Effectiveness of Combined Smartwatch and Social Media Intervention on Breast Cancer Survivor Health Outcomes: A 10-Week Pilot Randomized Trial

Abstract

Physical activity (PA) among breast cancer survivors (BCS) can improve this population’s health and quality of life (QoL). This study evaluated the effectiveness of a combined smartwatch- and social media-based health education intervention on BCS’s health outcomes. Thirty BCS (X¯age = 52.6 ± 9.3 years; X¯Wt = 80.2 ± 19.6 kg) participated in this 10-week, 2-arm randomized trial, with BCS randomized into: (1) experimental group (n = 16): received Polar M400 smartwatches for daily PA tracking and joined a Facebook group wherein Social Cognitive Theory-related PA tips were provided twice weekly; and (2) comparison group (n = 14): only joined separate, but content-identical Facebook group. Outcomes included PA, physiological, psychosocial, and QoL variables. Specifically, PA and energy expenditure (EE) was assessed by ActiGraph GT3X+ accelerometers while physiological, psychosocial, and QoL were examined via validated instruments at baseline and post-intervention. No baseline group differences were observed for any variable. Ten BCS dropped out of the study (experimental: 4; comparison: 6). Compared to completers, dropouts differed significantly on several outcomes. Thus, a per-protocol analysis was performed, revealing significant group differences for changes in social support (t = −2.1, p = 0.05) and barriers (t = −2.2, p = 0.04). Interestingly, the comparison group demonstrated improvements for both variables while the intervention group demonstrated slightly decreased social support and no change in barriers. Notably, both groups demonstrated similarly increased daily light PA, moderate-to-vigorous PA, EE, and steps of 7.7 min, 5.1 min, 25.1 kcals, and 339 steps, respectively, over time. Despite extensive user training, several experimental BCS found the Polar M400 use difficult—possibly decreasing intervention adherence. Future interventions should utilize simpler smartwatches to promote PA among middle-aged clinical/non-clinical populations.

A randomized controlled trial of WATAAP to promote physical activity in colorectal and endometrial cancer survivors

“…A similar low‐intensity intervention produced an increase of 18 min/wk of MVPA following a Fitbit intervention for overweight and obese adults . Further, a 10‐week wearable device and social media–based intervention yielded an increase of 25‐minute MVPA per week in breast cancer survivors . The considerable increase of 45 min/wk of MVPA observed in our intervention is almost double that of most previous studies and may be because of the evidence‐based BCTs that are now incorporated into smart‐tracker technology including self‐monitoring, goal setting, and behavioural feedback.…”

“…40 Further, a 10-week wearable device and social media-based intervention yielded an increase of 25-minute MVPA per week in breast cancer survivors. 25 The considerable increase of 45 min/wk of MVPA observed in our intervention is almost double that of most previous studies 25,37,40 and may be because of the evidence-based BCTs that are now incorporated into smart-tracker technology including self-monitoring, goal setting, and behavioural feedback. A recent higher-intensity Fitbit intervention with breast cancer survivors supports this finding, demonstrating a 103 min/wk net improvement in MVPA.…”

“…Reviews of trials incorporating wearables support the effectiveness of trackers for increasing PA and reducing sedentary behaviour . There is evidence to support the effectiveness of wearables for increasing PA among adults with chronic disease, postmenopausal women, and in breast cancer survivors . Research on “smart” wearables in survivors has thus far been limited to predominantly breast survivors and has not involved group sessions as components of the intervention.…”

“…21 There is evidence to support the effectiveness of wearables for increasing PA among adults with chronic disease, 22 postmenopausal women, 23 and in breast cancer survivors. 24,25 Research on "smart" wearables in survivors has thus far been limited to predominantly breast survivors and has not involved group sessions as components of the intervention. Our trial is novel because it includes group sessions and relational support 26 and the inclusion of BCTs (eg, action planning) that are absent from wearables and their Apps.…”

A randomized controlled trial of a wearable technology‐based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: The ACTIVATE Trial

“…Accelerometer‐measured levels of MVPA and step count were maintained over the 4‐week period following the supervised program, but use of the Fitbit One did not increase activity. Pope et al did not observe any significant between‐group differences following the delivery of their wearable technology‐based intervention, which was designed to increase MVPA and reduce sedentary behavior in breast cancer survivors. They used the Polar M400, which their postintervention user survey suggested was challenging to use.…”