Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, United States of America.
Department of Statistics, Dana-Farber Cancer Institute, United States of America.
Gynecol Oncol. 2021 May;161(2):581-586. doi: 10.1016/j.ygyno.2021.02.023. Epub 2021 Feb 23.
Physical activity improves physical function, quality of life, and mental health, yet fewer than 80% of ovarian cancer survivors meet activity guidelines. This pilot intervention study aimed to increase physical activity in ovarian cancer survivors by leveraging principles of behavioral economics, gamification, and social support.
This 24-week study (12-week intervention; 12-week follow-up) enrolled women with ovarian cancer after completion of first-line treatment with a self-selected "teammate." Participants used Fitbits to measure daily steps, select an increased step goal, and enroll in a collaborative game, including points and levels for achieving step goals. Primary outcomes were feasibility (defined a priori as ≥60% approach-to-consent ratio and ≥ 70% adherence to Fitbit), acceptability (≤20% of participants reporting burden or regret for participation) and preliminary efficacy (≥70% reporting increased motivation); exploratory outcomes included change in steps.
We recruited 24 participants (mean age = 63 years, range = 37-79 years) with a 94% approach-to-consent ratio. All participants completed the intervention with 94% tracker adherence. At 24-week follow-up, 1/24 (≤5%) of participants reported burden; 0/24 (0%) reported regret for study participation; and 22/24 (>90%) agreed/strongly agreed that "the study motivated me to increase activity levels." Participants' mean daily steps were 6210.7 (±3328.1) at baseline and increased to 7643 (± 3610.9) steps (p < 0.001) during the 12-week intervention.
This pilot study demonstrated feasibility, acceptability, and preliminary efficacy, justifying a larger randomized clinical trial to test efficacy at increasing activity levels. Future studies should examine strategies for maintaining increased activity levels in survivors over time.
体育活动可改善身体机能、生活质量和心理健康,但不足 80%的卵巢癌幸存者符合活动指南的要求。本试验性干预研究旨在利用行为经济学、游戏化和社会支持的原理来增加卵巢癌幸存者的体育活动量。
本 24 周研究(12 周干预期;12 周随访期)招募了一线治疗完成后、自选“队友”的卵巢癌女性患者。参与者使用 Fitbit 测量日常步数、选择增加的目标步数,并参与合作游戏,包括实现目标步数的积分和等级。主要结局是可行性(预先定义为达到意向比例≥60%,且 Fitbit 依从性≥70%)、可接受性(≤20%的参与者报告参与负担或后悔)和初步疗效(≥70%报告增加动力);探索性结局包括步数变化。
我们招募了 24 名参与者(平均年龄 63 岁,范围 37-79 岁),意向比例为 94%。所有参与者均完成了干预,追踪器依从率为 94%。在 24 周随访时,1/24(≤5%)的参与者报告有负担;0/24(0%)的参与者报告对研究参与后悔;22/24(>90%)的参与者同意/强烈同意“该研究激励我增加活动水平”。参与者的平均每日步数在基线时为 6210.7(±3328.1),在 12 周干预期间增加到 7643(±3610.9)步(p<0.001)。
本试验研究证明了可行性、可接受性和初步疗效,有理由进行更大规模的随机临床试验来测试提高活动水平的疗效。未来的研究应探讨长期维持幸存者增加活动水平的策略。