A Theory-based Mobile Health Physical Activity Intervention for Breast Cancer Patients during Chemotherapy:a Preliminary Evaluation (Preprint)

BACKGROUND Physical activity (PA), known as a modifiable protective factor, provides an approach to sustain physical and psycho-social health for breast cancer patients both during and after treatment. Mobile health (mHealth) application targeted promoting health behaviors demonstrates advantages in behavior tracking, knowledge sharing and social connecting and tailored intervention. However, process of mHealth application (App) development is lack of theoretical basis, restricting its sustainable benefits to cancer survivors. OBJECTIVE To construct a theory-based mHealth PA intervention program, and to determine whether this intervention would improve PA behavior change during chemotherapy for breast cancer patients, thus to capture their perspectives and experiences when participate it. METHODS Social cognitive theory (SCT), self-efficacy theory (SET) and the theory of planned behavior (TPB) are referred to construct mHealth intervention strategies. Smartphone application was chosen to implement a pre-post three-month PA intervention. A mixed method was utilized to test the preliminary effectiveness of MPAP. Quantitative results from online records and self-reported questionnaires were collected after intervention. Qualitative feedback through telephone interviewing was recorded to explore patients’ using experiences. RESULTS “Breast care” smartphone application was developed to improve self-management of breast cancer patients including PA. In the end, five main pages covering 6 functions (information delivering, disease tracking, events reminding based on calendar, online interaction, health behavior recording and self-reported assessment) were displayed in the app. In the preliminary evaluation process, twenty participants were recruited. Based on PA capability assessment and baseline PA evaluation, 12 patients were divided into active group, and 8 patients were grouped in sedentary lifestyle. Within three months, participants’ usage behavior identified at portal site indicated the accumulated app usage time is 40 minutes a week, and average login time of each participant was three times a week. The total PA increased 945.70 MET-min/w with a significant improvement(p=0.040) after 3 months. Walking displayed a significant improvement after intervention (904.20 MET-min/w) (p=0.030). Sedentary mean time declined 210 mins/w. Qualitative results showed satisfaction and willingness of breast cancer patients to use app to manage PA and relevant health behaviors. CONCLUSIONS The theory-based mHealth PA intervention has great potential to enhance breast cancer patients’ PA awareness and engagement, meanwhile to facilitate their PA behavior change.