Text message intervention delivered from Australian general practices to improve breast cancer survivors' physical activity and cardiovascular risk factors: protocol for the EMPOWER-SMS-GP effectiveness implementation randomised controlled trial

Anna C Singleton ^1,2, Stephanie R Partridge ^2,3, Karice K Hyun ^4,5

¹The Daffodil Centre, a joint venture between the University of Sydney and Cancer Council New South Wales, The University of Sydney, Sydney, New South Wales, Australia anna.singleton@sydney.edu.au.
²Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia.
³Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
⁵School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁶Consumer Representative Group, Breast Cancer Network Australia, Camberwell, Victoria, Australia.
⁷Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁸Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁹The Daffodil Centre, a joint venture between the University of Sydney and Cancer Council New South Wales, The University of Sydney, Sydney, New South Wales, Australia.
¹⁰Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
¹¹Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
¹²Westmead Breast Cancer Institute, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia.
¹³Radiation Oncology Network, Western Sydney Local Health District, Sydney, New South Wales, Australia.
¹⁴Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
¹⁵NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.
¹⁶Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.
¹⁷Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia.

⁰The Daffodil Centre, a joint venture between the University of Sydney and Cancer Council New South Wales, The University of Sydney, Sydney, New South Wales, Australia anna.singleton@sydney.edu.au.

Bmj Open +

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December 11, 2024

View abstract on PubMed

Summary

This study evaluated EMPOWER-SMS-GP, a text message intervention for Australian breast cancer survivors, to improve cardiovascular health. Results will inform low-resource health promotion strategies for cancer survivors.

Area Of Science

Oncology
Cardiovascular Health
Digital Health Interventions

Background

Australian breast cancer survivors face elevated cardiovascular disease and mortality risks.
Behavioral factors like poor diet and inactivity contribute significantly to these risks.
General practitioner (GP) delivered health promotion is recommended but limited by resources.

Purpose Of The Study

To evaluate the effectiveness and implementation of the EMPOWER-SMS-GP text message intervention.
To assess if text message interventions can be a low-resource solution for health promotion in general practice.
To determine the impact on physical activity and other health outcomes in breast cancer survivors.

Main Methods

A multi-centre, single-blind, hybrid I randomized controlled trial (RCT) involving 678 participants.
Comparison of EMPOWER-SMS-GP intervention group (n=339) against usual care (n=339).
Primary outcome: physical activity measured by accelerometer at 6 months; secondary outcomes include diet, quality of life, and adherence.

Main Results

The study is designed to measure the between-group difference in mean physical activity at 6 months.
Secondary outcomes will be analyzed using intention-to-treat principles with mixed-effects regression models.
A parallel mixed-methods process evaluation will assess Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM).

Conclusions

The EMPOWER-SMS-GP intervention may offer a feasible and effective low-resource strategy for improving health behaviors in breast cancer survivors.
Findings will guide the implementation of digital health interventions within primary care settings.
This research addresses a critical need for accessible and sustainable survivorship care.

Keywords:

Cell Phone Health Services Implementation Science ONCOLOGY PUBLIC HEALTH Primary Care