scholarly journals Development of a Modular Mobile Health App for Personalized Rehabilitation in the Breast Cancer Care Continuum (Preprint)

2020 ◽  
Author(s):  
Ji Young Lim ◽  
Jong Kwang Kim ◽  
Yoon Kim ◽  
So-Yeon Ahn ◽  
Jonghan Yu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mobile Health ◽  
Cancer Care ◽  
Medical Information ◽  
Mobile App ◽  
Self Management ◽  
User Evaluation ◽  
Breast Cancer Care ◽  
Care Continuum ◽  
Cancer Care Continuum

BACKGROUND Although many mobile health (mHealth) apps as a support tool for self-management of breast cancer have evolved, limited studies have developed a comprehensive app and described the algorithms for personalized rehabilitation in the breast cancer care continuum. OBJECTIVE This study aimed to develop a comprehensive mobile app and an algorithm that adjust personalized content to facilitate self-management throughout the breast cancer care continuum. METHODS The development process of the modular app included the following six steps: (1) organizing expert teams, (2) defining evidence-based fundamental content and modules, (3) classifying user cases according to surgery type and treatment, (4) describing algorithms of the key modules for personalized content, (5) constructing the app platform and connectivity to digital health care devices, and (6) conducting a user evaluation of the key modules using needs and satisfaction questionnaires after app testing. RESULTS The expert teams developed algorithms and the mHealth app to dynamically adjust the content for individual patients throughout the breast cancer care continuum. The review of the related literature, and guidelines and the development of the app took 18 months. User evaluation outcomes were positive, with needs and satisfaction questionnaire scores of 4.4 and 4.1 of 5, respectively. The ranking results demonstrated that personalized exercise was the most needed feature with the highest satisfaction score. CONCLUSIONS The strength of this study was the development of a comprehensive mHealth app and algorithms for adjusting content based on user medical information for personalized rehabilitation during the breast cancer care continuum and obtaining positive user evaluation results.

scholarly journals CanIMPACT: Understanding complexities, variation, and disparities in the breast cancer care continuum in Five Canadian provinces using administrative data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Patti Groome ◽  
Marcy Winget ◽  
Li Jiang ◽  
Kathleen Decker ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Data Processing ◽  
Cancer Care ◽  
Local Context ◽  
Longitudinal Analyses ◽  
Breast Cancer Care ◽  
Common Data Elements ◽  
Care Continuum ◽  
Cancer Care Continuum ◽  
Canadian Provinces

ABSTRACT ObjectiveCanIMPACT is a multi-province Canadian research team funded to understand the interplay between primary and oncology breast cancer care. A first step was to describe current practice and inter/intra-provincial care variation across the care continuum using provincial administrative health data. Here we describe the inter-provincial process and analysis plans. ApproachOur multi-disciplinary team includes five Canadian provinces: British Columbia, Alberta, Manitoba, Ontario and Nova Scotia. Cohorts consist of all breast cancers diagnosed from 2007 to at least 2011 in each of the five provinces. Common databases include cancer registries, census area-level income and rurality, outpatient physician claims, ambulatory care and inpatient hospitalizations. Other databases with laboratory, pharmacy, emergency services, and immigration data were available in some provinces. Common data elements across provincial datasets were identified, and a standardized methodology was developed. ResultsCommon data processing and analysis plans were finalized over 24 months; provinces refined details as per local context while maximizing methodological comparability. Basic descriptive analyses plus 18 phase-specific and 3 longitudinal analyses have been planned. Six plans for the diagnostic phase focus on identifying modifiable disparities in access and outcomes; 8 plans for the treatment phase focus on variation in chemotherapy treatment patterns, quality/safety, and utilization of primary care services; 4 plans for the survivorship phase focus on adherence to guidelines for follow-up breast cancer care, other chronic diseases and preventive care; 3 longitudinal analyses assess factors related to changes in utilization of chronic disease services over the cancer care continuum. ConclusionsWe have shown it is feasible to develop and standardize data processing and analyses across multiple provinces to address important cancer care questions across the continuum. This work will inform comparisons and improvements in Canadian cancer care. This effort has also helped increase research capacity in health services research.

