the program. Cancer-related quality of life was secondarily assessed in a one-time cross-sectional survey for survivors. Controls were a sample of Noom users with overweight/obesity who had no history of cancer but 0–1 chronic conditions. Primary outcomes were weight change at 16 weeks and program engagement over 16 weeks. Engagement included frequency of weight, food, and physical activity logging, as well as number of coach messages. Multiple regression controlling for baseline age, gender, engagement, and BMI showed that survivors lost less weight than controls (B = −2.40, s.e. = 0.97, p = 0.01). Survivors also weighed in less (survivors: 5.4 [2.3]; controls: 5.7 [2.1], p = 0.01) and exercised less (survivors: 1.8 [3.2]; controls: 3.2 [4.1], p < 0.001) than controls. However, survivors sent more coach messages (survivors: 2.1 [2.4]; controls: 1.7 [2.0], p < 0.001). Despite controls losing more weight than cancer survivors (−7.0 kg vs. −5.3 kg), survivors lost significant weight in 4 months (M = −6.2%). Cancer survivors can have success on digital commercial programs available outside of a clinical trial. However, they may require additional support to engage in weight management behaviors.
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29
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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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30
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Bruce JM, Cozart JS, Shook RP, Ruppen S, Siengsukon C, Simon S, Befort C, Lynch S, Mahmoud R, Drees B, Norouzinia AN, Bradish T, Posson P, Hibbing PR, Bruce AS. Modifying Diet and Exercise in MS (MoDEMS): Study design and protocol for a telehealth weight loss intervention for adults with obesity & Multiple Sclerosis. Contemp Clin Trials 2021; 107:106495. [PMID: 34216814 DOI: 10.1016/j.cct.2021.106495] [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: 05/11/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
Weight loss improves overall health, and reduces inflammation, risk of stroke, heart attack, diabetes, certain cancers, and death among individuals with obesity. Weight loss also improves mobility, increases stamina, and elevates mood. Between 25 and 33% of people with Multiple Sclerosis (pwMS) have obesity. Multiple Sclerosis (MS) and obesity are independently associated with reduced mobility, increased fatigue, and depression. Most behavioral weight loss trials exclude individuals with neurologic disease. Consequently, few studies have examined the effects of weight loss on symptom presentation and health outcomes among pwMS and obesity. This is the first study examining the efficacy of a comprehensive behavioral weight loss intervention designed specifically for pwMS. The purpose of this study is to develop and assess the efficacy of a telehealth administered weight loss intervention tailored for pwMS. Additionally, we aim to determine if weight loss reduces physical and emotional symptoms in individuals with obesity and MS. We will enroll 70 pwMS in a wait-list crossover trial to examine the efficacy of our intervention. If successful, findings will help determine whether we can help participants lose clinically significant weight - and whether weight loss among pwMS and overweight/obesity reduces fatigue, and improves mobility, mood, and quality of life.
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Affiliation(s)
- Jared M Bruce
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Julia S Cozart
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Robin P Shook
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Stephanie Ruppen
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Catherine Siengsukon
- Department of Physical Therapy and Rehab Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Steve Simon
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Christie Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rola Mahmoud
- Department of Neurology, Saint Luke's Hospital, Kansas City, MO, USA
| | - Betty Drees
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | | | - Taylor Bradish
- Department of Biomedical and Health Informatics, University of Missouri- Kansas City School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Paige Posson
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Paul R Hibbing
- Center for Healthy Lifestyle and Nutrition, Children's Mercy Hospitals, Kansas City, MO, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
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Collins A, Taylor A, Guttery DS, Moss EL. Innovative Follow-up Strategies for Endometrial Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e383-e392. [PMID: 34172343 DOI: 10.1016/j.clon.2021.06.001] [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: 02/02/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 01/22/2023]
Abstract
Increasing recognition of the heterogeneous nature of endometrial cancer, the excellent prognosis of low-risk cases and improvements in risk stratification offer opportunities for innovative, personalised follow-up strategies. This review article outlines the evidence base for alternative follow-up strategies in the different risk categories of endometrial cancer, cancer survivorship programmes and considers future directions in endometrial cancer follow-up, including emerging new techniques, such as the liquid biopsy, and opportunities for combining molecular and clinicopathological features to personalise endometrial cancer follow-up.
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Affiliation(s)
- A Collins
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - A Taylor
- Royal Marsden NHS Foundation Trust, London, UK
| | - D S Guttery
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - E L Moss
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
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32
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Kelley MM, Kue J, Brophy L, Peabody AL, Foraker RE, Yen PY, Tucker S. Mobile Health Applications, Cancer Survivors, and Lifestyle Modification: An Integrative Review. Comput Inform Nurs 2021; 39:755-763. [PMID: 34074873 PMCID: PMC8578050 DOI: 10.1097/cin.0000000000000781] [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] [Indexed: 11/25/2022]
Abstract
Cancer survivors' well-being is threatened by the risk of cancer recurrence and the increased risk of chronic diseases resulting from cancer treatments. Improving lifestyle behaviors attenuates these risks. Traditional approaches to lifestyle modification (ie, counseling) are expensive, require significant human resources, and are difficult to scale. Mobile health interventions offer a novel alternative to traditional approaches. However, to date, systematic reviews have yet to examine the use of mobile health interventions for lifestyle behavior improvement among cancer survivors. The objectives of this integrative review were to synthesize research findings, critically appraise the scientific literature, examine the use of theory in intervention design, and identify survivors' preferences in using mobile health interventions for lifestyle improvement. Nineteen articles met eligibility requirements. Only two studies used quantitative methods. Study quality was low, and only one study reported the use of theory in app design. Unfortunately, the evidence has not yet sufficiently matured, in quality or in rigor, to make recommendations on how to improve health behaviors or outcomes. However, six themes emerged as important considerations for intervention development for cancer survivors (app features/functionality, social relationships/support, provider relationships/support, app content, app acceptability, and barriers to use). These findings underscored the need for rigorous, efficacy studies before the use of mobile health interventions can be safely recommended for cancer survivors.
