An iPhone Application Intervention to Promote Surveillance Among Women with a BRCA Mutation: Pre‐intervention Data

Abstract

Women with BRCA mutations, at significantly increased risk for breast and ovarian cancer, do not consistently adhere to management guidelines due to lack of awareness and challenges tracking appointments. We developed an iPhone application (app) to help BRCA carriers manage their surveillance. We explored baseline awareness and adherence to surveillance guidelines and analytic data from 21 months of app use. Descriptive statistics were calculated on responses (N = 86) to a survey about surveillance awareness and practices. The majority were aware of breast surveillance guidelines, but only one third were aware of ovarian surveillance guidelines. In practice, the majority reported a clinical breast exam within 6 months, just over half reported a mammogram and breast MRI in the last year, and under half reported ovarian surveillance in the last year. Nearly 50% reported difficulty remembering appointments. Although only 69 received access codes, 284 unique users attempted to enter the app, which was visible in the iTunes store but only available to those with a study code. Evaluation of analytic data demonstrated user engagement with study participants accessing the app 427 times over the 21-month time period (range 2-57; mean = 6.28). Results indicate participants were more likely to know screening guidelines than practice them. There was interest in the app and users were engaged, suggesting app value. We will send a follow-up survey after 18 months of app use for additional evaluation and feedback.

Health professional and at‐risk BRCA young adult perspectives about information needs: What does Gen Y need to know?

“…An app or email alert system could feasibly by‐pass and streamline contact through an online referral process. For example, a US iPhone app has been made to improve adherence to surveillance guidelines (Cohen, Scherr, & Nixon, ; Scherr, Feuston, Nixon, & Cohen, ).…”

Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature

“…We identified three common themes for the use of mobile health apps in primary breast cancer prevention: knowledge and adherence to screening guidelines, the targeting of high-risk populations, and the incorporation of theoretical frameworks. Primary prevention studies focused on apps that increased breast cancer prevention knowledge and adherence to breast cancer guidelines and surveillance (77, 79, 80, 83–85). Six of the 9 studies used existing guidelines to inform their apps (77, 80, 81, 83, 85).…”

“…The targeted population for these primary prevention studies was primarily women at high risk for breast cancer (77, 79, 80, 82, 83) including post-menopausal women with high Gail risk scores (82), BRCA mutation carriers (79, 80), and African American women, who experience greater breast cancer disparities (85). Some studies also targeted broader populations that engaged in behaviors associated with higher breast cancer risk, such as smoking (78) and night shift work (26).…”

“…The need for user-friendly tools, such as scheduling assistants, emerged in a study of guideline adherence among BRCA carriers. Although their awareness of surveillance guidelines was high, adherence was low and half of respondents indicated they had a difficult time remembering to schedule appointments (79). Thus, the app was designed to remind users when to seek care personalized to their own risk factors.…”

“…With regard to app availability, 4 studies used publicly-available apps (Figure 5) (77, 79, 82, 84). Other studies used pre-existing apps, including My Fitness Pal (82), Snapchat (77), or incorporated their custom app to be used with FitBit and LoseIt!…”