scholarly journals Use of Evidence-Based Best Practices and Behavior Change Techniques in Breast Cancer Apps: Systematic Analysis (Preprint)

2019 ◽  
Author(s):  
Kerstin Kalke ◽  
Tamar Ginossar ◽  
Joshua M Bentley ◽  
Hannah Carver ◽  
Sayyed Fawad Ali Shah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Best Practices ◽  
Behavior Change ◽  
Goal Setting ◽  
Cancer Care ◽  
Screening Process ◽  
Behavior Change Techniques ◽  
Systematic Analysis ◽  
Care Continuum ◽  
Cancer Care Continuum

BACKGROUND Theoretically designed mobile health (mHealth) breast cancer interventions are essential for achieving positive behavior change. In the case of breast cancer, they can improve the health outcomes of millions of women by increasing prevention and care efforts. However, little is known about the theoretical underpinnings of breast cancer apps available to the general public. OBJECTIVE Given that theories may strengthen mHealth interventions, this study aimed to identify breast cancer apps designed to support behavior change, to assess the extent to which they address content along the cancer care continuum and contain behavior change techniques, and to assess the degree to which star rating is related to theory-based design. METHODS Using a criteria-based screening process, we searched 2 major app stores for breast cancer apps designed to promote behavior change. Apps were coded for content along the cancer care continuum and analyzed for behavior change techniques. The Mann-Whitney <i>U</i> test was used to examine the relationship between star ratings and the use of behavior change techniques in apps with star ratings compared to those without ratings. RESULTS The search resulted in a total of 302 apps, of which 133 were identified as containing breast cancer content. Only 9.9% (30/302) of apps supported behavior change and were further analyzed. These apps were disproportionally focused on behaviors to enhance early detection, whereas only a few apps supported care management, treatment, and posttreatment behaviors. Regarding theories, 63% (19/30) of apps customized content to users, 70% (21/30) established a health-behavior link, and 80% (24/30) provided behavior change instructions. Of the 30 apps, 15 (50%) prompted intention formation whereas less than half of the apps included goal setting (9/30, 30%) and goal reviewing (7/30, 23%). Most apps did not provide information on peer behavior (7/30, 23%) or allow for social comparison (6/30, 20%). None of the apps mobilized social norms. Only half of the apps (15/30, 50%) were user rated. The results of the Mann-Whitney <i>U</i> test showed that apps with star ratings contained significantly more behavior change techniques (median 6.00) than apps without ratings. The analysis of behavior change techniques used in apps revealed their shortcomings in the use of goal setting and social influence features. CONCLUSIONS Our findings indicate that commercially available breast cancer apps have not yet fully realized their potential to promote behavior change, with only a minority of apps focusing on behavior change, and even fewer including theoretical design to support behavior change along the cancer care continuum. These shortcomings are likely limiting the effectiveness of apps and their ability to improve public health. More attention needs to be paid to the involvement of professionals in app development and adherence to theories and best practices in app design to support individuals along the cancer care continuum.

scholarly journals Use of Evidence-Based Best Practices and Behavior Change Techniques in Breast Cancer Apps: Systematic Analysis

10.2196/14082 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e14082 ◽  
Author(s):  
Kerstin Kalke ◽  
Tamar Ginossar ◽  
Joshua M Bentley ◽  
Hannah Carver ◽  
Sayyed Fawad Ali Shah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Best Practices ◽  
Behavior Change ◽  
Goal Setting ◽  
Cancer Care ◽  
Screening Process ◽  
Behavior Change Techniques ◽  
Systematic Analysis ◽  
Care Continuum ◽  
Cancer Care Continuum

