JMIR Publications

Background:

Physical activity (PA), known as a modifiable protective factor, provides an approach to sustain physical and psycho-social health for breast cancer patients both during and after treatment. Mobile health (mHealth) application targeted promoting health behaviors demonstrates advantages in behavior tracking, knowledge sharing and social connecting and tailored intervention. However, process of mHealth application (app) development is lack of theoretical basis, restricting its sustainable benefits to cancer survivors.

Objective:

To construct a theory-based mHealth PA intervention program, and to determine whether this intervention would improve PA behavior change during chemotherapy for breast cancer patients, thus to capture their perspectives and experiences when participate it.

Methods:

Social cognitive theory (SCT), self-efficacy theory (SET) and the theory of planned behavior (TPB) were referred to construct mHealth intervention strategies. “Breast care” smartphone app based on above integrated theories was developed to improve self-management of breast cancer patients including PA. Guided by agile development model, the interface was formalized with five main pages covering 6 functions (information delivering, disease tracking, events reminding based on calendar, online interaction, health behavior recording and self-reported assessment). A three-month pre-post mHealth PA intervention was implemented. A mixed method was utilized to test the usability of this remotely intervening. Quantitative results from online records and self-reported questionnaires were collected to assess effectiveness of the mHealth PA intervention. Qualitative feedback through telephone interviewing was recorded to explore patients’ using experiences.

Results:

Twenty participants were recruited. Based on PA capability assessment and baseline PA evaluation, 12 patients were divided into active group, and 8 patients were grouped in sedentary lifestyle. Within three months, participants’ usage behavior identified at portal site indicated the accumulated app usage time was 40 minutes a week, and average login time of each participant was three times a week. The total PA increased 945.70 metabolic equivalents (MET) -min/w with a significant improvement (P=.04) after 3 months. Walking displayed a significant improvement after intervention (904.20 MET-min/w) (P=.03). In spite of none statistically significant difference, sedentary mean time exhibited a rather declining trend, being 112 mins/w (P=.49). Qualitative results showed satisfaction and willingness of breast cancer patients to use app to manage PA and relevant health behaviors.

Conclusions:

The theory-based mHealth PA intervention has great potential to enhance breast cancer patients’ PA awareness and engagement, meanwhile to facilitate their PA behavior change.

Clinicaltrial: