Increasing physical activity in cancer survivors using eHealth: A focus group study.

107 Background: Physical activity (PA) is beneficial in reducing disease and treatment related side‐effects of cancer. However, insufficient PA levels are common among cancer survivors. eHealth may offer an innovative delivery platform to support cancer survivors to increase PA. Few qualitative studies have explored the views of cancer survivors towards eHealth based PA interventions. Our aim was to use cancer survivors’ input to inform the design of a feasibility study of eHealth for PA promotion. Methods: A ten-item scoping questionnaire-based cross-sectional study was administered to 102 cancer survivors. It evaluated their knowledge of PA guidelines, their access to smartphones and interest in eHealth interventions designed to increase PA levels. Questions were refined and evaluated in a follow-up focus group study (7 groups, n=23). Focus groups were audio recorded and transcribed. Transcripts were coded using NVivo software and themes identified by thematic content analysis. Results: In the questionnaire study, only 17.6% (n=18) of participants correctly identified PA guidelines. Sixty-two (60.8%) participants reported having access to a smartphone. Interest in participating in an eHealth intervention was expressed by 56.9% of all participants (n=58) and by 75.8% (n=47) of those with access to a smartphone. Emergent themes from the focus groups included: the physical barriers to PA, the need for PA goals, the importance of both information from healthcare professionals about PA and of a support network (e.g. peer support), the need for technological support and a motivation to improve general health. Conclusions: Very few cancer survivors were aware of the correct PA guidelines. However, over half of our sample was interested in participating in an eHealth intervention for PA, demonstrating that the cancer survivor population is responsive to a PA program delivered using technology. The focus groups have given us insights about the key elements of an effective PA intervention for cancer survivors using eHealth. We are conducting a feasibility study (The IMPETUS study; NCT03036436) of an eHealth intervention targeting PA in cancer survivors; its design was informed by those insights.

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What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study

BMC Geriatrics ◽

10.1186/s12877-021-02692-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lisa Happe ◽

Andreas Hein ◽

Rebecca Diekmann

Keyword(s):

Physical Activity ◽

Focus Group ◽

Focus Groups ◽

Physical Activity Behaviour ◽

Geriatric Rehabilitation ◽

International Studies ◽

Focus Group Study ◽

Positive Effects ◽

Nutrition And Physical Activity ◽

Activity Behaviour

Abstract Background During geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant. Method Focus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis. Results Three focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements. Conclusion Experts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.

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Perceptions of eHealth-Enabled Physical Activity Interventions Among Cancer Survivors: Mixed Methods Study

JMIR Cancer ◽

10.2196/16469 ◽

2020 ◽

Vol 6 (1) ◽

pp. e16469

Author(s):

Ciaran Haberlin ◽

Dearbhaile M O' Donnell ◽

Jonathan Moran ◽

Julie Broderick

Keyword(s):

Physical Activity ◽

Focus Group ◽

Cancer Survivors ◽

Technical Specification ◽

Health Impact ◽

Human Interaction ◽

Cancer Center ◽

Focus Group Study ◽

High Level ◽

Motivating Factor

Background Achieving adequate levels of physical activity (PA) is especially important for cancer survivors to mitigate the side effects of cancer and its treatment as well as for other health benefits. Electronic health (eHealth)-based PA interventions may offer feasible alternatives to traditionally delivered programs and optimize physical recovery after a cancer diagnosis, but perspectives of cancer survivors on this new delivery medium have not been extensively explored. Objective The overall aim was to explore participants’ perspectives of eHealth-enabled PA interventions to inform the design of a future intervention among cancer survivors. Methods The study took place in a designated cancer center in Dublin, Ireland. A preceding questionnaire-based study was conducted primarily to establish interest in participating in subsequent eHealth-based studies. A follow-on focus group study was conducted to explore the concept of eHealth-based PA interventions for cancer survivors. The data were analyzed using thematic analysis. Results The questionnaire-based study (N=102) indicated that participants had a high level of interest in participating in follow-on eHealth-based studies. The focus group study (n=23) indicated that, despite some trepidation, overall positivity was expressed by participants toward the concept of eHealth-based PA interventions. Four themes were generated: (1) Health impact, including PA as a barrier and as a motivating factor, (2) Education needs, which emphasized the need for integrated information about PA and to increase technical literacy, (3) Goal setting, which should be integrated within the technical specification as a motivating factor, and (4) Support needs, as well as the importance of personalized human interaction, in tandem with technology. Conclusions Qualitative research at the pretrial phase adds value to the design of a complex intervention and is especially useful in an area such as eHealth. The findings highlighted an interest in participating in eHealth-focused research as well as barriers, training needs, and key design features that can be applied to optimize the design of future eHealth-based PA interventions in cancer.

