Research Department of Behavioural Science & Health, University College London, London, United Kingdom.
Institute of Health Informatics, University College London, London, United Kingdom.
JMIR Mhealth Uhealth. 2019 Jan 4;7(1):e10918. doi: 10.2196/10918.
Physical activity (PA) can improve a range of outcomes following a cancer diagnosis. These include an improvement in experience of side effects of treatment (eg, fatigue) and management of comorbid conditions. PA might also increase survival and reduce recurrence. Digital interventions have shown potential for PA promotion among cancer survivors, but most in a previous review were Web-based, and few studies used mobile apps. There are many PA apps available for general public use, but it is unclear whether these are suitable as a PA intervention after a cancer diagnosis.
This study sought posttreatment nonmetastatic breast, prostate, and colorectal cancer survivors' opinions of using smartphone apps to promote PA and gathered their views on existing publicly available PA apps to inform a future intervention.
Each participant was randomly assigned to download 2 of 4 apps (Human, The Walk, The Johnson & Johnson Official 7 Minute Workout, and Gorilla Workout). Participants used each app for 1 week consecutively. In-depth semistructured telephone interviews were then conducted to understand participants' experiences of using the apps and how app-based PA interventions could be developed for cancer survivors. The interviews were analyzed using thematic analysis.
Thirty-two participants took part: 50% (16/32) had prostate cancer, 25% (8/32) had breast cancer, and 25% (8/32) had colorectal cancer. Three core themes were identified. The first theme was that multiple factors affect engagement with PA apps and this is highly personalized. Factors affecting engagement included participants' perceptions of (1) the advantages and disadvantages of using apps to support PA, (2) the relevance of the app to the user (eg, in terms of cancer-related factors, their PA goals, the difficulty level of the app, the way in which they interact with their mobile phone, and the extent to which the app fits with their self-identity), (3) the quality of the app (eg, usability, accuracy, quality of production, and scientific evidence-base), and (4) the behavior change techniques used to promote PA. In the second theme, participants recommended that apps that promote walking are most appealing, as walking removes many barriers to PA. Finally, the participants suggested that PA apps should be integrated into cancer care, as they valued guidance and recommendations from health care professionals.
This sample of breast, prostate, and colorectal cancer survivors was receptive to the use of apps to promote PA. Although no publicly available PA app was deemed wholly suitable, many suggestions for adaptation and intervention development were provided. The results can inform the development of an app-based PA intervention for cancer survivors. They also highlight the wide-ranging and dynamic influences on engagement with digital interventions, which can be applied to other evaluations of mobile health products in other health conditions and other health behaviors.
身体活动（PA）可以改善癌症诊断后的一系列结果。其中包括改善治疗副作用的体验（例如疲劳）和管理合并症。PA 还可能提高生存率并降低复发率。数字干预措施已显示出在癌症幸存者中促进 PA 的潜力，但之前的大多数综述都是基于网络的，很少有研究使用移动应用程序。有许多适用于普通大众的 PA 应用程序，但尚不清楚这些应用程序是否适合作为癌症诊断后的 PA 干预措施。
本研究旨在了解非转移性乳腺癌、前列腺癌和结直肠癌治疗后幸存者使用智能手机应用程序促进 PA 的意见，并收集他们对现有公开可用的 PA 应用程序的看法，以为未来的干预措施提供信息。
每位参与者被随机分配下载 4 个应用程序中的 2 个（Human、The Walk、The Johnson & Johnson Official 7 Minute Workout 和 Gorilla Workout）。参与者连续使用每个应用程序一周。然后进行深入的半结构化电话访谈，以了解参与者使用应用程序的经验以及如何为癌症幸存者开发基于应用程序的 PA 干预措施。使用主题分析对访谈进行分析。
共有 32 名参与者参加：50%（16/32）患有前列腺癌，25%（8/32）患有乳腺癌，25%（8/32）患有结直肠癌。确定了三个核心主题。第一个主题是，多种因素会影响对 PA 应用程序的参与度，而且这种参与度具有高度个性化。影响参与度的因素包括参与者对（1）使用应用程序支持 PA 的优缺点的看法，（2）应用程序对用户的相关性（例如，就与癌症相关的因素、他们的 PA 目标、应用程序的难度水平、他们与移动电话的交互方式以及应用程序与他们的自我身份的契合程度而言），（3）应用程序的质量（例如，可用性、准确性、制作质量和科学证据基础），以及（4）用于促进 PA 的行为改变技术。在第二个主题中，参与者建议最吸引人的是促进步行的应用程序，因为步行消除了 PA 的许多障碍。最后，参与者建议将 PA 应用程序纳入癌症护理中，因为他们重视来自医疗保健专业人员的指导和建议。
本研究中，乳腺癌、前列腺癌和结直肠癌幸存者愿意使用应用程序来促进 PA。尽管没有完全适合的公共可用 PA 应用程序，但提供了许多适应和干预措施开发的建议。结果可以为癌症幸存者的基于应用程序的 PA 干预措施的开发提供信息。它们还强调了对数字干预措施的广泛和动态影响，这可应用于其他健康状况和其他健康行为的移动健康产品的评估中。
