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Sangameswaran S, Casanova-Perez R, Patel H, Cronkite DJ, Idris A, Rosenberg DE, Wright JL, Gore JL, Hartzler AL. Improving physical activity among prostate cancer survivors through a peer-based digital walking program. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:608-617. [PMID: 38222338 PMCID: PMC10785891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Physical activity is important for prostate cancer survivors. Yet survivors face significant barriers to traditional structured exercise programs, limiting engagement and impact. Digital programs that incorporate fitness trackers and peer support via social media have potential to improve the reach and impact of traditional support. Using a digital walking program with prostate cancer survivors, we employed mixed methods to assess program outcomes, engagement, perceived utility, and social influence. After 6 weeks of program use, survivors and loved ones (n=18) significantly increased their average daily step count. Although engagement and perceived utility of using a fitness tracker and interacting with walking buddies was high, social media engagement and utility were limited. Group strategies associated with social influence were driven more by group attraction to the collective task of walking than by interpersonal bonds. Findings demonstrate the feasibility of a digital walking program to improve physical activity and extend the reach of traditional support.
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Affiliation(s)
- Savitha Sangameswaran
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - Reggie Casanova-Perez
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - Harsh Patel
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - David J Cronkite
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Ayah Idris
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Urology, University of Washington, Seattle, WA, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - John L Gore
- Urology, University of Washington, Seattle, WA, USA
| | - Andrea L Hartzler
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
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Zhang R, Sun J, Zheng X, Liu M, Wang H, Wang X, Guan J. Prostate cancer patients' experiences and preferences for web-based physical activity applications: A qualitative meta-synthesis. J Clin Nurs 2023; 32:6998-7009. [PMID: 37401765 DOI: 10.1111/jocn.16819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The incidence of prostate cancer increases with age. Physical activity can improve the prognosis and quality of life of patients. However, studies have observed lower levels of physical activity in men with prostate cancer, and most do not meet physical activity guidelines. Web-based physical activity is a promising form of exercise that will play an important role in prostate cancer patients. AIMS To synthesise the experiences and preferences of prostate cancer patients for web-based PA applications, thereby providing a basis for the construction of intervention programs tailored to the needs of patients. METHODS We systematically searched PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and three Chinese databases. This review includes qualitative empirical reports from the date of establishment of the respective databases until April 2023. Data extraction was performed by two independent reviewers and study quality was assessed. RESULTS A total of nine studies were included. The experiences and preferences of prostate cancer patients with web-based physical activity apps were synthesised into the following three analysis themes: (1) Pursuing individualised management strategies; (2) Perceiving and seeking social support and (3) Moving forwards in the struggle. CONCLUSION Our study found that men with prostate cancer experienced greater challenges in engaging in physical activity. Because of individual differences between patients, health care providers need to provide care that is tailored to each patient. Future studies should further explore the specific effects of web-based PA applications in promoting the physical function of prostate cancer patients to increase their flexibility. RELEVANCE TO CLINICAL PRACTICE This article synthesises prostate cancer patients' experiences with web-based physical activity applications, highlighting their specific information needs. The results suggest several implications for the application of individualised management strategies, the perception and search for social support, and health- literacy. The results of this study will inform future research and program design that recognises the importance of patient-centred efforts to better self-manage physical function. PATIENT OR PUBLIC CONTRIBUTION In the early stages of the study, objectives and subsequent findings were presented and discussed in a meeting with a reference group that represented patients, health professionals and the public.