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A focus group study exploring gynecological cancer survivors’ experiences and perceptions of participating in a RCT testing the efficacy of a home-based physical activity intervention

Supportive Care in Cancer ◽

10.1007/s00520-012-1716-0 ◽

2013 ◽

Vol 21 (6) ◽

pp. 1697-1708 ◽

Cited By ~ 9

Author(s):

C. M. Donnelly ◽

A. Lowe-Strong ◽

J. P. Rankin ◽

A. Campbell ◽

J. M. Blaney ◽

...

Keyword(s):

Physical Activity ◽

Focus Group ◽

Cancer Survivors ◽

Physical Activity Intervention ◽

Gynecological Cancer ◽

Focus Group Study ◽

Home Based ◽

Gynecological Cancer Survivors

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Perceptions of eHealth-Enabled Physical Activity Interventions Among Cancer Survivors: Mixed Methods Study (Preprint)

10.2196/preprints.16469 ◽

2019 ◽

Author(s):

Ciaran Haberlin ◽

Dearbhaile M O' Donnell ◽

Jonathan Moran ◽

Julie Broderick

Keyword(s):

Physical Activity ◽

Focus Group ◽

Cancer Survivors ◽

Technical Specification ◽

Health Impact ◽

Human Interaction ◽

Cancer Center ◽

Focus Group Study ◽

High Level ◽

Motivating Factor

BACKGROUND Achieving adequate levels of physical activity (PA) is especially important for cancer survivors to mitigate the side effects of cancer and its treatment as well as for other health benefits. Electronic health (eHealth)-based PA interventions may offer feasible alternatives to traditionally delivered programs and optimize physical recovery after a cancer diagnosis, but perspectives of cancer survivors on this new delivery medium have not been extensively explored. OBJECTIVE The overall aim was to explore participants’ perspectives of eHealth-enabled PA interventions to inform the design of a future intervention among cancer survivors. METHODS The study took place in a designated cancer center in Dublin, Ireland. A preceding questionnaire-based study was conducted primarily to establish interest in participating in subsequent eHealth-based studies. A follow-on focus group study was conducted to explore the concept of eHealth-based PA interventions for cancer survivors. The data were analyzed using thematic analysis. RESULTS The questionnaire-based study (N=102) indicated that participants had a high level of interest in participating in follow-on eHealth-based studies. The focus group study (n=23) indicated that, despite some trepidation, overall positivity was expressed by participants toward the concept of eHealth-based PA interventions. Four themes were generated: (1) Health impact, including PA as a barrier and as a motivating factor, (2) Education needs, which emphasized the need for integrated information about PA and to increase technical literacy, (3) Goal setting, which should be integrated within the technical specification as a motivating factor, and (4) Support needs, as well as the importance of personalized human interaction, in tandem with technology. CONCLUSIONS Qualitative research at the pretrial phase adds value to the design of a complex intervention and is especially useful in an area such as eHealth. The findings highlighted an interest in participating in eHealth-focused research as well as barriers, training needs, and key design features that can be applied to optimize the design of future eHealth-based PA interventions in cancer.