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Affiliation(s)
- Marjorie M Kelley
- Author Affiliations: College of Nursing, The Ohio State University (Drs Kelley, Kue, and Tucker); James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center (Brophy); and EngageHealth, Inc (Peabody), Columbus, OH; and Institute for Informatics, Washington University School of Medicine (Drs Foraker and Yen); Department of Internal Medicine, Washington University (Dr Foraker); Department of Medicine, Washington University School of Medicine (Dr Yen); and Goldfarb School of Nursing, Barnes-Jewish College, BJC HealthCare (Dr Yen), St Louis, MO
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33
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Khoo S, Mohbin N, Ansari P, Al-Kitani M, Müller AM. mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115798. [PMID: 34071342 PMCID: PMC8198944 DOI: 10.3390/ijerph18115798] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 12/25/2022]
Abstract
This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.
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Affiliation(s)
- Selina Khoo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (S.K.); (A.M.M.)
| | - Najihah Mohbin
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Payam Ansari
- DCU Business School, Dublin City University, Dublin, Ireland;
| | - Mahfoodha Al-Kitani
- Physical Education and Sports Sciences Department, College of Education, Sultan Qaboos University, Muscat 123, Oman;
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Correspondence: (S.K.); (A.M.M.)
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Robert C, Erdt M, Lee J, Cao Y, Naharudin NB, Theng YL. Effectiveness of eHealth Nutritional Interventions for Middle-Aged and Older Adults: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e15649. [PMID: 33999005 PMCID: PMC8167617 DOI: 10.2196/15649] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/28/2020] [Accepted: 04/12/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The risk of development of chronic diseases related to poor nutrition increases with age. In the face of an aging population, it is important for health care sectors to find solutions in delivering health services efficiently and effectively to middle-aged and older adults. OBJECTIVE The aim of this systematic review and meta-analysis was to consolidate the literature that reported the effectiveness of eHealth apps in delivering nutritional interventions for middle-aged and older adults. METHODS A literature search from five databases (PubMed, CINAHL, Cochrane, Web of Science, and Global Health) from the past 5 years was performed. Studies were selected for inclusion that used eHealth to deliver nutritional interventions to adults aged 40 years and above, and reported health and behavioral outcomes. Two independent reviewers searched for research articles and assessed the eligibility of studies to be included in the review. A third reviewer resolved disagreements on study inclusion. We also assessed the quality of the included studies using the CONSORT 2010 checklist. RESULTS A total of 70 studies were included for analysis. The study quality ranged from 44% to 85%. The most commonly used eHealth intervention type was mobile apps (22/70, 31%). The majority of studies (62/70, 89%) provided multicomponent health interventions, which aimed to improve nutrition and other health behaviors (eg, exercise, smoking cessation, medication adherence). Meta-analysis results indicated high and significant heterogeneity; hence, conclusions based on these results should be considered with caution. Nonetheless, the results generally showed that eHealth interventions improved anthropometric and clinical outcomes, but not behavioral outcomes such as fruit and vegetable consumption. CONCLUSIONS The use of eHealth apps to deliver health interventions has been increasing in recent years, and these apps have the potential to deliver health services to a larger group of people. Our findings showed that the effectiveness of eHealth apps to deliver health interventions for middle-aged to older adults was supported by the improvement of anthropometric and clinical outcomes. Future work could aim to develop research frameworks in administering eHealth interventions to address heterogeneity in this field of research.
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Affiliation(s)
- Caroline Robert
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - Mojisola Erdt
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
- Institute for Infocomm Research, A*STAR, Singapore, Singapore
| | - James Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Yuanyuan Cao
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Nurhazimah Binte Naharudin
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore, Singapore
| | - Yin-Leng Theng
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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Lim JY, Kim JK, Kim Y, Ahn SY, Yu J, Hwang JH. A Modular Mobile Health App for Personalized Rehabilitation Throughout the Breast Cancer Care Continuum: Development Study. JMIR Form Res 2021; 5:e23304. [PMID: 33847589 PMCID: PMC8080147 DOI: 10.2196/23304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/04/2020] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background Although many mobile health (mHealth) apps have evolved as support tools for self-management of breast cancer, limited studies have developed a comprehensive app and described the algorithms for personalized rehabilitation throughout the breast cancer care continuum. Objective This study aimed to develop a comprehensive mobile app and to describe an algorithm that adjusts personalized content to facilitate self-management throughout the breast cancer care continuum. Methods The development process of the modular mHealth app included the following 4 steps: (1) organizing expert teams, (2) defining evidence-based fundamental content and modules, (3) classifying user information for algorithms to personalize the content, and (4) creating the app platform and connectivity to digital health care devices. Results We developed a modular mHealth app service, which took 18 months, including a review of related literature and guidelines and the development of the app and connectivity to digital health care devices. A total of 11 functionalities were defined in the app with weekly analysis. The user information classification was formulated for personalized rehabilitation according to 5 key criteria: general user information, breast operation type, lymph node surgery type, chemotherapy and hormonal therapy use, and change in treatment after surgery. The main modules for personalized content included a self-monitoring screen, personalized health information, personalized exercise, and diet management. Conclusions The strength of this study was the development of a comprehensive mHealth app and algorithms to adjust content based on user medical information for personalized rehabilitation during the breast cancer care continuum.