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Affiliation(s)
- Rui Zhang
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xiaowen Zheng
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Min Liu
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Haifeng Wang
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaoxue Wang
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jingjing Guan
- The First Hospital of Jilin University, Changchun, Jilin, China
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Zhou X, Yang Y, Li C, Gu S, Hou W, Lai X, Zhai L, Zhu Y. What information can we gain from the quality appraisal of guidelines with physical activity recommendations for cancer patients?A systematic review using the AGREE II and AGREE-REX tools. Support Care Cancer 2023; 31:97. [PMID: 36598576 PMCID: PMC9811039 DOI: 10.1007/s00520-022-07567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE There has been growing amount of evidence supporting the benefits of physical activity (PA) on oncological patients' cancer-related health outcomes. Although guidelines on cancer rehabilitation are widely available, the varying quality and practical applicability limited the clinical application of PA recommendations. To assist the future development of guidelines, in this systematic review, we evaluated the quality and applicability of current cancer rehabilitation guidelines with PA recommendations and synthesized PA recommendations for the oncological population. METHODS A systematic search was conducted in PubMed, CINAHL, PEDro, EMBASE, and guideline repositories to identify guidelines with PA recommendations for cancer patients from 1 May 2016 to 1 June 2022. The quality of included guidelines was appraised using the tools "Appraisal of Guidelines for Research and Evaluation II" (AGREE II) and AGREE-REX (Recommendation Excellence). PA recommendations were synthesized from the guidelines. RESULTS Sixteen guidelines were extracted. The AGREE II domain "clarity of presentation" obtained the highest score, while "applicability" received the lowest, ranging from 33.33% to 98.58%. The AGREE-REX domains "values and preferences" and "implementability" generally scored lower and ranged from 45.83% to 74.17% and 55% to 88.33%, respectively. Eight high-quality guidelines were identified, and the included PA recommendations were extracted. CONCLUSION There were some disparities in the quality of the included guidelines. Methodological weaknesses were commonly observed in domains "applicability," "values and preferences," and "implementability"; particular attention should be given to these domains when developing future guidelines. Furthermore, this analysis indicated that more rigorous, high-quality studies are needed to generate evidence for supporting PA recommendations and provide guidance on research gaps in the field of cancer rehabilitation.
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Affiliation(s)
- Xue Zhou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Yujie Yang
- University of Health and Rehabilitation Sciences, Qingdao, 266000 Shandong China
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Shanshan Gu
- Department of Physical Therapy, University of Toronto, Toronto, Ontario Canada
| | - Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Xigui Lai
- Department of Kinesiology, Shanghai University of Sport, Shanghai, 200438 China
| | - Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000 Henan China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan China
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Curry J, Roberts H, Smith A, Riley D, Pearson M, Forbes CC. Developing and testing the ExerciseGuide UK website for people with lung cancer: reflections on the added value of patient and public involvement within a doctoral degree. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:66. [PMID: 36451251 PMCID: PMC9709754 DOI: 10.1186/s40900-022-00395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Lung cancer has one of the highest incidence and mortality rates worldwide. Physical activity can provide those diagnosed with lung cancer with several physical and psychological benefits. However, the examination of digitally delivered physical activity to those with lung cancer is not as researched as other common cancers. Often, those diagnosed with lung cancer are older adults (65 years or older). Older adults are often wrongly assumed to lack digital skills, interest, and not engage with digital technology regularly. Although individuals are interested, would involving older people in designing of websites and apps result in better engagement? MAIN BODY In this article, the authors discuss the process of adapting a digital platform with a patient and public involvement group to provide those who have received a lung cancer diagnosis with a tailored physical activity program and health educational modules. We discuss the influence of recurrent patient and public involvement on the study, the patient and public involvement members, and the doctoral researcher. CONCLUSION Working with a patient and public involvement group over several months, especially potential users of a digital intervention, may enhance its relevance, accessibility, and usability. By engaging with patients, family, or caregivers for someone with lung cancer, the doctoral student gained insight into the needs of the study population and what to consider during development. All group members expressed their interest and enjoyment in their involvement, and several are now active members of a wider patient and public involvement network.
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Affiliation(s)
- Jordan Curry
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK.
