Purpose: Despite the benefits of physical activity for breast cancer survivors, the majority remain insufficiently active. Mobile health (mHealth) physical activity interventions may be a more scalable strategy to increase activity among survivors. However, little is known about their preferences for mHealth intervention features. This study explored survivors' preferences for these features.Methods: Survivors [N=96; M age = 55.8 (SD=10.2)] self-reported demographic and disease characteristics, physical activity. A subset (n=28) completed a semi-structured phone interview. Transcribed interviews were evaluated using a thematic content analysis approach and consensus review. Following interviews, the full sample self-reported interests and preferences for

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Objectives Physical activity is associated with better quality of life (QOL) among breast cancer survivors. However, it is unknown the extent to which time spent sedentary or replacing this time with active behaviors may affect QOL. Our aim was to determine the effect of substituting time between sedentary and active behaviors on QOL indicators in breast cancer survivors. Methods An isotemporal substitution approach was used to examine the associations of reallocating time to sedentary and active behaviors measured by accelerometry with Functional Assessment of Cancer Treatment—Breast (FACT‐B; total, physical, social, emotional, functional well‐being, and breast cancer–specific concerns) and the Hospital Anxiety and Depression Scale (HADS) scores in a pooled analysis of breast cancer survivors (n = 753; Mage = 56.9 ± 9.5 y) from two observational studies. Results Reallocating 30 minutes of sedentary time to 30 minutes of moderate‐to‐vigorous intensity physical activity (MVPA) was associated with improved FACT‐B total (B = 3.0; 95% CI, 0.6‐4.5), physical well‐being (B = 0.8; 95% CI, 0.33‐1.2), and functional well‐being (B = 0.6; 95% CI, 0.03‐1.2) scores. Reallocating 30 minutes of light activity to 30 minutes of MVPA was associated with improved FACT‐B total (B = 2.4; 95% CI, 0.3‐6.0) and physical well‐being (B = 0.72; 95% CI, 0.27‐1.2) scores. There was no significant substitution of time effects on HADS scores. Conclusions Substituting sedentary time with MVPA showed the greatest range of effects across QOL indicators. These results can inform intervention development interventions and more comprehensive activity recommendations for breast cancer survivors.

Background: Increased activity is beneficial during chemotherapy, but treatment-related symptoms may be a barrier. This study examines the relationship between daily fluctuations in symptoms and activity during chemotherapy. Methods: Women undergoing chemotherapy for breast cancer [n = 67; Mage = 48.6 (SD = 10.3)] wore an accelerometer 24 hours/day and received four text prompts/day to rate symptoms for 10 consecutive days at the beginning, middle, and end of chemotherapy. Mixed-effects models were used to examine the between and within-person relationships between symptom ratings on a given day and moderate to vigorous physical activity (MVPA) and light physical activity (LPA) on that day and the following day controlling for relevant covariates and using the Bonferroni correction for multiple comparisons. Results: For MVPA and LPA, within-person associations were statistically significant for same day affect, fatigue, pain, walking, activities of daily living (ADL) physical function, and cognitive function. Previous day anxiety was associated with next day LPA. Every one point worse symptom rating than an individual's overall average was associated with: (i) between 1.49 (pain) and 4.94 (fatigue) minutes less MVPA and between 4.48 (pain) and 24.72 (ADL physical function) minutes less LPA that day, and (ii) 11.28 minutes less LPA the next day. No between-person effects were significant for MVPA or LPA. Conclusions: Daily within-person variations in symptoms were associated with MVPA and LPA during chemotherapy for breast cancer. Impact: Future work should explore relationships between symptoms and activity further and identify whether tailoring to symptoms enhances efficacy of physical activity promotion interventions during chemotherapy.

BACKGROUND:The benefits of moderate to vigorous physical activity (MVPA) for breast cancer survivors are well established. However, most are insufficiently active. Fit2Thrive used the Multiphase Optimization Strategy methodology to determine the effect of 5 intervention components on MVPA in this population. METHODS: Two hundred sixty-nine participants (mean age, 52.5 years; SD, 9.9 years) received a core intervention (the Fit2Thrive self-monitoring app and Fitbit) and were randomly assigned to 5 intervention components set to on/off in a full factorial experiment: support calls, deluxe app, buddy, online gym, and text messages. The intervention was delivered over 12 weeks with a 12-week follow-up. MVPA was measured via accelerometry at the baseline (T1), at 12 weeks (T2), and at 24 weeks (T3). The main effects and interaction effects at each time point were examined for all components. RESULTS: Trial retention was high: 91.8% had valid accelerometer data at T2 or T3. Across all conditions, there were significant increases in MVPA (+53.6 min/wk; P < .001) and in the proportion of survivors meeting MVPA guidelines (+22.3%; P < .001) at T2 that were maintained but attenuated at T3 (MVPA, +24.6 min/wk; P < .001; meeting guidelines, +12.6%; P < .001). No individual components significantly improved MVPA, although increases were greater for the on level versus the off level for support calls, buddy, and text messages at T2 and T3. CONCLUSIONS: The Fit2Thrive core intervention (the self-monitoring app and Fitbit) is promising for increasing MVPA in breast cancer survivors, but the components provided no additional increases in MVPA. Future research should evaluate the core intervention in a randomized trial and determine what components optimize MVPA behaviors in breast cancer survivors.