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Affiliation(s)
- Ji Young Lim
- Department of Physical Therapy, General Graduate School of Medical Sciences, Konyang University, Daejeon, Republic of Korea
| | | | - Yoon Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - So-Yeon Ahn
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Janda M, Robledo KP, Gebski V, Armes JE, Alizart M, Cummings M, Chen C, Leung Y, Sykes P, McNally O, Oehler MK, Walker G, Garrett A, Tang A, Land R, Nicklin JL, Chetty N, Perrin LC, Hoet G, Sowden K, Eva L, Tristram A, Obermair A. Complete pathological response following levonorgestrel intrauterine device in clinically stage 1 endometrial adenocarcinoma: Results of a randomized clinical trial. Gynecol Oncol 2021; 161:143-151. [PMID: 33762086 DOI: 10.1016/j.ygyno.2021.01.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/24/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE Intrauterine levonorgestrel (LNG-IUD) is used to treat patients with endometrial adenocarcinoma (EAC) and endometrial hyperplasia with atypia (EHA) but limited evidence is available on its effectiveness. The study determined the extent to which LNG-IUD with or without metformin (M) or weight loss (WL) achieves a pathological complete response (pCR) in patients with EAC or EHA. PATIENTS AND METHODS This phase II randomized controlled clinical trial enrolled patients with histologically confirmed, clinically stage 1 FIGO grade 1 EAC or EHA; a body mass index > 30 kg/m2; a depth of myometrial invasion of less than 50% on MRI; a serum CA125 ≤ 30 U/mL. All patients received LNG-IUD and were randomized to observation (OBS), M (500 mg orally twice daily), or WL (pooled analysis). The primary outcome measure was the proportion of patients developing a pCR (defined as absence of any evidence of EAC or EHA) after 6 months. RESULTS From December 2012 to October 2019, 165 patients were enrolled and 154 completed the 6-months follow up. Women had a mean age of 53 years, and a mean BMI of 48 kg/m2. Ninety-six patients were diagnosed with EAC (58%) and 69 patients with EHA (42%). Thirty-five participants were randomized to OBS, 36 to WL and 47 to M (10 patients were withdrawn). After 6 months the rate of pCR was 61% (95% CI 42% to 77%) for OBS, 67% (95% CI 48% to 82%) for WL and 57% (95% CI 41% to 72%) for M. Across the three treatment groups, the pCR was 82% and 43% for EHA and EAC, respectively. CONCLUSION Complete response rates at 6 months were encouraging for patients with EAC and EHA across the three groups. TRIAL REGISTRATION U.S. National Library of Medicine, NCT01686126.
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Affiliation(s)
- Monika Janda
- Centre for Health Services Research, The University of Queensland, QLD, Australia
| | - Kristy P Robledo
- University of Sydney NHMRC Clinical Trials Centre, Sydney, NSW, Australia
| | - Val Gebski
- University of Sydney NHMRC Clinical Trials Centre, Sydney, NSW, Australia
| | - Jane E Armes
- Sunshine Coast University Hospital Laboratory, Birtinya, QLD, Australia
| | | | - Margaret Cummings
- University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia; Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, Brisbane, Australia
| | - Yee Leung
- Division of Obstetrics and Gynaecology, The University of Western Australia, WA, Australia
| | - Peter Sykes
- Christchurch Women's Hospital, Canterbury District Health Board, Christchurch, New Zealand; University of Otago, Christchurch, New Zealand
| | - Orla McNally
- Department of Oncology and Dysplasia, Royal Women's Hospital, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Andrea Garrett
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Amy Tang
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Russell Land
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - James L Nicklin
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Naven Chetty
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Mater Health Services, Brisbane, Australia
| | - Lewis C Perrin
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Mater Health Services, Brisbane, Australia
| | - Greet Hoet
- The Townsville Hospital, Townsville, QLD, Australia
| | | | - Lois Eva
- National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | | | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
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Martin E, Di Meglio A, Charles C, Ferreira A, Gbenou A, Blond M, Fagnou B, Arvis J, Pistilli B, Saghatchian M, Vaz Luis I. Use of mHealth to Increase Physical Activity Among Breast Cancer Survivors With Fatigue: Qualitative Exploration. JMIR Cancer 2021; 7:e23927. [PMID: 33749606 PMCID: PMC8088868 DOI: 10.2196/23927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/29/2021] [Accepted: 02/20/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physical activity has shown beneficial effects in the treatment of breast cancer fatigue; nevertheless, a significant portion of patients remain insufficiently physically active after breast cancer. Currently most patients have a smartphone, and therefore mobile health (mHealth) holds the promise of promoting health behavior uptake for many of them. OBJECTIVE In this study, we explored representations, levers, and barriers to physical activity and mHealth interventions among inactive breast cancer patients with fatigue. METHODS This was an exploratory, qualitative study including breast cancer patients from a French cancer center. A total of 4 focus groups were conducted with 9 patients; 2 independent groups of patients (groups A and B) were interviewed at 2 consecutive times (sessions 1 to 4), before and after their participation in a 2-week mHealth group experience consisting of (1) a competitive virtual exercise group activity (a fictitious world tour), (2) participation in a daily chat network, and (3) access to physical activity information and world tour classification feedback. We used a thematic content analysis. RESULTS Several physical activity levers emerged including (1) physical factors such as perception of physical benefit and previous practice, (2) psychological factors such as motivation increased by provider recommendations, (3) social factors such as group practice, and (4) organizational factors including preplanning physical activity sessions. The main barriers to physical activity identified included late effects of cancer treatment, lack of motivation, and lack of time. The lack of familiarity with connected devices was perceived as the main barrier to the use of mHealth as a means to promote physical activity. The tested mHealth group challenge was associated with several positive representations including well-being and good habit promotion and being a motivational catalyzer. Following feedback, modifications were implemented into the mHealth challenge. CONCLUSIONS mHealth-based, easily accessed group challenges were perceived as levers for the practice of physical activity in this population. mHealth-based group challenges should be explored as options to promote physical activity in a population with fatigue after breast cancer.
