Feasibility and Acceptability of a Web-Based Dietary Intervention with Text Messages for Colorectal Cancer: A Randomized Pilot Trial

Abstract

◥Background: Diet is associated with colorectal cancer survival. Yet, adherence to nutrition guidelines is low among colorectal cancer survivors.Methods: We conducted a pilot trial among colorectal cancer survivors to evaluate a 12-week remote dietary intervention. Participants received print materials and were randomized (1:1) to intervention (website, text messages) or wait-list control. Primary outcomes included feasibility and acceptability. We also explored change in diet from 0 to 12 and 24 weeks and change from 0 to 12 weeks in anthropometry and circulating biomarkers (Trial Registration: NCT02965521).Results: We randomized 50 colorectal cancer survivors (25 intervention, 25 control). Retention was 90% at 12 weeks and 84% at 24 weeks. Participants had a median age of 55 years and were 66% female, 70% non-Hispanic white, and 96% had a college degree. The intervention arm responded to a median 15 (71%) of 21 text messages that asked for a reply [interquartile range (IQR) ¼ 8, 19] and visited the website a median of 13 (15%) days (IQR ¼ 1, 33) of the 84 study days.Conclusions: We developed a Web-based dietary intervention for colorectal cancer survivors. Our pilot results suggest that colorectal cancer survivors may engage more with text messages than a study website. Research to improve tailoring of text messages, while maintaining scalability, is needed.Impact: Remote dietary interventions using text messages may be feasible for colorectal cancer survivors.See all articles in this CEBP Focus section, "Modernizing Population Science."

Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer

“…Most studies used a combination of strategies including mailed intervention, telephone calls, group sessions, individual sessions, automated messages, web-based interventions, and newsletters. However, there was always a predominant strategy: Eight studies used group interventions [ 36 , 37 , 40 , 43 , 50 , 51 , 52 , 54 ], four studies used mailed interventions [ 33 , 34 , 35 , 41 ], three studies used telephone counselling [ 39 , 42 , 49 ], two studies used individual sessions [ 38 , 53 ], and two studies were a web-based intervention [ 47 , 48 ]. One study [ 33 ] considered the ethnic difference in the study population by tailoring the resources based on age, race, and style of coping with cancer such as cognitive avoider, helpless or hopeless.…”

“…Seven studies used an attention control group and provided participants with untailored information booklets [ 33 , 34 , 35 , 37 , 53 ], newsletters, and cooking classes [ 42 ] or suggested participants to follow a weight loss programme on their own [ 36 ]. Six studies used a waiting list control group and provided participants with general information [ 41 , 47 , 49 , 50 , 51 , 52 ]. Six studies used the usual care group with no additional support [ 38 , 39 , 40 , 43 , 48 , 54 ].…”

“…Four studies (21%) did not publish a protocol but included a description of the intervention in the main paper [ 36 , 48 , 49 , 51 ]. Additionally, seven studies (37%) provided limited information on the intervention [ 35 , 38 , 43 , 47 , 50 , 52 , 53 ].…”

Human-centered approaches that integrate sensor technology across the lifespan: Opportunities and challenges

“…The NINR has been pivotal in providing funding to nurse scientists to develop and test technology to improve symptom and self-management and to reduce health disparities as evidenced by the P20 Exploratory Centers, P30 Centers of Excellence, and Omics Nursing Science and Education Network. [61][62][63] Nurses have integrated wearable technology (actigraphy, smart phones, Fitbit) to capture physiological monitoring such as heart rate, sleep patterns, physical activity [61][62][63][64][65][66][67][68][69][70] with machine learning to characterize changes in selfmanagement to promote communication between the patient and healthcare provider. 5,[71][72][73] Biological technologies such as genomics and metabolomics have been used by nurses to characterize symptom phenotypes and to identify biomarkers for early detection of disease onset and new strategies for intervention.…”

Modernizing Population Sciences in the Digital Age

“…6), and the use of digital applications in the field to assess physical and cognitive function in the 10,000 Families Study (7). Real-time mobile tools are also being deployed for intervention studies, such as text-based dietary interventions among colorectal cancer survivors (8) and the use of wearables (e.g., Fitbit) to promote physical activity (9, 10). To handle high-density data, the CTS describes the transformation of their infrastructure for moving data storage, management, data analysis, and data sharing activities to the cloud (11).…”