Background Theoretically designed mobile health (mHealth) breast cancer interventions are essential for achieving positive behavior change. In the case of breast cancer, they can improve the health outcomes of millions of women by increasing prevention and care efforts. However, little is known about the theoretical underpinnings of breast cancer apps available to the general public. Objective Given that theories may strengthen mHealth interventions, this study aimed to identify breast cancer apps designed to support behavior change, to assess the extent to which they address content along the cancer care continuum and contain behavior change techniques, and to assess the degree to which star rating is related to theory-based design. Methods Using a criteria-based screening process, we searched 2 major app stores for breast cancer apps designed to promote behavior change. Apps were coded for content along the cancer care continuum and analyzed for behavior change techniques. The Mann-Whitney U test was used to examine the relationship between star ratings and the use of behavior change techniques in apps with star ratings compared to those without ratings. Results The search resulted in a total of 302 apps, of which 133 were identified as containing breast cancer content. Only 9.9% (30/302) of apps supported behavior change and were further analyzed. These apps were disproportionally focused on behaviors to enhance early detection, whereas only a few apps supported care management, treatment, and posttreatment behaviors. Regarding theories, 63% (19/30) of apps customized content to users, 70% (21/30) established a health-behavior link, and 80% (24/30) provided behavior change instructions. Of the 30 apps, 15 (50%) prompted intention formation whereas less than half of the apps included goal setting (9/30, 30%) and goal reviewing (7/30, 23%). Most apps did not provide information on peer behavior (7/30, 23%) or allow for social comparison (6/30, 20%). None of the apps mobilized social norms. Only half of the apps (15/30, 50%) were user rated. The results of the Mann-Whitney U test showed that apps with star ratings contained significantly more behavior change techniques (median 6.00) than apps without ratings. The analysis of behavior change techniques used in apps revealed their shortcomings in the use of goal setting and social influence features. Conclusions Our findings indicate that commercially available breast cancer apps have not yet fully realized their potential to promote behavior change, with only a minority of apps focusing on behavior change, and even fewer including theoretical design to support behavior change along the cancer care continuum. These shortcomings are likely limiting the effectiveness of apps and their ability to improve public health. More attention needs to be paid to the involvement of professionals in app development and adherence to theories and best practices in app design to support individuals along the cancer care continuum.

scholarly journals Tailoring Therapies: Improving the Outcome of Breast Cancer in a Comprehensive Cancer Center in West Africa—The University of Nigeria Teaching Hospital Experience

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 163s-163s
Author(s):  
N. Lasebikan ◽  
N. Iloanusi ◽  
T. Onyeka ◽  
C. Ilo ◽  
K. Nwankwo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Palliative Care ◽  
Cancer Care ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Management Strategies ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Continuum ◽  
Cancer Care Continuum

Background and context: Early detection and improved treatments are associated with a reduction in breast cancer mortality and morbidity. UNTH is a leading comprehensive cancer center in Nigeria with referrals from the entire southeast and south south regions. Our goal is to offer high quality comprehensive cancer care services across the cancer care continuum from public health awareness campaigns and provision of screening services all the way to palliative care and survivorship. This is the first attempt by any institution in the country to standardize and harmonize available treatment options for breast cancer. Aim: To optimize, standardize and harmonize treatment options and management strategies for breast cancer using a multidisciplinary approach by developing guidelines adapted to our peculiar infrastructure and health system. Strategy/Tactics: The practice guideline was specifically developed for UNTH using a multidisciplinary approach and taking into consideration circumstances peculiar to UNTH, including the following: UNTH's specific patient population; UNTH's services and structure; and UNTH's clinical information. Program/Policy process: The process used recognized methods that are robust, objective, scientifically valid, consistent and adaptable to UNTH and engaged all identified multisectoral and multidisciplinary stakeholders involved in the care of patients with breast cancer. Outcomes: We reviewed substantial evidence on documented and proven strategies for community screening and prevention, less expensive and only marginally less effective diagnostic tools, locoregional and systemic therapies for the management of breast cancer. The team also recommended all patients receive psycho-oncology support through a dedicated team and through the breast cancer support group. It was agreed that palliative care be incorporated within the first 8 weeks of commencing treatment in line with the current ASCO guidelines and receive consultation from the exercise immunology unit. What was learned: Institutionalized care offers better management strategies and standardized treatment in line with best global practices of care for patients with breast cancer across the cancer care continuum which will ultimately translate to better treatment outcomes.

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