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Allicock M, Kendzor D, Sedory A, Gabriel KP, Swartz MD, Thomas P, Yudkin JS, Rivers A. A Pilot and Feasibility Mobile Health Intervention to Support Healthy Behaviors in African American Breast Cancer Survivors. J Racial Ethn Health Disparities 2021; 8:157-165. [PMID: 32385847 DOI: 10.1007/s40615-020-00767-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
African American breast cancer (AA BC) survivors are more likely to have cancer-related comorbidities compared with other women, ultimately putting them at higher risk for overall mortality and breast cancer-specific mortality. Survivorship care guidelines emphasize the importance of attention to obesity, weight management, and physical activity. Mobile technologies have been effective for improving health behaviors among cancer survivors, though few studies have focused on AA BC survivors. Creating Healthy Actions through Technology (CHAT) was a 4-week pilot intervention that employed an ecological momentary assessment (EMA) to improve survivors' physical activity and diet behaviors. We evaluated the acceptability, feasibility, and impact of a mHealth intervention for AA BC survivors. Participants (N = 22) were randomized to intervention (n = 13) or control (n = 9). All participants completed daily EMAs via smartphone for 4 weeks and wore accelerometers for seven consecutive days at baseline, 4, and 8 weeks. Intervention participants additionally received tailored health messages. Diet was measured using a self-reported questionnaire and physical activity with accelerometers. Participant engagement was high. Of 84 EMA assessments, the average response was 63 (SD 16.1). Participant accelerometer wear was at least 6 of the 7 days (SD 1.7) for each assessment. Eighty-five percent of participants reported the intervention helped change behaviors. Intervention participants reduced their sedentary time by 4.37 (SD = 7.14) hours/day versus controls (p = .05), reduced fast food intake by 1.5 servings (p = 0.008), and increased vigorous activity by 0.56 (SD = 28.10) minutes, which was non-significant (p = 0.959). Findings show feasibility and acceptability and potential of the intervention to positively impact physical activity among AA BC survivors.
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Affiliation(s)
- Marlyn Allicock
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA.
- Department of Health Promotion & Behavioral Sciences, 5323 Harry Hines Blvd., V8.112, Dallas, TX, 75390-9128, USA.
| | - Darla Kendzor
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Tobacco Intervention Research Clinic, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Abigail Sedory
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Kelley Pettee Gabriel
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Michael D Swartz
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Priya Thomas
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Joshua S Yudkin
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Aeisha Rivers
- Memorial Breast Cancer Center, Memorial Regional Hospital, Memorial Hospital West, Hollywood, FL, USA
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Buneviciene I, Mekary RA, Smith TR, Onnela JP, Bunevicius A. Can mHealth interventions improve quality of life of cancer patients? A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 157:103123. [PMID: 33190065 PMCID: PMC7574857 DOI: 10.1016/j.critrevonc.2020.103123] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 01/13/2023] Open
Abstract
mHealth can be used to deliver interventions to optimize Health-related quality of life (HRQoL) of cancer patients. In this systematic-review and meta-analysis, we explored the possible impact of health interventions delivered via mHealth tools on HRQoL of cancer patients. The systematic literature search was performed on July 20, 2019, to identify studies that evaluated the impact of mHealth intervention on HRQoL of cancer patients. We identified 25 studies (17 randomized controlled trials and 8 pre-post design studies; 957 patients) that evaluated mHealth interventions. The most commonly studied mHealth interventions included physical activity/ fitness interventions (9 studies), cognitive behavioral therapy (6 studies), mindfulness/ stress management (3 studies). In the majority of studies, mHealth interventions were associated with an improved HRQoL of cancer patients. The meta-analysis of the identified studies supported the positive effect of mHealth interventions for HRQoL of cancer patients. mHealth interventions are promising for improving HRQoL of cancer patients.
