Puszkiewicz Patrycja, Roberts Anna L, Smith Lee, Wardle Jane, Fisher Abigail
Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, London, United Kingdom.
The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
JMIR Cancer. 2016 May 31;2(1):e7. doi: 10.2196/cancer.5380.
Regular participation in physical activity (PA) is associated with improved physical and psychosocial outcomes in cancer survivors. However, PA levels are low during and after cancer treatment. Interventions to promote PA in this population are needed. PA mobile apps are popular and have potential to increase PA participation, but little is known about how appropriate or relevant they are for cancer survivors.
This study aims to (1) assess recruitment, study uptake, and engagement for a publicly available PA mobile app (GAINFitness) intervention in cancer survivors; (2) assess cancer survivors' attitudes towards the app; (3) understand how the app could be adapted to better meet the needs of cancer survivors; and (4) to determine the potential for change in PA participation and psychosocial outcomes over a 6-week period of using the app.
The present study was a one-arm, pre-post design. Cancer survivors (N=11) aged 33 to 62 years with a mean (SD) age of 45 (9.4), and 82% (9/11) female, were recruited (via community/online convenience sampling to use the app for 6 weeks). Engagement with the app was measured using self-reported frequency and duration of usage. Qualitative semi-structured telephone interviews were conducted after the 6-week study period and were analyzed using thematic analysis. PA, well-being, fatigue, quality of life (QOL), sleep quality, and anxiety and depression were self-reported at baseline and at a 6-week follow-up using the Godin Leisure Time Exercise Questionnaire (GLTEQ), the Functional Assessment of Cancer Therapy-General (FACT-G), the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Questionnaire, the Health and Quality of Life Outcomes (EQ5D) Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS), respectively.
Of the people who responded to the study advertisement, 73% (16/22) agreed to participate and 100% (11/11) of the participants who started the study completed all baseline and follow-up outcome measures and the telephone interview. On average, participants used the app twice a week for 25 minutes per session. Four themes were identified from the qualitative interviews surrounding the suitability of the app for cancer survivors and how it could be adapted: (1) barriers to PA, (2) receiving advice about PA from reliable sources, (3) tailoring the application to one's lifestyle, and (4) receiving social support from others. Pre-post comparison showed significant increases in strenuous PA, improvements in sleep quality, and reductions in mild PA. There were no significant changes in moderate PA or other psychosocial outcomes.
All participants engaged with the app and qualitative interviews highlighted that the app was well-received. A generic PA mobile app could bring about positive improvements in PA participation and psychosocial outcomes among cancer survivors. However, a targeted PA app aimed specifically towards cancer survivors may increase the relevance and suitability of the app for this population.
定期参加体育活动（PA）与癌症幸存者身体和心理社会状况的改善相关。然而，在癌症治疗期间及之后，体育活动水平较低。需要采取干预措施来促进这一人群的体育活动。PA移动应用程序很受欢迎，有可能增加PA的参与度，但对于它们对癌症幸存者的适用性或相关性知之甚少。
本研究旨在（1）评估一款公开可用的PA移动应用程序（GAINFitness）干预措施在癌症幸存者中的招募情况、研究接受度和参与度；（2）评估癌症幸存者对该应用程序的态度；（3）了解该应用程序如何进行调整以更好地满足癌症幸存者的需求；（4）确定在使用该应用程序6周期间PA参与度和心理社会状况改变的可能性。
本研究采用单组前后设计。招募了年龄在33至62岁之间、平均（标准差）年龄为45（9.4）岁且82%（9/11）为女性的癌症幸存者（通过社区/在线便利抽样）使用该应用程序6周。使用自我报告的使用频率和时长来衡量对应用程序的参与度。在为期6周的研究期结束后进行了定性半结构化电话访谈，并使用主题分析法进行分析。在基线和6周随访时分别使用戈丁休闲时间运动问卷（GLTEQ）、癌症治疗功能评估通用版（FACT-G）、慢性病治疗功能评估（FACIT）-疲劳量表问卷、健康和生活质量结果（EQ5D）问卷、匹兹堡睡眠质量指数（PSQI）以及医院焦虑抑郁量表（HADS）自我报告PA、幸福感、疲劳、生活质量（QOL）、睡眠质量以及焦虑和抑郁情况。
在回复研究广告的人群中，73%（16/22）同意参与，开始研究的参与者中有100%（11/11）完成了所有基线和随访结果测量以及电话访谈。参与者平均每周使用该应用程序两次，每次使用25分钟。围绕该应用程序对癌症幸存者的适用性及其调整方式，从定性访谈中确定了四个主题：（1）PA的障碍；（2）从可靠来源获得有关PA的建议；（3）使应用程序适合个人生活方式；（4）获得他人的社会支持。前后比较显示剧烈PA显著增加、睡眠质量改善以及轻度PA减少。中度PA或其他心理社会状况没有显著变化。
所有参与者都参与了该应用程序，定性访谈突出表明该应用程序受到好评。一款通用的PA移动应用程序可以在癌症幸存者的PA参与度和心理社会状况方面带来积极改善。然而，一款专门针对癌症幸存者的有针对性的PA应用程序可能会增加该应用程序对这一人群的相关性和适用性。
