scholarly journals Web-based Lifestyle Interventions for Cancer Survivors: Usability and Associations with Participant Characteristics and Behavior Change (Preprint)

10.2196/30974 ◽  
2021 ◽  
Author(s):  
Victoria Williams ◽  
Nashira Brown ◽  
Justin Xavier Moore ◽  
David Farrell ◽  
Suzanne Perumean-Chaney ◽  
...  
2021 ◽  
Author(s):  
Victoria Williams ◽  
Nashira Brown ◽  
Justin Xavier Moore ◽  
David Farrell ◽  
Suzanne Perumean-Chaney ◽  
...  

BACKGROUND Internet-based lifestyle programs are increasingly being used to deliver health behavior change interventions to cancer survivors. However, little is known about website use in this population or its associations with healthy lifestyle changes. OBJECTIVE To describe lifestyle intervention website use (logins, time on website, and clicks) among cancer survivors, as well as patterns of use by participant characteristics. Additionally, associations were explored between website use and changes in healthy lifestyle knowledge and practice. METHODS Thirty-five cancer survivors participated in a single-arm pilot test of the SurvivorSHINE website. Knowledge and practices related to healthful diet and physical activity behaviors were measured at baseline and follow-up. Website use (e.g., time spent on the website, frequency of logins, webpage visits, and clicks) were collected from the SurvivorSHINE administrative site during a 2-week intervention period. Patterns of use were examined by participants’ gender and race. Associations between website use and changes in healthy lifestyle knowledge, physical activity, diet, and weight were explored. Independent t-tests were used to compare website use between males and females, and Non-Hispanic Whites (NHW) and Blacks (NHB). Pearson correlations were used to examine associations between website use and behavior change. RESULTS Participants logged into the SurvivorSHINE website an average of 3.2 times (SD = 2) over the 2-week period and spent a total average of 94 minutes (SD = 56 minutes). Examining website activity, 1905 clicks were logged. The user profile (344 clicks) and the home sections (301 clicks) were the most visited components. No associations were observed between the frequency of logins or the total time on the website and improvements in knowledge-related to healthy lifestyles, nor in changes in body weight or dietary intake. However, the total time on the website was positively correlated with improvements in accelerometer-measured physical activity (r = 0.74, p = 0.02), as well as self-reported physical activity (r = 0.35, p = 0.047). CONCLUSIONS Cancer survivors demonstrated clear interest in a diet and exercise website as evidenced by their frequency of logins, clicks on numerous features, and total viewing time. Moreover, increased website usage was correlated with improvements in physical activity. CLINICALTRIAL NCT00303875, NCT00630591 INTERNATIONAL REGISTERED REPORT RR2-10.1007/s13187-021-02026-x


2020 ◽  
Author(s):  
Elizabeth Y Wang ◽  
Rebecca E Graff ◽  
June M Chan ◽  
Crystal S Langlais ◽  
Jeanette M Broering ◽  
...  

BACKGROUND Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population. OBJECTIVE This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits. METHODS TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods. RESULTS In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention. CONCLUSIONS These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.


JMIR Cancer ◽  
10.2196/19362 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19362
Author(s):  
Elizabeth Y Wang ◽  
Rebecca E Graff ◽  
June M Chan ◽  
Crystal S Langlais ◽  
Jeanette M Broering ◽  
...  

Background Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population. Objective This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits. Methods TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods. Results In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention. Conclusions These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.


2015 ◽  
Vol 49 (6) ◽  
pp. 819-827 ◽  
Author(s):  
Julie B. Wang ◽  
John P. Pierce ◽  
Guadalupe X. Ayala ◽  
Lisa A. Cadmus-Bertram ◽  
Shirley W. Flatt ◽  
...  

2020 ◽  
Author(s):  
Nataliya Ivankova ◽  
Laura Rogers ◽  
Ivan Herbey ◽  
Michelle Martin ◽  
Maria Pisu ◽  
...  

BACKGROUND With the growing number of older cancer survivors, it is imperative to optimize the reach of interventions that promote healthy lifestyles. Because internet use is growing rapidly among older adults, web-based delivery holds considerable promise for increasing the reach of such interventions. However, few studies have explored the views of older cancer survivors on this approach and potential variations in these views by gender and/or rural and urban residence. Objectives: Explore older cancer survivors’ views regarding features of web-based healthy lifestyle interventions based on gender and rural/urban residence to inform the design of the web-based Aim, Plan, and Act on Lifestyles (AMPLIFY) Survivor Health diet and exercise program. OBJECTIVE Explore older cancer survivors’ views regarding features of web-based healthy lifestyle interventions based on gender and rural/urban residence to inform the design of the web-based Aim, Plan, and Act on Lifestyles (AMPLIFY) Survivor Health diet and exercise program. METHODS Using a qualitative descriptive approach, we conducted 10 focus groups with 57 cancer survivors recruited from hospital cancer registries in one southeastern U.S. state. Data were analyzed using inductive thematic and content analyses with NVivo 12.5. RESULTS 29 male and 28 female urban and rural dwelling Black and White survivors, mean age 65 years, shared their views about a web-based healthy lifestyle program for cancer survivors. Five themes emerged related to program content, design, delivery, participation, technology training, and receiving feedback. Cancer survivors felt that web-based healthy lifestyle programs for cancer survivors must deliver credible, high quality, and individually-tailored information as recommended by health care professionals or content experts. Urban survivors were more concerned about information reliability, while women were more likely to trust physicians’ recommendations. Male and rural survivors wanted the information to be tailored on cancer type and age group. Privacy, usability, interaction frequency, and session length were noted as important for engaging older cancer survivors with a web-based program. Female and rural participants liked the interactive nature and visual appeal of e-learning sessions. Learning from experts, an attractive design, flexible schedule and opportunity to interact with other survivors in Facebook closed groups emerged as factors promoting program participation. Low computer literacy, lack of experience with web program features, and concerns about Facebook group privacy were important concerns influencing older cancer survivors’ potential participation. Participants noted importance of technology training preferring individualized help to standardized computer classes. More rural survivors acknowledged the need to learn how to use a computer. The receipt of regular feedback about progress was noted as encouragement toward goal achievement, while women were particularly interested in receiving immediate feedback to stay motivated. CONCLUSIONS Important considerations for designing web-based healthy lifestyle interventions for older cancer survivors include program quality, participants’ privacy, ease of use, attractive design, and a prominent role of a health care provider and content expert. Cancer survivors’ preferences based on gender and residence should be considered to promote program participation.


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