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Affiliation(s)
- Inesa Buneviciene
- Department of Public Communications, Vytautas Magnus University, Kaunas, Lithuania
| | - Rania A Mekary
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, MCPHS University, Boston, MA, United States
| | - Timothy R Smith
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Adomas Bunevicius
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Lithuanian University of Health Sciences, Lithuania; Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
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Scott IA, Scuffham P, Gupta D, Harch TM, Borchi J, Richards B. Going digital: a narrative overview of the effects, quality and utility of mobile apps in chronic disease self-management. AUST HEALTH REV 2020; 44:62-82. [PMID: 30419185 DOI: 10.1071/ah18064] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/04/2018] [Indexed: 12/16/2022]
Abstract
Objective Smartphone health applications (apps) are being increasingly used to assist patients in chronic disease self-management. The effects of such apps on patient outcomes are uncertain, as are design features that maximise usability and efficacy, and the best methods for evaluating app quality and utility. Methods In assessing efficacy, PubMed, Cochrane Library and EMBASE were searched for systematic reviews (and single studies if no systematic review was available) published between January 2007 and January 2018 using search terms (and synonyms) of 'smartphone' and 'mobile applications', and terms for each of 11 chronic diseases: asthma, chronic obstructive lung disease (COPD), diabetes, chronic pain, serious mental health disorders, alcohol and substance addiction, heart failure, ischaemic heart disease, cancer, cognitive impairment, chronic kidney disease (CKD). With regard to design features and evaluation methods, additional reviews were sought using search terms 'design', 'quality,' 'usability', 'functionality,' 'adherence', 'evaluation' and related synonyms. Results Of 13 reviews and six single studies assessing efficacy, consistent evidence of benefit was seen only with apps for diabetes, as measured by decreased glycosylated haemoglobin levels (HbA1c). Some, but not all, studies showed benefit in asthma, low back pain, alcohol addiction, heart failure, ischaemic heart disease and cancer. There was no evidence of benefit in COPD, cognitive impairment or CKD. In all studies, benefits were clinically marginal and none related to morbid events or hospitalisation. Twelve design features were identified as enhancing usability. An evaluation framework comprising 32 items was formulated. Conclusion Evidence of clinical benefit of most available apps is very limited. Design features that enhance usability and maximise efficacy were identified. A provisional 'first-pass' evaluation framework is proposed that can help decide which apps should be endorsed by government agencies following more detailed technical assessments and which could then be recommended with confidence by clinicians to their patients. What is known about the topic? Smartphone health apps have attracted considerable interest from patients and health managers as a means of promoting more effective self-management of chronic diseases, which leads to better health outcomes. However, most commercially available apps have never been evaluated for benefits or harms in clinical trials, and there are currently no agreed quality criteria, standards or regulations to ensure health apps are user-friendly, accurate in content, evidence based or efficacious. What does this paper add? This paper presents a comprehensive review of evidence relating to the efficacy, usability and evaluation of apps for 11 common diseases aimed at assisting patients in self-management. Consistent evidence of benefit was only seen for diabetes apps; there was absent or conflicting evidence of benefit for apps for the remaining 10 diseases. Benefits that were detected were of marginal clinical importance, with no reporting of hard clinical end-points, such as mortality or hospitalisations. Only a minority of studies explicitly reported using behaviour change theories to underpin the app intervention. Many apps lacked design features that the literature identified as enhancing usability and potential to confer benefit. Despite a plethora of published evaluation tools, there is no universal framework that covers all relevant clinical and technical attributes. An inclusive list of evaluation criteria is proposed that may overcome this shortcoming. What are the implications for practitioners? The number of smartphone apps will continue to grow, as will the appetite for patients and clinicians to use them in chronic disease self-management. However, the evidence to date of clinical benefit of most apps already available is very limited. Design features that enhance usability and clinical efficacy need to be considered. In making decisions about which apps should be endorsed by government agencies and recommended with confidence by clinicians to their patients, a comprehensive but workable evaluation framework needs to be used by bodies assuming the roles of setting and applying standards.
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Affiliation(s)
- Ian A Scott
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane 4102, Australia. Email
| | - Paul Scuffham
- Menzies Health Institute Queensland, Griffith University (Nathan campus), 170 Kessels Road, Nathan, Brisbane 4111, Australia. Email
| | - Deepali Gupta
- Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane 4102, Australia. Email
| | - Tanya M Harch
- eHealth Queensland, 2/315 Brunswick St, Fortitude Valley, Brisbane 4006, Australia.
| | - John Borchi
- eHealth Queensland, 2/315 Brunswick St, Fortitude Valley, Brisbane 4006, Australia.
| | - Brent Richards
- Gold Coast University Hospital, 1 Hospital Boulevard, Southport 4215, Australia. Email
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Abstract
This narrative review of web-delivered weight management, diet quality, and physical activity interventions for cancer survivors relies on a systematic search of PubMed, Psych Info, and EBSCOhost which identified 19 unique web-delivered lifestyle interventions for cancer survivors. The sample sizes for these studies ranged from 11–492. Intervention duration ranged from 1–12 months; however, most interventions were 6–12 weeks in length. Ten studies were randomized controlled trials (RCTs), two were two-arm quasi RCTs, and seven employed a single-arm pre/post-test design. Many (N= 15) of the interventions were well-grounded in behavioral theory, which may have led to favorable behavior change. Most studies (15-of-19) targeted and reported increases in physical activity, while only a few targeted and reported improvements in diet quality (36.9% and 15.8%, respectively) and weight management (26.3% and 10.5%, respectively). A notable limitation was that most studies were conducted among populations that were primarily White and female. Future directions for Internet-based lifestyle interventions for cancer survivors include increasing: (a) focus on multiple behavior change, (b) representation of male and minority populations to improve generalizability of findings, (c) extended intervention duration and follow-up to evaluate long-term efficacy of web-based lifestyle interventions, and (d) sample size to allow for adequate statistical power.
