Let’s build an app for that

The promotion of physical activity behavior change among adults with cancer is a research priority. Within this field, increasing attention is being devoted to the use of health technology, which includes mobile phones and applications, or apps, to support and deliver physical activity behavior change interventions. While building a mobile app is a popular proposal among exercise oncology researchers, little practical information exists on how this process should be done or what considerations researchers should take in collaboration with participants and industry. The present article provides an overview of recent experiences with app development in exercise oncology and outlines several recommendations for future research. Methods and Results: After forming an interdisciplinary team of researchers, industry partners, and exercise oncology program participants, an iterative, user-centered app improvement process was followed to collect feedback and make meaningful changes to an existing mobile health app for its use in exercise oncology. Participant feedback was summarized and addressed collaboratively via open discussion and detailed action plans. Changes made include enhanced introductory materials for the app and improvements to usability and personalization. Some requests remain to be addressed in future updates. Two challenges identified during the app improvement process were balancing the unique needs and priorities of all parties, as well as addressing the variable feedback from a variable population of adults with cancer. Conclusions and significance: A multidisciplinary participant-oriented app improvement process led to meaningful updates to the mobile application of interest, preparing researchers to carry out an evaluation of its effectiveness within exercise oncology. Furthermore, based on lessons learned, the research team present key recommendations to consider in future mobile app research before, during, and after the development process.

Tailored physical activity behavior change interventions: challenges and opportunities

Lay Summary Being physically active has many social, emotional, and health benefits, but very few individuals are active enough to see those benefits. Using interventions that are tailored, in other words, individualized to a person’s characteristics, needs, preferences, and/or situation, may help improve physical activity participation rates. However, a better understanding of how to do tailoring is needed. Our collaboration reviewed the literature and convened to suggest two key opportunities to better understand how tailored approaches to physical activity can be done: (a) improve engagement of those who the research is intended for and (b) understand the ethical impacts and patient/provider experience of using technology to support tailoring.

Using a Smartphone Application to Promote Physical Activity Behavior Change Among Researchers From Human Movement Sciences: Qualitative Focus Group Study (Preprint)

BACKGROUND Physical inactivity is the fourth leading risk factor for mortality worldwide. Currently, we count on technologies’ vertiginous advances, mostly in smartphone applications (apps), which showed to be useful in the introduction or expansion of physical activity. However, little attention has been paid to understanding the viewpoint of researchers from human movement sciences. OBJECTIVE To understand the perception of researchers from human movement sciences about using a smartphone app to promote physical activity behavior change. METHODS Ten physically active researchers (8 men and 2 women, mean [SD] age 32.4 [5.21] years), users of the Pacer smartphone app participated in a focus group. The focus group lasted two hours and was mediated by the first author using guiding questions grouped into three categories: app features, barriers and facilitators to physical activity and challenges to behavior change. We performed a qualitative analysis, using the content analysis approach based on the audio records, using participants' verbal reports as a unit of analysis. RESULTS The focus group revealed that physical activity has always been present in the participants' lives. Participants identified changes in their patterns of physical activity over time, incorporating technologies during their exercise sessions. They realized that throughout life the goal in physical activity changed from improving performance to improving health. Participants' life history of physical activity was associated with their preference for the app that stimulated competitiveness. The possibility of competing and being rewarded by their achievements are essential motivational tools. In this way, participants appreciated the possibility of creating groups and ranking among them. As facilitators for physical activity, the group pointed to the adequate city infrastructure and the possibilities of exercising with someone and being challenged by colleagues. As barriers, participants listed a lack of safety and the need to take the smartphone for the app using. CONCLUSIONS Our study reporting challenges and possibilities to drive changes in physical activity behavior by using smartphone apps. The focus group provided important resources and characteristics that had a positive impact on the behavior change and should be considered, such as: the participants’ challenge of overcoming themselves, the opportunity to compete with their peers to achieve personal goals, and the possibility to measure the amount of physical activity. These finds can contribute to improving app development and user acceptability, especially regarding features based on behavior change techniques. Additionally, although this is a descriptive qualitative study with a limited sample, using a smartphone app seems to contribute to physical activity behavior change, even among participants with adequate levels of physical activity.

The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer

Regular physical activity (PA) can address many of the negative side effects experienced by individuals following cancer treatment and support the optimization of physical and psychosocial well-being. However, many survivors of cancer are not sufficiently active to achieve these health benefits. The purpose of this study was to describe the development of a physical activity behavior change (PABC) intervention, MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), which aims to increase cancer survivors’ PA levels. A review of the literature and focus groups with survivors of cancer were conducted in order to generate recommendations to inform the intervention development process. This process was guided and informed by: (1) the Medical Research Council’s (MRC) framework for the development, evaluation, and implementation of complex interventions, (2) the Behaviour Change Wheel (BCW), and (3) the Theoretical Domains Framework (TDF). Recommendations for strategies to support habitual PA and adherence to community-based exercise programs, generated by survivors of cancer who participated in 7 focus groups (n = 41), were synthesized with 13 statements of findings that were generated from 10 studies included within the review of the literature. Detailed mapping exercises are presented which outline the link between these sources, the MRC framework, the BCW and TDF, and the intervention content. MedEx IMPACT is the first PABC intervention for survivors of cancer to be developed through the application of the MRC framework, BCW, and TDF. The next phase in this research is to test the acceptability and effectiveness of MedEx IMPACT.