| | - Helen Roberts
- Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Alan Smith
- Involve Hull, Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Diane Riley
- Involve Hull, Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Mark Pearson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Cynthia C Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston Upon Hull, Cottingham Road, Hull, HU6 7RX, UK
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Curry J, Lind M, Short CE, Vandelanotte C, Evans HEL, Pearson M, Forbes CC. Evaluating a web-based computer-tailored physical activity intervention for those living with and beyond lung cancer (ExerciseGuide UK): protocol for a single group feasibility and acceptability study. Pilot Feasibility Stud 2022; 8:182. [PMID: 35964141 PMCID: PMC9375062 DOI: 10.1186/s40814-022-01129-6] [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: 04/05/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related death globally. Physical activity and exercise provide unequivocal benefits to those living with and beyond lung cancer. However, few of those living with and beyond cancer meet the national physical activity guidelines. Various barriers exist for this population's engagement in physical activity and exercise, such as the lack of knowledge and lack of tailored information, little access to exercise specialists, fatigue, and mobility challenges. Digitally delivered programmes have the potential to address several of these barriers, with techniques like "computer-tailoring" available to enable the delivery of tailored content at a time and place that is convenient. However, evaluation of such programmes is needed prior to implementation. This protocol describes a single group study that will examine the feasibility and acceptability of an online tool (ExerciseGuide UK) that provides those living with and beyond lung cancer web-based computer-tailored physical activity prescription and modules underpinned by behaviour change theories. METHODS Thirty-five individuals diagnosed with lung cancer, or cancer affecting the lung (e.g. pleural mesothelioma), will be recruited into a single-intervention arm. The platform will provide tailored resources and a personalised physical activity programme using IF-THEN algorithms. Exercise prescription will be tailored on factors such as self-reported specific pain location, exercise history, and current physical fitness. In addition, modules grounded in behaviour change will supplement the physical activity programme and will focus on topics such as exercise benefits, safety, goal setting, and tracking. The primary outcome will be assessed using pre-established criteria on feasibility and mixed-methods approach for acceptability. Secondary outcomes will explore changes in the physical activity, quality of life, anxiety, and depression. DISCUSSION This manuscript describes the protocol for a study examining the feasibility and acceptability of a web-based computer-tailored physical activity intervention for those living with and beyond lung cancer. The publication of this protocol aims to increase the transparency of the methods, report pre-determined criteria, and aid replication of the study and associated materials. If feasible and acceptable, this intervention will inform future studies of digital-based interventions. TRAIL REGISTRATION ClinicalTrails.gov , NCT05121259. Registered on November 16, 2021.
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Affiliation(s)
- Jordan Curry
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK.
| | - Michael Lind
- Academic Department of Oncology, Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, Hull, UK
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, North Rockhampton, Queensland, Australia
| | - Holly E L Evans
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,iNform Research Institute, iNform Health and Fitness, Adelaide, South Australia, Australia
| | - Mark Pearson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK
| | - Cynthia C Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK
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Acceptability and Preliminary Efficacy of a Web- and Telephone-Based Personalised Exercise Intervention for Individuals with Metastatic Prostate Cancer: The ExerciseGuide Pilot Randomised Controlled Trial. Cancers (Basel) 2021; 13:cancers13235925. [PMID: 34885036 PMCID: PMC8656540 DOI: 10.3390/cancers13235925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Previous research supports the participation in supervised exercise among individuals with metastatic prostate cancer to help lessen the physical and psychological disease burden. However, many individuals experience considerable barriers to attending face-to-face exercise services. To overcome some of these limitations, digital interventions that can be delivered remotely have been proposed. Our pilot study investigated the acceptability, safety and preliminary efficacy of an 8-week computer-tailored web-based exercise intervention. We demonstrated that a web-based exercise program with telehealth support was acceptable and could be implemented safely. Participants in the intervention group increased their participation in moderate to vigorous physical activity compared to the control group. This study provides insight into the prospect of web-based exercise prescription for individuals with metastatic prostate cancer as an alternative for individuals who cannot access supervised exercise interventions. Abstract Preliminary research has shown the effectiveness of supervised exercise-based interventions in alleviating sequela resulting from metastatic prostate cancer. However, many individuals encounter barriers that limit the uptake of face-to-face exercise. Technology-enabled interventions offer a distance-based alternative. This pilot study aimed to explore the acceptability, safety and preliminary efficacy of a web-based exercise intervention (ExerciseGuide) in individuals with metastatic prostate cancer. Forty participants (70.2 ± 8.5 years) with metastatic prostate cancer were randomised into the 8-week intervention (N = 20) or a wait-list control (N = 20). The intervention arm had access to a computer-tailored website, personalised exercise prescription and remote supervision. ExerciseGuide was deemed acceptable with a score ≥20 on the client satisfaction questionnaire; however, the usability score was just below the pre-specified score of ≥68 on the software usability scale. There were no serious adverse events reported. Moderate-to-vigorous physical activity levels between baseline and follow-ups were significantly higher (10.0 min per day; 95% CI = (1.3–18.6); p = 0.01) in the intervention group compared to wait-list control. There were also greater improvements in step count (1332; 95% CI = (159–2505); p = 0.02) and identified motivation (0.4, 95% CI = (0.0, 0.7); p = 0.04). Our findings provide preliminary evidence that ExerciseGuide is acceptable, safe and efficacious among individuals with metastatic prostate cancer.
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