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Lampousi AM, Berglind D, Forsell Y. Association of changes in cardiorespiratory fitness with health-related quality of life in young adults with mobility disability: secondary analysis of a randomized controlled trial of mobile app versus supervised training. BMC Public Health 2020; 20:1721. [PMID: 33198702 PMCID: PMC7670607 DOI: 10.1186/s12889-020-09830-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/04/2020] [Indexed: 11/10/2022] Open
Abstract
AbstractBackgroundYoung adults with mobility disability report lower health-related quality of life (HRQoL) than their able-bodied peers. This study aims to examine potential differences between the effects of mobile app versus supervised training and the association of cardiorespiratory fitness change with HRQoL in young adults with mobility disability.MethodsThis is a secondary analysis of a parallel randomized controlled trial of a mobile app (n = 55) and a supervised health program (n = 55) that was provided for 12 weeks to 110 adults (18–45 years) with self-perceived mobility disability. Recruitment took place at rehabilitation centers in Stockholm, Sweden. Cardiorespiratory fitness was estimated from the results of a submaximal cycle ergometer test and HRQoL was assessed with the SF-36 questionnaire. Follow up was at 6 weeks, 12 weeks, and 1-year and all examinations were performed by blinded investigators. Between group differences of changes in HRQoL at follow up were estimated in intention-to-treat analysis using linear regression models. Crude and adjusted mixed-effects models estimated the associations between cardiorespiratory fitness change and HRQoL. Stratified analysis by intervention group was also performed.ResultsIn total, 40/55 from the mobile app group and 49/55 from the supervised training group were included in the intention to treat analysis. No significant differences were observed between the effects of the two interventions on HRQoL. In both crude and adjusted models, cardiorespiratory fitness change was associated with the general health (adjusted β = 1.30, 95% CI: 0.48, 2.13) and emotional role functioning (adjusted β = 1.18, 95% CI: 0.11, 2.25) domains of SF-36. After stratification, the associations with general health (adjusted β = 1.88, 95% CI: 0.87, 2.90) and emotional role functioning (adjusted β = 1.37, 95% CI: 0.18, 2.57) were present only in the supervised group.ConclusionThis study found positive associations between cardiorespiratory fitness change and HRQoL in young adults with mobility disability who received supervised training. The effects of mobile app versus supervised training on HRQoL remain unclear.Trial registrationInternational Standard Randomized Controlled Trial Number (ISRCTN) registryISRCTN22387524; Prospectively registered on February 4th, 2018.
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Buchanan A, Roddy M, Badr H. Patient-reported outcomes of non-pharmacological interventions for endometrial cancer survivors: a systematic review. J Cancer Surviv 2020; 15:526-535. [PMID: 33140266 DOI: 10.1007/s11764-020-00946-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE The objective of this review was to assess the efficacy of non-pharmacological interventions on endometrial cancer (EC) survivors' QOL, and their use of patient-reported outcome measures (PROMs). METHODS We conducted a systematic review of randomized controlled trials (RCTs) of non-pharmacological interventions that assessed the impact of intervention on EC survivors' general and domain-specific QOL (i.e., physical, psychological, and social well-being) using PROMs. RESULTS Of the 3178 studies identified, 28 full-text articles were reviewed, and 10 were included in the review. Nine RCTs assessed at least one PROM as a primary outcome and six assessed a PROM as a secondary outcome, but few studies used validated PROMs. Significant improvements in general QOL were found in two studies, domain-specific QOL in three studies, and both general and domain-specific QOL in three studies; however, effect sizes ranged from small to large and no significant effects were found for social well-being and few were found for psychological well-being. CONCLUSIONS Few non-pharmacological interventions for EC survivors targeted QOL, even though QOL was assessed as either a primary or secondary outcome of the RCT. Despite this, findings suggest that non-pharmacological interventions for EC survivors hold promise for improving general and domain-specific QOL. Use of validated PROMs would greatly enhance outcome reporting and facilitate comparisons across studies. More interventions are also needed that address social and psychological functioning in this population. IMPLICATIONS FOR CANCER SURVIVORS Our review highlights a need to (1) expand non-pharmacological RCTs for EC survivors, (2) increase the use of validated PROMs measuring QOL, and (3) address psychosocial domains of QOL when developing interventions for this population.
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Affiliation(s)
- Ashley Buchanan
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - McKenzie Roddy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
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Walsh JC, Richmond J, Mc Sharry J, Groarke A, Glynn L, Kelly MG, Harney O, Groarke JM. Examining the Impact of a Mobile Health Behavior Change Intervention with a brief in-person component for Cancer Survivors with Overweight/Obesity: Randomized Controlled Trial (Preprint). JMIR Mhealth Uhealth 2020; 9:e24915. [PMID: 36260394 PMCID: PMC8406099 DOI: 10.2196/24915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/01/2021] [Accepted: 05/07/2021] [Indexed: 02/01/2023] Open
Abstract
Background Cancer survivorship in Ireland is increasing in both frequency and longevity. However, a significant proportion of cancer survivors do not reach the recommended physical activity levels and have overweight. This has implications for both physical and psychological health, including an increased risk of subsequent and secondary cancers. Mobile health (mHealth) interventions demonstrate potential for positive health behavior change, but there is little evidence for the efficacy of mobile technology in improving health outcomes in cancer survivors with overweight or obesity. Objective This study aims to investigate whether a personalized mHealth behavior change intervention improves physical and psychological health outcomes in cancer survivors with overweight or obesity. Methods A sample of 123 cancer survivors (BMI≥25 kg/m2) was randomly assigned to the standard care control (n=61) or intervention (n=62) condition. Group allocation was unblinded. The intervention group attended a 4-hour tailored lifestyle education and information session with physiotherapists, a dietician, and a clinical psychologist to support self-management of health behavior. Over the following 12 weeks, participants engaged in personalized goal setting to incrementally increase physical activity (with feedback and review of goals through SMS text messaging contact with the research team). Direct measures of physical activity were collected using a Fitbit accelerometer. Data on anthropometric, functional exercise capacity, dietary behavior, and psychological measures were collected at face-to-face assessments in a single hospital site at baseline (T0), 12 weeks (T1; intervention end), and 24 weeks (T2; follow-up). Results The rate of attrition was 21% (13/61) for the control condition and 14% (9/62) for the intervention condition. Using intent-to-treat analysis, significant reductions in BMI (F2,242=4.149; P=.02; ηp2=0.033) and waist circumference (F2,242=3.342; P=.04; ηp2=0.027) were observed in the intervention group. Over the 24-week study, BMI was reduced by 0.52 in the intervention condition, relative to a nonsignificant reduction of 0.11 in the control arm. Waist circumference was reduced by 3.02 cm in the intervention condition relative to 1.82 cm in the control condition. Physical activity level was significantly higher in the intervention group on 8 of the 12 weeks of the intervention phase and on 5 of the 12 weeks of the follow-up period, accounting for up to 2500 additional steps per day (mean 2032, SD 270). Conclusions The results demonstrate that for cancer survivors with a BMI≥25 kg/m2, lifestyle education and personalized goal setting using mobile technology can yield significant changes in clinically relevant health indicators. Further research is needed to elucidate the mechanisms of behavior change and explore the capacity for mHealth interventions to improve broader health and well-being outcomes in the growing population of cancer survivors. Trial Registration ISRCTN Registry ISRCTN18676721; https://www.isrctn.com/ISRCTN18676721 International Registered Report Identifier (IRRID) RR2-10.2196/13214
