Coughlin Steven S, Besenyi Gina M, Bowen Deborah, De Leo Gianluca
Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA, USA.
Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA.
Mhealth. 2017 Feb 15;3:5. doi: 10.21037/mhealth.2017.02.02. eCollection 2017.
In the U.S., breast cancer accounts for more cancer deaths in women than any site other than lung cancer. Based upon attributable risks, about 30-35% of breast cancers could potentially be prevented by addressing obesity, physical inactivity, increased alcohol consumption, and carcinogenic exposures such as hormone replacement therapy (HRT). We need methods of reducing women's risks of this disease that are attractive and easy to use, widely accessible to diverse women, and able to be easily amended to account for new research.
The overall objective of this 12-month project is to develop and test a smartphone app to provide women with information about how they can reduce their risk of breast cancer through healthy behaviors such as physical activity, weight management, restricting caloric intake, consuming a healthy diet and proper nutrition, engaging in regular physical activity, and avoiding carcinogenic exposures such as HRT and alcohol. The specific aims are: (I) to develop a smartphone app for breast cancer prevention using a behavioral framework; (II) to ensure interconnectivity with commercially available products (Fitbit device for monitoring physical activity and the LoseIt! smartphone app for monitoring and tracking diet and nutrition); and (III) to ensure that the mHealth intervention is suitable for women with varying levels of health literacy and eHealth literacy.
The app, referred to as Physical activity and Your Nutrition for Cancer (PYNC), is being coded on an iOS platform. Users will be able to access the breast cancer prevention app using their smartphone or tablet. The app's design will ensure interconnectivity with commercially available products for monitoring and tracking physical activity, caloric intake, diet and nutrition. Using the app, it will be feasible for users to connect and sync their Fitbit and LoseIt! accounts so that information collected about physical activity, caloric intake, diet, and nutrition can be conveniently assessed from one portal. The Fitbit device and app provides reminders and allows users to set physical activity goals. Users will be able to access health education information about breast cancer risk-reduction with attractive graphics and visual displays.
Future directions will include testing the efficacy of the mHealth intervention in increasing physical activity, improving diet and nutrition, and weight management through a randomized controlled trial, and widespread dissemination and implementation research.
在美国，乳腺癌导致女性癌症死亡的人数超过除肺癌以外的任何其他部位。根据可归因风险，通过解决肥胖、缺乏体育锻炼、饮酒量增加以及激素替代疗法（HRT）等致癌暴露因素，约30% - 35%的乳腺癌有可能得到预防。我们需要一些方法来降低女性患这种疾病的风险，这些方法要有吸引力且易于使用，能被不同的女性广泛获取，并且能够根据新的研究轻松修改。
这个为期12个月的项目的总体目标是开发并测试一款智能手机应用程序，为女性提供有关如何通过健康行为降低乳腺癌风险的信息，这些健康行为包括体育活动、体重管理、限制热量摄入、保持健康饮食和适当营养、定期进行体育锻炼以及避免致癌暴露，如激素替代疗法和饮酒。具体目标如下：（I）使用行为框架开发一款用于预防乳腺癌的智能手机应用程序；（II）确保与市售产品（用于监测体育活动的Fitbit设备以及用于监测和跟踪饮食与营养的LoseIt!智能手机应用程序）实现互联互通；（III）确保移动健康干预措施适用于健康素养和电子健康素养水平各异的女性。
这款应用程序名为“体育活动与癌症营养（PYNC）”，正在iOS平台上进行编码。用户将能够使用智能手机或平板电脑访问这款乳腺癌预防应用程序。该应用程序的设计将确保与市售的用于监测和跟踪体育活动、热量摄入、饮食和营养的产品实现互联互通。通过使用该应用程序，用户连接并同步他们的Fitbit和LoseIt!账户将是可行的，这样从一个门户就能方便地评估收集到的有关体育活动、热量摄入、饮食和营养的信息。Fitbit设备和应用程序会提供提醒，并允许用户设定体育活动目标。用户将能够通过吸引人的图形和视觉展示获取有关降低乳腺癌风险的健康教育信息。
未来的方向将包括通过随机对照试验测试移动健康干预措施在增加体育活动、改善饮食和营养以及体重管理方面的效果，以及广泛传播和实施研究。
