Evaluation of a Translatable Web-Based Intervention for Increasing Physical Activity Among Cancer Survivors: Pilot...

Cancer survivors face long-term health challenges posttreatment. Physical activity (PA) can help manage cancer-related side effects and offer additional health benefits, yet up to 80% of survivors do not meet PA guidelines. Effective and translatable PA interventions are needed.

This randomized trial assessed the feasibility, acceptability, and preliminary efficacy of a 12-week automated Internet program for increasing moderate-to-vigorous physical activity (MVPA) among cancer survivors. A secondary aim examined the effect of the intervention on physical and mental well-being.

Inactive (<60 min/wk of PA) cancer survivors who completed cancer-directed treatment in the past 3-12 months or those on a stable maintenance treatment regimen were randomized to the Energize! Exercise Program or Newsletter control condition. The Energize! Program was fully automated and involved weekly behaviorally-based video lessons, homework assignments, exercise planning and reporting, and progressive MVPA goals (75 to 200 min/wk). Algorithm-generated personalized feedback was provided based on PA goal attainment and homework completion. The newsletter group received bimonthly PA education newsletters (a total of 6). Assessments occurred at baseline, 3 months (postintervention), and 6 months (following a 3-month no-contact follow-up). Feasibility was assessed via enrollment and retention rates, acceptability was assessed via intervention engagement metrics and program satisfaction questionnaire, and MVPA was assessed via both self-report and accelerometer (min/wk of total and "bouted" MVPA [accumulated in bouts ≥10 min]). Health-related outcomes (eg, quality of life, fatigue, psychological distress, psychological symptoms, and fear of cancer recurrence) were assessed via electronic questionnaires.

Forty-six adults aged 55.2 (SD 8.3) years, with BMI mean 33.0 (SD 7.6) kg/m²; 42 (91.3%) female, and 37 (80.4%) non-Hispanic White enrolled in this trial. Feasibility metrics indicate that 69% (46/67) of those who screened eligible were randomized and 6-month retention among randomized participants was 94% (43/46). Acceptability was also high, as evidenced by the percentage of lessons viewed (mean 87.7%, SD 21.3%), exercise plans submitted (mean 82.6%, SD 25.8%), homework assignments completed (mean 77.2%, SD 25.2%), and weeks in which exercise minutes were logged (mean 85.9%, SD 22.1%). Program satisfaction ratings were higher in Energize (mean 5.8, SD 1.6; 1-7 scale) versus Newsletter (mean 3.2, SD 1.6; P<.001). Energize! increased self-reported (92.7 min/wk), bouted (35.4 min/wk), and total (46.3 min/wk) MVPA at 3 months (Cohen d=0.74-0.94), and these changes were partially maintained at 6 months. Increases in MVPA were smaller among Newsletter participants (d=0.28-0.47). Group differences in health-related outcomes were minimal and mixed, favoring Energize! over Newsletter for vitality (d=0.63) and somatization (d=0.76) at 3 months, and for depression (d=0.59) and anxiety (d=0.51) at 6 months.

The automated Energize! Program is feasible, acceptable, and associated with positive changes in MVPA, yet future studies are needed to improve MVPA long-term. Findings suggest that self-guided PA programs may be beneficial for increasing MVPA among cancer survivors.