A Personalized Physical Activity Coaching App for Breast Cancer Survivors: Design Process and Early Prototype Testing

Abstract

Background Existing evidence supports the many benefits of physical activity (PA) in breast cancer survival. However, few breast cancer survivors adhere to the recommended levels of activity. A PA coaching app that provides personalized feedback, guidance, and motivation to the user might have the potential to engage these individuals in a more active lifestyle, in line with the general recommendations. To develop a successful tool, it is important to involve the end users in the design process and to make theoretically grounded design decisions. Objective This study aimed to execute the design process and early prototype evaluation of a personalized PA coaching app for posttreatment breast cancer survivors. In particular, the study explored a design combining behavioral theory and tailored coaching strategies. Methods The design process was led by a multidisciplinary team, including technical and health professionals, and involved input from a total of 22 survivors. The process comprised 3 stages. In stage 1, the literature was reviewed and 14 patients were interviewed to understand the needs and considerations of the target population toward PA apps. In stage 2, the global use case for the tool was defined, the features were ideated and refined based on theory, and a digital interactive prototype was created. In stage 3, the prototype went through usability testing with 8 patients and was subjected to quality and behavior change potential evaluations by 2 human-computer interaction experts. Results The design process has led to the conceptualization of a personalized coaching app for walking activities that addresses the needs of breast cancer survivors. The main features of the tool include a training plan and schedule, adaptive goal setting, real-time feedback and motivation during walking sessions, activity status through the day, activity history, weekly summary reports, and activity challenges. The system was designed to measure users’ cadence during walking, use this measure to infer their training zone, and provide real-time coaching to control the intensity of the walking sessions. The outcomes from user testing and expert evaluation of the digital prototype were very positive, with scores from the system usability scale, mobile app rating scale, and app behavior change scale of 95 out of 100, 4.6 out of 5, and 15 out of 21, respectively. Conclusions Implementing a user-centered design approach for the development and early evaluation of an app brings essential considerations to tailor the solution to the user’s needs and context. In addition, informing the design on behavioral and tailored coaching theories supports the conceptualization of the PA coaching system. This is critical for optimizing the usability, acceptability, and long-term effectiveness of the tool. After successful early in-laboratory testing, the app will be developed and evaluated in a pilot study in a real-world setting.

Breast Cancer Patients’ Experiences with Online Group-Based Physical Exercise in a COVID-19 Context: A Focus Group Study

“…In this sense, not only did online and supervised group-based activities assist patients in engaging and preventing the recurrence of cancer-related side effects, but they also controlled COVID-19-related fear and provided an alternative to promote mental health-related quality of life. This is in accordance with earlier observations, which showed that online, web-based, and digital interventions have potential for physical exercise promotion among cancer patients [ 45 , 46 ], though a more sustained and direct instructor-to-group approach, as suggested by our participants, would be required.…”

Perceptions of Racially and Ethnically Diverse Women at High Risk of Breast Cancer Regarding the Use of a Web-Based Decision Aid for Chemoprevention: Qualitative Study Nested Within a Randomized Controlled Trial

“…Regarding theme 4, our results demonstrate that, based on the information needs reported, the high-risk women enrolled in our study wanted to learn more about general breast cancer risk factors and breast cancer screening strategies, including mammographic frequency, in addition to chemoprevention. Existing evidence suggests that interventions that are tailored based on unique characteristics and provide personalized feedback, guidance, and motivation to users might assist them in engaging in more active lifestyles [ 37 - 39 ] and are an effective method of promoting mammography adherence [ 40 ]. Therefore, based on our findings, future iterations of RealRisks may consider incorporating tailoring with a broader focus on breast cancer risk reduction and should incorporate guidance on other breast cancer risk factors.…”

Machine Learning in Health Promotion and Behavioral Change: Scoping Review

“…The deployment of virtual agents allowed feedback and data output from ML algorithms to be presented to users and was typically designed to mimic human-like appearances or facial expressions. The data analyzed in the 29 studies included self-reports [20,24,26,29,[32][33][34][35][36][37]39,[43][44][45][46][47][48], GPS or wearable sensor data [20,23,25,29,31,36,39,45,46], application-generated data such as conversations with chatbots or users' interactions in applications [21][22][23][24][27][28][29]31,34,35,[38][39][40][41][42]45,46], and clinical data and health records [21,49].…”

“…One such challenge was related to usability. In some studies, usability has been considered beforehand and thus would usually not complicate subsequent testing [28,44,45]. However, in 1/29 (3%) study targeting physical activity [29], problems with usability were noted because of space constraints in the participants' homes and the need to switch between various digital systems in their homes.…”