Usability, feasibility, and acceptability of a smartphone-supported behavioral activation intervention for patients...

Advanced cancer can disrupt participation in meaningful daily activities. Sustaining or increasing these activities through behavioral activation may improve mood and quality of life for the growing population of people living with advanced cancer.

The goal of this study was to develop and evaluate the preliminary usability, feasibility, and acceptability of BALANCE (Behavioral Activation-Led Activity eNgagement for Cancer Empowerment), an 8-week smartphone-based intervention aimed at increasing engagement in meaningful daily activities in the context of advanced cancer.

We first developed BALANCE in collaboration with a Community Patient Advisory Board. Second, we conducted usability testing of BALANCE with patients with advanced cancer. Finally, we conducted a single-arm pilot trial to evaluate the feasibility and acceptability of BALANCE. We also examined the preliminary effects of the intervention on patient-reported outcomes.

Usability testing participants (n = 7) rated the BALANCE app as easy (7.9/10), pleasant (8.6/10), and not burdensome to use (1.8/10). Results of the single-arm trial (n = 22) also suggest good usability (System Usability Scale score of 79.3/100), feasibility (indicated by 100% participant retention, average engagement with the application on 82% of days, and completion of 81% of planned meaningful activities), and acceptability (based on high [8.1/10] likelihood of recommending BALANCE to a friend with cancer). While the primary goal of this work was to assess feasibility and acceptability, we also observed a statistically significant decrease in patient-reported anxiety (F(2, 40) = 3.52, P = .039, ηg2 = 0.017).

BALANCE is a feasible and acceptable smartphone-based intervention that may help patients with advanced cancer maintain and increase valued daily activities.