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Development of a hybrid sleep and physical activity improvement intervention for adults with osteoarthritis-related pain and sleep disturbance: a focus group study with potential users

British Journal of Pain ◽

10.1177/20494637211026049 ◽

2021 ◽

pp. 204946372110260

Author(s):

Daniel Whibley ◽

Kevin Stelfox ◽

Alasdair L Henry ◽

Nicole KY Tang ◽

Anna L Kratz

Keyword(s):

Physical Activity ◽

Pain Management ◽

Focus Groups ◽

Thematic Analysis ◽

Sleep Disturbances ◽

Physical Activity Intervention ◽

Focus Group Study ◽

Intervention Component ◽

Beneficial Impact ◽

Improvement Intervention

Objective: Suboptimal sleep and physical activity are common among people living with osteoarthritis (OA) and simultaneous improvements in both may have a beneficial impact on pain. This study aimed to gather perspectives of people living with OA on important aspects to incorporate in a hybrid sleep and physical activity improvement intervention for OA pain management. Design: Qualitative study using two rounds of two focus groups. Setting and participants: Focus groups were conducted with adults living with OA-related chronic pain and sleep disturbances. Eighteen people attended focus groups in January 2020 and, of these, 16 attended subsequent focus groups in February 2020. Methods: Discussion at the first round of focus groups informed generation of prototype intervention materials that were shared, discussed and refined at the second round of focus groups. Thematic analysis was used to identify themes and sub-themes from the data. Results: Three themes, each with three sub-themes, were identified: facilitators of engagement with the intervention (sub-themes: motivational language, accountability and education); barriers to engagement (sub-themes: suboptimal interaction with healthcare practitioners, recording behaviour as burdensome/disruptive and uncertainty about technique) and characteristics of a physical activity intervention component (sub-themes: tailored, sustainable and supported). Conclusion: We have identified important aspects to incorporate into the design and delivery of a hybrid sleep and physical activity improvement intervention for OA pain management. Insights will be incorporated into intervention materials and protocols, with feasibility and acceptability assessed in a future study.

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Cancer-related psychosocial factors and self-reported changes in lifestyle among gynecological cancer survivors: cross-sectional analysis of PROFILES registry data

Supportive Care in Cancer ◽

10.1007/s00520-021-06433-0 ◽

2021 ◽

Author(s):

Karin A. J. Driessen ◽

Belle H. de Rooij ◽

M. Caroline Vos ◽

Dorry Boll ◽

Johanna M. A. Pijnenborg ◽

...

Keyword(s):

Physical Activity ◽

Cancer Survivors ◽

Psychosocial Factors ◽

Initial Treatment ◽

Gynecological Cancer ◽

Gastrointestinal Symptoms ◽

Cross Sectional ◽

Body Change ◽

Change Concerns ◽

Gynecological Cancer Survivors

Abstract Purpose Obesity is prevalent in gynecological cancer survivors and is associated with impaired health outcomes. Concerns due to cancer and its treatment may impact changes in lifestyle after cancer. This study aimed to assess the association between cancer-related psychosocial factors and changes in physical activity and diet, 18 months after initial treatment among gynecological cancer survivors. Methods Cross-sectional data from the ROGY Care study were used, including endometrial and ovarian cancer patients treated with curative intent. The Impact of Cancer Scale (IOCv2) was used to assess cancer-related psychosocial factors. Self-reported changes in nutrients/food groups and in physical activity post-diagnosis were classified into change groups (less/equal/more). Multivariable logistic regression models were used to assess associations. Results Data from 229 cancer survivors (59% endometrial, 41% ovarian, mean age 66 ± 9.5, 70% tumor stage I) were analyzed. In total, 20% reported to eat healthier from diagnosis up to 18 months after initial treatment, 17% reported less physical activity and 20% more physical activity. Health awareness (OR 2.79, 95% CI: 1.38; 5.65), body change concerns (OR 3.04 95% CI: 1.71; 5.39), life interferences (OR 4.88 95% 2.29; 10.38) and worry (OR 2.62, 95% CI: 1.42; 4.85) were significantly associated with less physical activity up to 18 months after initial treatment whereby gastrointestinal symptoms were an important confounder. Conclusion(s) This study underlines the need to raise awareness of the benefits of a healthy lifestyle and to provide tailored lifestyle advice, taking into account survivors’ health awareness, body change concerns, life interferences, worry and gastrointestinal symptoms, in order to improve health behavior among gynecological cancer survivors. Trial Registration http://clinicaltrials.gov Identifier: NCT01185626, August 20, 2010

