Physical Activity, Mental Health, and Technology Preferences to Support Cancer Survivors During the COVID-19 Pandemic: Cross-sectional Study

Abstract

Background COVID-19 has had significant health-related and behavioral impacts worldwide. Cancer survivors (hereafter referred to as “survivors”) are particularly prone to behavioral changes and are encouraged to be more vigilant and observe stricter social distancing measures. Objective We explored (1) changes in physical activity and sedentary behaviors since the onset of COVID-19, along with changes in mental health status, and (2) alternative strategies to support survivors’ physical activity and social health during and after COVID-19, along with the role of digital health in such strategies. Methods A questionnaire was distributed among survivors participating (currently or previously) in the community-based physical activity program LIVESTRONG at the Young Men’s Christian Association (YMCA), from 3 sites outside an urban area in Massachusetts. Questions addressed pre–COVID-19 vs current changes in physical activity and sedentary behavior. Anxiety and depression were assessed using the 2-item Generalized Anxiety Disorder scale (GAD-2) and 2-item Patient Health Questionnaire (PHQ-2), and scores ≥3 indicated a clinical diagnosis of anxiety or depression, respectively. Digital health preferences were assessed through closed-ended questions. Open-ended responses addressing other preferences for physical activity programs and social support were analyzed, coded, and categorized into themes. Results Among 61 participants (mean age 62 [SD 10.4] years; females: 51/61 [83.6%]), 67.2% (n=41) reported decreased physical activity and 67.2% (n=41) reported prolonged sitting times since the onset of COVID-19. Further, 24.6% (n=15) and 26.2% (n=16) met the GAD-2 and PHQ-2 criteria for clinical anxiety and depression, respectively. All participants owned a cellphone; 90% (n=54) owned a smartphone. Preferences for physical activity programs (n=28) included three themes: (1) use of digital or remote platforms (Zoom, other online platforms, and video platforms), (2) specific activities and locations (eg, outdoor activities, walking, gardening, biking, and physical activities at the YMCA and at senior centers), and (3) importance of social support regardless of activity type (eg, time spent with family, friends, peers, or coaches). The survey revealed a mean score of 71.8 (SD 21.4; scale 0-100) for the importance of social support during physical activity programs. Social support preferences (n=15) revealed three themes: (1) support through remote platforms (eg, texting, Zoom, phone calls, emails, and Facebook), (2) tangible in-person support (YMCA and senior centers), and (3) social support with no specific platform (eg, small gatherings and family or friend visits). Conclusions Physical activity and mental health are critical factors for the quality of life of survivors, and interventions tailored to their activity preferences are necessary. Digital or remote physical activity programs with added social support may help address the ongoing needs of survivors during and after the pandemic.

COVID-19 depression and its risk factors in Asia Pacific – A systematic review and meta-analysis

“… Chen et al, 2021 ), ( Crowe et al, 2021 ), ( Fang et al, 2021 ), ( Hammond et al, 2021 ), ( He et al, 2021 ), ( Li et al, 2021 ), (Y. Liu et al, 2021 ), ( Parthasarathy et al, 2021 ), ( Perera et al, 2021 ) Maritial status 7 2.77 ( Fukase et al, 2021 ), ( Hazarika et al, 2021 ), ( Rashid et al, 2021 ), (Yu an Liu et al, 2021 ), ( Sakib et al, 2021 ), ( Veldhuis et al, 2021 ), ( Yan et al, 2021 ) Education level 7 2.77 ( Fang et al, 2021 ), ( Guo et al, 2021 ), ( Kar et al, 2021 ), ( Kim et al, 2021 ), ( Liu et al, 2020 ), (Song et al, 2021), ( Yan et al, 2021 ) Lack of outdoor activity/exercise 7 2.77 (Xu Chen et al, 2021 ), ( Chi et al, 2021 ), ( Dun et al, 2021 ), ( Faro et al, 2021 ), ( Suzuki et al, 2021 ), (R. K. Yadav et al, 2021 ), ( Yasmin et al, 2021 ) Disruption of education 7 2.77 (Xu Chen et al, 2021 ), ( Chi et al, 2021 ), ( Gotlib et al, 2021 ), (Y. Liu et al, 2021 ), ( Ma et al, 2021 ), ( Nishimura et al, 2021 ), (Yunus et al, 2021) Information overload & reliability 7 2.77 ( Crowe et al, 2021 ), ( ...…”

Changes in physical activity and associations with quality of life among a global sample of cancer survivors during the COVID-19 pandemic

“…Secondly, PA is largely influenced by social and environmental contexts; therefore, COVID-19 prevention measures (i.e., physical distancing and stay-at-home orders) can lead to reduced participation [ 54 ]. Changes to the physical and social environment surrounding PA was dramatically changed, as fitness facilities were unavailable or avoided by cancer survivors due to a potential increased risk of COVID-19 transmission [ 27 , 52 ]. Home-based PA promotion strategies for cancer survivors that reflect this new landscape surrounding PA environments are needed [ 17 , 27 ].…”

“…Thus, understanding the impact of the pandemic on the PA behaviors and QoL of cancer survivors is an essential first step needed to inform effective strategies for improving PA and subsequent health outcomes [ 38 ]. To our knowledge, only one study to date has examined PA participation of cancer survivors during the pandemic [ 27 ]. In a cross-sectional survey of cancer survivors who previously participated in an exercise program designed for cancer survivors ( n = 61), 67.2% of participants self-reported a decrease in PA [ 27 ].…”

“…To our knowledge, only one study to date has examined PA participation of cancer survivors during the pandemic [ 27 ]. In a cross-sectional survey of cancer survivors who previously participated in an exercise program designed for cancer survivors ( n = 61), 67.2% of participants self-reported a decrease in PA [ 27 ]. Though this study suggests COVID-19 has negative implications for cancer survivors, the relationship between PA changes and QoL during the pandemic remains unexplored.…”

Quality of Life and Psychosocial Impacts of the Different Restrictive Measures during One Year into the COVID-19 Pandemic on Patients with Cancer in Italy: An Ecological Study

“…Some practical implications of this research include: promoting mass screening campaigns in order to identify the presence or the risk to develop mental disorders; the spreading of recommendations about how to deal with the mental health consequences of the pandemic and the development of tailored innovative psychosocial interventions in order to help the population at risk. Moreover, health providers should offer equitable access to digital health tools and platforms, as well as implement local territorial medicine services in order to guarantee in-person support (home care) and continuity of treatments [ 25 , 50 ].…”