RiseTx: testing the feasibility of a web application for reducing sedentary behavior among prostate cancer survivors receiving androgen deprivation therapy

Abstract

BackgroundGiven the high levels of sedentary time and treatment-related side effects in prostate cancer survivors (PCS), interventions targeting sedentary behavior (SED) may be more sustainable compared to physical activity (PA).PurposeTo examine the feasibility of a web-based intervention (RiseTx) for reducing SED and increasing moderate-to-vigorous physical activity (MVPA) among PCS undergoing ADT. Secondary outcomes include changes in SED, MVPA, light intensity PA, and quality of life.MethodsForty-six PCS were recruited from two cancer centres in Toronto, Ontario, Canada between July 2015–October 2016. PCS were given an activity tracker (Jawbone), access to the RiseTx website program, and provided with a goal of increasing walking by 3000 daily steps above baseline levels over a 12-week period. A range of support tools were progressively released to reduce SED time (e.g., self-monitoring of steps) during the five-phase program. Objective measures of SED, MVPA, and daily steps were compared across the 12-week intervention using linear mixed models.ResultsOf the 46 PCS enrolled in the study, 42 completed the SED intervention, representing a 9% attrition rate. Measurement completion rates were 97 and 65% at immediately post-intervention and 12-week follow-up for all measures, respectively. Overall adherence was 64% for total number of logins (i.e., > 3 visits each week). Sample mean age was 73.2 ± 7.3 years, mean BMI was 28.0 ± 3.0 kg/m2, mean number of months since diagnosis was 93.6 ± 71.2, and 72% had ADT administered continuously. Significant reductions of 455.4 weekly minutes of SED time were observed at post-intervention (p = .005). Significant increases of + 44.1 for weekly minutes of MVPA was observed at immediately post-intervention (p = .010). There were significant increases in step counts of + 1535 steps from baseline to post-intervention (p < .001).ConclusionsRiseTx was successful in reducing SED and increasing MVPA in PCS. PCS were satisfied with the intervention and its components. Additional strategies may be needed though for maintenance of behavior change. The next step for RiseTx is to replicate these findings in a larger, randomized controlled trial that will have the potential for reducing sedentary time among PCS.Trial registrationNCT03321149 (ClinicalTrials.gov Identifier).

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

“…Despite the growing body of evidence relating to the health risks associated with sedentary behavior, only a handful of trials have attempted to reduce sitting time in cancer survivors . Trinh et al demonstrated that a web‐based intervention, combined with use of a Jawbone wearable device, reduced sedentary behavior in prostate cancer survivors receiving androgen deprivation therapy. This pilot trial (n = 46) resulted in a 455 min/wk reduction in postintervention sedentary behavior.…”

Effects of the ACTIVity And TEchnology (ACTIVATE) intervention on health‐related quality of life and fatigue outcomes in breast cancer survivors

“…Few randomized controlled trials examining distance‐based approaches to promoting physical activity in cancer survivors have used wearable activity trackers . Only a few studies testing wearables have reported patient reported outcomes such as HRQoL and fatigue . For example, in one randomized trial of African American breast cancer survivors (N = 35), survivors were randomized to either a FitBit device combined with access to a web‐based health platform (SparkPeople) group, or a waitlist control group.…”

“…At both 3 and 6 months, no differences in QoL were observed between the groups (using the Quality of Life in Adult Cancer Survivors Scale). In another trial, 46 prostate cancer survivors received a Jawbone UP 24 activity tracker . No statistically significant effects on HRQoL (using the FACT scales) were observed at either 12‐ or 24‐week follow‐up.…”

Evaluating a web- and telephone-based personalised exercise intervention for individuals living with metastatic prostate cancer (ExerciseGuide): protocol for a pilot randomised controlled trial

“…Reviews of digital health interventions for behaviour change suggest that some level of human support is important for e cacy (27,28). E-Health interventions utilizing some of these techniques to support prostate, colorectal, breast, and leukemia cancer populations have already been trialed with good effects in terms of improved physical activity levels and reduced sedentary behaviour (24,(29)(30)(31)(32).…”