Forbes Cynthia C, Blanchard Chris M, Mummery W Kerry, Courneya Kerry S
University of Alberta, Edmonton, AB, Canada.
Dalhousie University, Halifax, NS, Canada.
JMIR Cancer. 2015 Nov 23;1(2):e12. doi: 10.2196/cancer.4586.
Physical activity (PA) behavior change interventions among cancer survivors have used face-to-face, telephone, email, and print-based methods. However, computer-tailored, Internet-delivered programs may be a more viable option to achieve PA behavior change.
The objective of this study is to test the feasibility and preliminary efficacy of a Web-based PA behavior change program among cancer survivors.
Nova Scotian cancer survivors (N=415) who previously expressed interest in a research study were approached. Interested participants were asked to complete an online assessment of PA and quality of life (QOL) before being randomized to either a theory-based PA behavior change program using the PA tracking website UWALK (UCAN; n=48) or usual care (UC; n=47). After the intervention (9 weeks), participants completed another online assessment of PA and QOL as well as measures to evaluate the program and website. Descriptive analyses from surveys and Web analytic software were used to assess feasibility and mean change scores were used to test efficacy.
Of all contacted survivors, 95 (22.3%, 95/415) completed baseline measures and were randomized with 84 (88%, 84/95) completing the 9-week assessment. The behavior change program and website were rated highly on the satisfaction items. Average logins were 10.3 (1.1 per week) and 26.0% (111/432) of the weekly modules were completed. Most participants (71%, 29/41) indicated they were more aware of their daily PA levels and 68% (28/41) found the site easily navigable. Adjusted group differences in total exercise minutes favored the UCAN group by an increase of 42 minutes (95% CI -65 to 150; P=.44, d=0.17). Results were more pronounced, though still nonsignificant, among those not meeting guidelines at baseline where UCAN increased PA by 52 minutes compared to a decrease of 15 minutes in UC (adjusted between group difference=75, 95% CI -95 to 244; P=.38, d=0.27).
We found that Internet-delivery may be a feasible alternative to more costly methods to promote PA among Nova Scotian cancer survivors. Moreover, there was a trend toward increased PA among those in the UCAN group, especially among those who were not meeting PA guidelines at baseline. Future research should focus on recruiting inactive cancer survivors and engaging them in the website to determine the optimal potential of Web-based interventions for promoting PA in cancer survivors.
癌症幸存者的身体活动（PA）行为改变干预措施采用了面对面、电话、电子邮件和基于印刷品的方法。然而，计算机定制的、通过互联网提供的项目可能是实现PA行为改变的更可行选择。
本研究的目的是测试基于网络的PA行为改变项目在癌症幸存者中的可行性和初步疗效。
联系了之前表示有兴趣参与研究的新斯科舍省癌症幸存者（N = 415）。感兴趣的参与者在被随机分配到使用PA追踪网站UWALK的基于理论的PA行为改变项目（UCAN；n = 48）或常规护理（UC；n = 47）之前，被要求完成PA和生活质量（QOL）的在线评估。干预（9周）后，参与者完成了PA和QOL的另一项在线评估以及评估该项目和网站的措施。使用来自调查和网络分析软件的描述性分析来评估可行性，并使用平均变化分数来测试疗效。
在所有被联系的幸存者中，95人（22.3%，95/415）完成了基线测量并被随机分组，其中84人（88%，84/95）完成了9周的评估。行为改变项目和网站在满意度项目上获得了高度评价。平均登录次数为10.3次（每周1.1次），每周模块的完成率为26.0%（111/432）。大多数参与者（71%，29/41）表示他们更了解自己的日常PA水平，68%（28/41）的人认为该网站易于导航。调整后的总运动分钟数的组间差异有利于UCAN组，增加了42分钟（95%CI -65至150；P = 0.44，d = 0.17）。在基线时未达到指南的人群中，结果更为明显，尽管仍无统计学意义，其中UCAN组的PA增加了52分钟，而UC组减少了15分钟（调整后的组间差异 = 75，95%CI -95至244；P = 0.38，d = 0.27）。
我们发现，对于新斯科舍省的癌症幸存者，通过互联网提供服务可能是一种比成本更高的方法更可行的促进PA的替代方案。此外，UCAN组的PA有增加的趋势，尤其是在基线时未达到PA指南的人群中。未来的研究应侧重于招募不活跃的癌症幸存者并让他们参与该网站，以确定基于网络的干预措施在促进癌症幸存者PA方面的最佳潜力。