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Affiliation(s)
- Jane C Walsh
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
| | | | - Jenny Mc Sharry
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
| | - AnnMarie Groarke
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
| | - Liam Glynn
- Health Research Institute and Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - Owen Harney
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
| | - Jenny M Groarke
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
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Hwang NK, Jung YJ, Park JS. Information and Communications Technology-Based Telehealth Approach for Occupational Therapy Interventions for Cancer Survivors: A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8040355. [PMID: 32977651 PMCID: PMC7712965 DOI: 10.3390/healthcare8040355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients’ health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind–body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul 02062, Korea;
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division DongSeo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
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Sunil Kumar D, Prakash B, Subhash Chandra BJ, Kadkol PS, Arun V, Thomas JJ. An android smartphone-based randomized intervention improves the quality of life in patients with type 2 diabetes in Mysore, Karnataka, India. Diabetes Metab Syndr 2020; 14:1327-1332. [PMID: 32755831 DOI: 10.1016/j.dsx.2020.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Associated with severe complications and morbidity, Diabetes Mellitus is a significant public health burden. The need for regular monitoring and adherence to treatment and lifestyle changes have a high impact on the quality of life of the patients. This study attempts to assess the effect of smartphone-based lifestyle modification intervention in the quality of life of patients with type 2 Diabetes through a randomized filed trial. METHODS A randomized field trial was performed among the patients attending the outpatient department of a tertiary care hospital in Mysuru city. A mobile application named DIAGURU, mainly focusing on the lifestyle modification and medication management was used for a period of 6 months from April 2019 to September 2019 by 150 patients in the intervention group while another 150 participants served as controls. The quality of life was assessed using the WHO QOL BREF questionnaire at the beginning of the study and after six months. RESULTS The change in the quality of life in a positive direction was significantly higher in the intervention group compared to the non-intervention group after six months. The differences in the change in scores of quality of life of participants recruited in intervention and non-intervention groups were statistically significant in all the four domains after the intervention with a p value < 0.001. CONCLUSION The evidence generated in this study suggest that such technological approaches can be used as a public health measure to improve the quality of life of patients with type 2 Diabetes Mellitus.
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Affiliation(s)
- D Sunil Kumar
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India
| | - B Prakash
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India
| | - B J Subhash Chandra
- Department of General Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India
| | - Padma Shrinivas Kadkol
- Department of Information Science & Engineering, JSS S&T University (Formally SJCE), Mysuru, India
| | - Vanishri Arun
- Department of Information Science & Engineering, JSS S&T University (Formally SJCE), Mysuru, India
| | - Jose Jom Thomas
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India.
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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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Yan BC, Li Y, Ma FH, Feng F, Sun MH, Lin GW, Zhang GF, Qiang JW. Preoperative Assessment for High-Risk Endometrial Cancer by Developing an MRI- and Clinical-Based Radiomics Nomogram: A Multicenter Study. J Magn Reson Imaging 2020; 52:1872-1882. [PMID: 32681608 DOI: 10.1002/jmri.27289] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/26/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND High- and low-risk endometrial cancer (EC) differ in whether lymphadenectomy is performed. Assessment of high-risk EC is essential for planning surgery appropriately. PURPOSE To develop a radiomics nomogram for high-risk EC prediction preoperatively. STUDY TYPE Retrospective. POPULATION In all, 717 histopathologically confirmed EC patients (mean age, 56 years ± 9) divided into a primary group (394 patients from Center A), validation groups 1 and 2 (146 patients from Center B and 177 patients from Centers C-E). FIELD STRENGTH/SEQUENCE 1.5/3T scanners; T2 -weighted imaging, diffusion-weighted imaging, apparent diffusion coefficient, and contrast enhancement sequences. ASSESSMENT A radiomics nomogram was generated by combining the selected radiomics features and clinical parameters (metabolic syndrome, cancer antigen 125, age, tumor grade following curettage, and tumor size). The area under the curve (AUC) of the receiver operator characteristic was used to evaluate the predictive performance of the radiomics nomogram for high-risk EC. The surgical procedure suggested by the nomogram was compared with the actual procedure performed for the patients. Net benefit of the radiomics nomogram was evaluated by a clinical decision curve (CDC), net reclassification index (NRI), and integrated discrimination improvement (IDI). STATISTICAL TESTS Binary least absolute shrinkage and selection operator (LASSO) logistic regression, linear regression, and multivariate binary logistic regression were used to select radiomics features and clinical parameters. RESULTS The AUC for prediction of high-risk EC for the radiomics nomogram in the primary group, validation groups 1 and 2 were 0.896 (95% confidence interval [CI]: 0.866-0.926), 0.877 (95% CI: 0.825-0.930), and 0.919 (95% CI: 0.879-0.960), respectively. The nomogram achieved good net benefit by CDC analysis for high-risk EC. NRIs were 1.17, 1.28, and 1.51, and IDIs were 0.41, 0.60, and 0.61 in the primary group, validation groups 1 and 2, respectively. DATA CONCLUSION The radiomics nomogram exhibited good performance in the individual prediction of high-risk EC, and might be used for surgical management of EC. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY STAGE: 2 J. MAGN. RESON. IMAGING 2020;52:1872-1882.