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Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽

10.1136/bmjopen-2021-049829 ◽

2021 ◽

Vol 11 (8) ◽

pp. e049829

Author(s):

Elizabeth Tyler ◽

Fiona Lobban ◽

Rita Long ◽

Steven H Jones

Keyword(s):

Older Adults ◽

Bipolar Disorder ◽

Focus Group ◽

Older People ◽

Focus Groups ◽

Later Life ◽

Focus Group Study ◽

Age Related ◽

Health Related ◽

Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

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Iterative development of a multiple technology-based physical activity intervention for Latina adolescents: The Chicas Fuertes Study (Preprint)

10.2196/preprints.26195 ◽

2020 ◽

Author(s):

Britta Larsen ◽

Emily D. Greenstadt ◽

Brittany L. Olesen ◽

Bess H. Marcus ◽

Job Godino ◽

...

Keyword(s):

Physical Activity ◽

Social Media ◽

Focus Group ◽

Focus Groups ◽

Text Messaging ◽

Physical Activity Intervention ◽

Target Population ◽

Text Messages ◽

Study Objective ◽

Latina Adolescents

BACKGROUND Adolescent girls report the lowest levels of physical activity (PA) of any demographic group, with rates especially low for racial/ethnic minority girls. Only 3% of Latina teens meet national PA guidelines, and these habits appear to persist into adulthood. Developing effective interventions to increase PA in Latina teens is necessary for preventing disease and reducing disparities. OBJECTIVE The study objective was to develop a mHealth PA intervention for Latina adolescents using a multi-stage iterative process based on an adaptation of the IDEAS (Integrate, DEsign, Assess, Share) framework. METHODS Development of the intervention was accomplished through three iterations: 1) feedback from a previous web-based pilot study, Niñas Saludables; 2) conducting focus groups with the target population; and, 3) vetting the final materials with a youth advisory board (YAB) comprising Latina adolescents. Based on feedback from participants in the Niñas Saludables study, plans to improve the intervention included incorporating visual social media posts and text messaging, adding a commercial wearable tracker, and revising the existing website to be primarily visual; proposed procedures and material were then refined through focus groups. Participants for focus groups (N=50) were girls age 13-18 who could speak and read in English who were recruited from local high schools and after school programs serving a high proportion of Latinos. Facilitated discussions focused on experience with PA and social media apps, and specific feedback on intervention material prototypes and possible names and logos. Materials were refined based on their feedback, then were beta tested by the YAB. YAB members (N=4) were Latinas age 13-18 who were not regularly active and were recruited via word of mouth and selected through an application process. RESULTS The focus group discussions yielded the following findings: PA preferences included walking, running and group fitness classes, while the least popular activities were running, swimming, and biking. Most participants used some form of social media, with Instagram being the most favored. Participants preferred text messages be sent no more than once a day, be personalized, and be positively worded. Focus group participants preferred an intervention directly targeting Latinas, and social media posts that were brightly colored, included girls of all body types, and provided specific tips and information. Modified intervention materials were generally perceived favorably by the YAB members, who provided suggestions for further refinements including incorporation of some Spanish phrases. CONCLUSIONS Latina teens were generally enthusiastic about an mHealth PA intervention, provided the materials were targeted specifically to them and their preferences. Through multiple iterations of development and feedback with the target population, we gained insight into the needs of Latina teens and joined with industry partners to build a viable final product.

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