Adjuvant endocrine hormonal therapy (EHT) is highly effective and appropriate for nearly all breast cancer patients with hormone receptor-positive tumors, which represent 75% of all breast cancer diagnoses. Long-term use of EHT reduces recurrence rates and nearly halves the risk of death during the second decade after diagnosis. Despite the proven benefits, about 33% of women receiving EHT do not take their medication as prescribed. This causes an increase in the risk for recurrence and death.To promote adherence to EHT among breast cancer patients, this study will develop and pilot-test an intervention consisting of 1) a bilingual, culturally tailored, personalized, interactive smartphone application (app); and 2) support from a patient navigator. The control group will receive usual care. This 2-group randomized control trial will recruit 120 breast cancer patients receiving EHT at the Mays Cancer Center at UT Health San Antonio. The two-year study will have 3-time assessments (baseline, 3 and 6 months).This theory-based intervention will empower patients' self-monitoring and management. It will facilitate patient education, identification/reporting of side effects, delivery of self-care advice, and simplify communication between the patient and the oncology team. The ultimate goal of this innovative multi-communication intervention is to improve overall survival and life expectancy, enhance quality of life, reduce recurrence, and decrease healthcare cost. The anticipated outcome is a scalable, evidence-based, and easily disseminated intervention with potentially broad use to patients using EHT and other oral anticancer agents.
It has been a decade since smartphone application stores started allowing developers to post their own applications. This paper presents a narrative review on the state-of-the-art and the future of technology used by researchers in the field of mobile health promotion. Researchers build high cost, complex systems with the purpose of promoting health and collecting data. These systems promote health by using a feedback component that "educates" the subject. Other researchers instead use platforms which provide them with data collected by others, which allows for no communication with subjects, but may be cheaper than building a system to collect the data. This second type of systems cannot be used directly for health promotion. However, both types of systems are relevant to the field of health promotion, because they are precursors to a third type of systems that are emerging, the gig economy systems for mobile health data collection, which are low cost, globally available, and provide limited communication with subjects. If such systems evolve to include more channels for communication with the data-generating subjects, and also bring developers into the economy, they may eventually revolutionize the field of mobile health promotion and data collection by giving researchers new capabilities, such as the ability to replicate existing health promotion campaigns with the click of a button and the appropriate licenses. In this paper we present a review of state-of-the-art systems for mobile health promotion and data collection and a model for what these systems may look like in the future.
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