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Affiliation(s)
- Bi Cong Yan
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Ying Li
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Feng Hua Ma
- Departments of Radiology, Obstetrics & Gynecology Hospital, Fudan University, Shanghai, China
| | - Feng Feng
- Departments of Radiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ming Hua Sun
- Departments of Radiology, Huadong Hospital of Fudan University, Fudan University, Shanghai, China
| | - Guang Wu Lin
- Departments of Radiology, Cancer Hospital of Nantong University, Nantong, China
| | - Guo Fu Zhang
- Departments of Radiology, Obstetrics & Gynecology Hospital, Fudan University, Shanghai, China
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
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A Longitudinal Study of a Multicomponent Exercise Intervention with Remote Guidance among Breast Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103425. [PMID: 32423038 PMCID: PMC7277866 DOI: 10.3390/ijerph17103425] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 12/25/2022]
Abstract
Purpose: Breast cancer patients in treatment suffer from long-term side effects that seriously influence their physical and mental health. The aim of this study was to examine effectiveness of a 12-week multicomponent exercise (ME) with remote guidance intervention on health-related outcomes after one year among breast cancer patients. Methods: In phases I–III, 60 patients (51.2 ± 7.9 years) with breast cancer (BC) who completed chemotherapy/postoperative radiotherapy within the previous four months to two years were randomly assigned to (1) multicomponent exercise with remote guidance (ME) and (2) usual care (UC). Eligible participants were approached to assess cancer-related quality of life (QOL), muscle strength, cardiorespiratory endurance, and physical activity (PA) barriers after one year. Results: The results demonstrated that, after one year, the ME group reported higher vitality-related QOL (5.776, 95% confidence interval [CI] 0.987, 10.565, effect size [ES] = 0.360), mental health-related QOL (9.938, 95% CI 4.146, 15.729, ES = 0.512), leg strength and endurance (2.880, CI 1.337, 4.423, ES = 0.557), and strength and endurance of upper extremities (2.745, 95% CI 1.076, 4.415, ES = 0.491) and lower physical activity (PA) hindrance (5.120, 95% CI 1.976, 8.264, ES = 0.486) than the UC group. Conclusions: The ME group observed significant differences from the UC group in QOL, muscle strength, cardiopulmonary endurance, and PA participation. These findings suggested that the multicomponent exercise intervention with remote guidance produced long-term health benefits for breast cancer patients.
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Krok-Schoen JL, Naughton MJ, Young GS, Moon J, Poi M, Melin SA, Wood ME, Hopkins JO, Paskett ED, Post DM. Increasing Adherence to Adjuvant Hormone Therapy Among Patients With Breast Cancer: A Smart Phone App-Based Pilot Study. Cancer Control 2020; 26:1073274819883287. [PMID: 31736324 PMCID: PMC6862779 DOI: 10.1177/1073274819883287] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study tested the feasibility and efficacy of using a text-based intervention to increase initiation, decrease discontinuation, and improve adherence as prescribed to adjuvant hormone therapy (AHT) among hyphenate post-menopausal breast cancer survivors. METHODS The 3-month intervention consisted of daily text message reminders to take medication, coupled with a dynamic (eg, feedback on progress) tailored intervention using weekly interactive surveys delivered by a smartphone app. Five clinic sites within the Alliance for Clinical Trials in Oncology participated. Hormone levels were measured prior to AHT initiation and at study exit. RESULTS Of the 39 patients recruited to the pilot study, 27 (69.2%) completed all study requirements (completed both the baseline and the exit surveys, both blood draws, and did not miss more than 2 weekly surveys). Significant improvements were observed pre- to postintervention for self-reported medication adherence (P = .015), mental health functioning (P = .007), and perceived stress (P = .04). Significant decreases in estradiol, estrogen, and estrone hormone levels were observed from baseline to study exit (P < .001), indicating the accuracy of self-reported AHT adherence. Participants (91.9%) and physicians (100%) agreed that participant participation in the intervention was beneficial. CONCLUSIONS The results of this pilot study established the general feasibility and efficacy of an app-based intervention to support patient AHT adherence. Larger controlled, randomized trials are needed to examine the effectiveness of the app-based intervention in improving AHT and quality of life among breast cancer survivors.
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Affiliation(s)
- Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Michelle J Naughton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gregory S Young
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Jennifer Moon
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | | | - Susan A Melin
- Department of Hematology and Oncology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Marie E Wood
- Division of Hematology and Oncology, University of Vermont Medical Center, Burlington, VT, USA
| | - Judith O Hopkins
- Novant Health Oncology Specialists, Kernersville Medical Pkwy, Kernersville, NC, USA
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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