Nursing Department, First Affiliated Hospital, Xiamen University, Xiamen, China.
Department of Nursing, School of Medicine, Xiamen University, Xiamen, China.
JMIR Mhealth Uhealth. 2020 Sep 16;8(9):e18896. doi: 10.2196/18896.
Many app-based interventions targeting women with breast cancer have been developed and tested for effectiveness. However, information regarding the evaluation of the usage of these interventions is scarce. A better understanding of usage data is important to determine how women use apps and how these interventions affect health outcomes.
This study aimed to examine the usage duration and login frequency of an app-based intervention, the Breast Cancer e-Support (BCS) program, and to investigate the association between usage data and participants' demographic and medical characteristics.
This study is a secondary data analysis of a randomized controlled trial assessing the effectiveness of the BCS program. The BCS program contains four modules: Learning Forum, Discussion Forum, Ask-the-Expert Forum, and Your Story Forum. A total of 57 women in the intervention group accessed the BCS program during their 12-week chemotherapy. The app's background system tracked the usage duration and login frequency for each forum and the entire BCS program.
The total usage duration per participant ranged from 0 to 9371 minutes, and the login frequency per participant ranged from 0 to 774 times. The Discussion Forum and the Learning Forum were the most frequently used modules. The general linear model showed that age, education, family monthly income, and employment were associated with BCS usage duration and/or login frequency. Age (F=10.09, P=.003, B=115.34, 95% CI 42.22-188.47) and education level (F=7.22, P=.01, B=1949.63, 95% CI 487.76-3411.50) were positively associated with the usage duration of the entire BCS program. Family monthly income was positively associated with the usage duration of the Learning Forum (F=11.85, P=.001, B=1488.55, 95% CI 617.58-2359.51) and the login frequency of the entire BCS program (F=4.47, P=.04, B=113.68, 95% CI 5.33-222.03). Employment was negatively associated with the usage duration of the Ask-the-expert Forum (F=4.50, P=.04, B=-971.87, 95% CI -1894.66 to -49.07) and the Your Story Forum (F=5.36, P=.03, B=-640.71, 95% CI -1198.30 to -83.11) and positively associated with the login frequency of the entire BCS program (F=10.86, P=.002, B=192.88, 95% CI 75.01-310.74). No statistical differences were found between BCS usage data and cancer stage, BMI, comorbidity, types of surgery, or cycles of chemotherapy.
Overall, this study found considerable variability in the usage of app-based interventions. When health care professionals incorporate app-based interventions into their routine care for women with breast cancer, the learning and discussion functions of apps should be strengthened to promote engagement. Additionally, characteristics of women with breast cancer, such as age, level of education, income, and employment status, should be taken in consideration to develop tailored apps that address their particular needs and therefore improve their engagement with the app.
Australian New Zealand Clinical Trials Registry ACTRN12616000639426; http://www.ANZCTR.org.au/ACTRN12616000639426.aspx.
许多针对乳腺癌女性的基于应用程序的干预措施已经开发并测试了其有效性。然而，关于这些干预措施使用情况的信息却很少。更好地了解使用数据对于确定女性如何使用应用程序以及这些干预措施如何影响健康结果非常重要。
本研究旨在检查基于应用程序的干预措施——乳腺癌电子支持（BCS）计划的使用时长和登录频率，并研究使用数据与参与者的人口统计学和医学特征之间的关联。
本研究是对 BCS 计划有效性的随机对照试验的二次数据分析。BCS 计划包含四个模块：学习论坛、讨论论坛、专家咨询论坛和你的故事论坛。在为期 12 周的化疗期间，干预组的 57 名女性中有 57 名访问了 BCS 计划。应用程序的后台系统跟踪了每个论坛和整个 BCS 计划的使用时长和登录频率。
每位参与者的总使用时长范围为 0 到 9371 分钟，每位参与者的登录频率范围为 0 到 774 次。讨论论坛和学习论坛是最常使用的模块。一般线性模型显示，年龄、教育程度、家庭月收入和就业状况与 BCS 使用时长和/或登录频率有关。年龄（F=10.09，P=.003，B=115.34，95%CI 42.22-188.47）和教育程度（F=7.22，P=.01，B=1949.63，95%CI 487.76-3411.50）与整个 BCS 计划的使用时长呈正相关。家庭月收入与学习论坛的使用时长（F=11.85，P=.001，B=1488.55，95%CI 617.58-2359.51）和整个 BCS 计划的登录频率（F=4.47，P=.04，B=113.68，95%CI 5.33-222.03）呈正相关。就业与专家咨询论坛（F=4.50，P=.04，B=-971.87，95%CI-1894.66 至-49.07）和你的故事论坛（F=5.36，P=.03，B=-640.71，95%CI-1198.30 至-83.11）的使用时长呈负相关，与整个 BCS 计划的登录频率呈正相关（F=10.86，P=.002，B=192.88，95%CI 75.01-310.74）。BCS 使用数据与癌症分期、BMI、合并症、手术类型或化疗周期之间没有统计学差异。
总的来说，本研究发现基于应用程序的干预措施的使用情况存在相当大的差异。当医疗保健专业人员将基于应用程序的干预措施纳入乳腺癌女性的常规护理中时，应加强应用程序的学习和讨论功能，以促进参与度。此外，乳腺癌女性的特征，如年龄、教育程度、收入和就业状况，应被考虑在内，以开发针对特定需求的定制应用程序，从而提高她们对应用程序的参与度。
澳大利亚新西兰临床试验注册 ACTRN12616000639426；http://www.ANZCTR.org.au/ACTRN12616000639426.aspx。
