Short Camille E, Finlay Amy, Sanders Ilea, Maher Carol
School of Medicine, Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia.
Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia.
BMC Health Serv Res. 2018 Jan 16;18(1):27. doi: 10.1186/s12913-017-2818-7.
Participation in regular physical activity holds key benefits for cancer survivors, yet few cancer survivors meet physical activity recommendations. This study aimed to develop and pilot test a mHealth app referral service aimed at assisting cancer survivors to increase their physical activity. In particular, the study sought to examine feasibility and acceptability of the service and determine preliminary efficacy for physical activity behaviour change.
A systematic search identified potentially appropriate Apple (iOS) and Android mHealth apps. The apps were audited regarding the type of physical activity encouraged, evidence-based behavioural strategies and other characteristics, to help match apps to users' preferences and characteristics. A structured service was devised to deliver the apps and counselling, comprising two face-to-face appointments with a mid-week phone or email check-up. The mHealth app referral service was piloted using a pre-post design among 12 cancer survivors. Participants' feedback regarding the service's feasibility and acceptability was sought via purpose-designed questionnaire, and analysed using inductive thematic analysis and descriptive statistics. Change in physical activity was assessed using a valid and reliable self-report tool and analysed using paired t-tests. In line with recommendations for pilot studies, confidence intervals and effect sizes were reported to aid interpretation of clinical significance, with an alpha of 0.2 used to denote statistical significance.
Of 374 mHealth apps identified during the systematic search, 54 progressed to the audit (iOS = 27, Android = 27). The apps consistently scored well for aesthetics, engagement and functionality, and inconsistently for gamification, social and behaviour change features. Ten participants completed the pilot evaluation and provided positive feedback regarding the service's acceptability and feasibility. On average, participants increased their moderate-vigorous physical activity by 236 min per week (d = 0.73; 95% CI = -49 to 522; p = 0.09).
This study offered initial evidence that a mHealth app referral service for cancer survivors is feasible and acceptable and may increase physical activity levels. The large increase in physical activity is promising, but should be interpreted with caution given the small sample size and lack of control group. Further research is warranted on a larger scale to investigate generalisability, long-term compliance and application in clinical settings.
定期进行体育活动对癌症幸存者有诸多关键益处，但很少有癌症幸存者达到体育活动的建议标准。本研究旨在开发并试点测试一项移动健康（mHealth）应用程序推荐服务，旨在帮助癌症幸存者增加体育活动量。具体而言，该研究试图检验该服务的可行性和可接受性，并确定其对体育活动行为改变的初步效果。
通过系统检索确定了潜在合适的苹果（iOS）和安卓mHealth应用程序。对这些应用程序在鼓励的体育活动类型、基于证据的行为策略及其他特征方面进行审核，以帮助将应用程序与用户的偏好和特征相匹配。设计了一项结构化服务来提供应用程序和咨询，包括两次面对面预约以及在周中进行电话或电子邮件检查。采用前后测设计，在12名癌症幸存者中对mHealth应用程序推荐服务进行试点。通过专门设计的问卷征求参与者对该服务可行性和可接受性的反馈，并使用归纳主题分析和描述性统计进行分析。使用有效且可靠的自我报告工具评估体育活动的变化，并使用配对t检验进行分析。根据试点研究的建议，报告置信区间和效应大小以帮助解释临床意义，α值设定为0.2表示具有统计学意义。
在系统检索中确定的374个mHealth应用程序中，有54个进入审核阶段（iOS = 27个，安卓 = 27个）。这些应用程序在美观性、参与度和功能方面的得分一直较高，而在游戏化、社交和行为改变功能方面的得分则不一致。10名参与者完成了试点评估，并对该服务的可接受性和可行性给予了积极反馈。平均而言，参与者每周的中度至剧烈体育活动增加了236分钟（d = 0.73；95%置信区间 = -49至522；p = 0.09）。
本研究提供了初步证据，表明针对癌症幸存者的mHealth应用程序推荐服务是可行且可接受的，并且可能会提高体育活动水平。体育活动量的大幅增加很有前景，但鉴于样本量小且缺乏对照组，应谨慎解读。有必要进行更大规模的进一步研究，以调查其普遍性、长期依从性以及在临床环境中的应用情况。
