Exercise Promotion and Distress Reduction Using a Mobile App-Based Community in Breast Cancer Survivors

Abstract

Physical activity (PA) enhancement and mental distress reduction are important issues in cancer survivorship care. Mobile technology, as an emerging method for changing health behaviors, is gaining attention from many researchers. This study aimed to investigate the effect of a mobile app-based community on enhancing PA and decreasing distress in breast cancer survivors. We conducted a non-randomized, prospective, interventional study that had a mobile community-later arm and mobile community-first arm. With an Android smartphone app (WalkON ®), daily walk steps and weekly distress scores using app-based Distress Thermometer (DT) questionnaires were collected from participants for about 12 weeks. To examine the difference in weekly step counts before and during the community activity, we used a paired t-test method. For a comparative analysis, we referred to a previous prospective observational study without a mobile community intervention that had the same setting as the present study. After propensity score matching (PSM), multivariable regression modeling with difference-indifference (DID) was performed to estimate the effect of the mobile app-based community on PA and mental distress. From January to August 2018, a total of 64 participants were enrolled in this study. In the univariate analysis, after participation in the mobile community, the participants showed a significant increase in total weekly steps (t = −3.5341; P = 0.00208). The mean of the differences was 10,408.72 steps. In the multivariate analysis after PSM, the mobile community significantly increased steps by 8,683.4 per week (p value <0.0001) and decreased DT scores by 0.77 per week (p value = 0.009) in the mixed effect model. In the two-way fixed effect model, the mobile community showed a significant increase in weekly steps by 8,723.4 (p value <0.0001) and decrease in weekly DT by 0.73 (p value = 0.013). The mobile app-based community is an effective and less resource-intensive tool to increase PA and decrease distress in breast cancer survivors.

mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review

“…Of the 31 included studies, 14 were conducted in the United States [ 10 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], five in Australia [ 38 , 53 , 54 , 55 , 56 ], four in Republic of Korea [ 57 , 58 , 59 , 60 ], two each in Canada [ 61 , 62 ] and France [ 63 , 64 ], and one each in The Netherlands [ 65 ], Germany [ 66 ], Spain [ 67 ], and United Kingdom [ 68 ]. All studies were conducted between 2015 and 2020.…”

“…All studies were conducted between 2015 and 2020. Sixteen of the included studies were RCT [ 38 , 40 , 42 , 44 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 56 , 61 , 64 , 65 , 69 ], whereas 12 studies employed a pre-post [ 41 , 43 , 45 , 50 , 54 , 55 , 59 , 60 , 62 , 63 , 67 , 68 ], and three studies applied a quasi-experimental design [ 57 , 58 , 66 ]. The study duration ranged from two weeks [ 55 ] to six months [ 41 , 45 , 46 , 48 , 51 , 54 , 63 ].…”

“…The study duration ranged from two weeks [ 55 ] to six months [ 41 , 45 , 46 , 48 , 51 , 54 , 63 ]. Comparator groups included active controls in 10 studies [ 42 , 46 , 49 , 51 , 53 , 56 , 57 , 64 , 66 , 69 ] and inactive controls in eight studies [ 38 , 40 , 44 , 47 , 52 , 58 , 61 , 65 ]. In one study where more than one comparator group was used, one control group was active and the other inactive [ 48 ].…”

Cardiovascular Health during and after Cancer Therapy

“…Related technologies preceded but are now accelerated by the recent COVID-19 pandemic [ 114 ]. Studies have demonstrated the feasibility of implementing remote cancer survivorship care delivery in high-risk patients [ 115 , 116 , 117 ], setting the stage for the development of population-based CVD interventions in large cohorts of survivors at a fraction of the cost that in-person care requires. These efforts set the stage for innovative delivery of care that will encourage patients to be actively engaged in CVD prevention and treatment during and after cancer therapy.…”

Surgery and Financial Toxicity are Risk Factors for Distress in Cancer Survivors: A Cross-sectional Study

“…The Distress Thermometer and Problem List (DT&PL) is widely used as a self-reporting tool for the screening of distress in patients with cancer. [14,15] The DT is a single-item, self-reporting instrument measuring the amount of distress experienced by patients within the last week, with a score ranging from 0 (no distress) to 10 (extreme distress). The PL groups various problems patients with cancer encounter after diagnosis into ve problem categories: practical, family, emotional, physical, and spiritual.…”