ICanSTEP : Increasing Physical Activity With Text Messaging

June 7, 2021 updated by: Duke University

ICanSTEP: Increasing Physical Activity in Cancer Survivors Through a Text-messaging Exercise Motivation Program

The proposed pilot study will develop and test feasibility and preliminary efficacy of an exercise motivation intervention using a 12-week smartphone-text messaging program tailored to physical activity data retrieved from a Fitbit. Target population is 15 cancer survivors and 15 patients actively undergoing cancer treatment.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cancer survivors have substantial residual cardiometabolic risk due to the fact that they are living longer and are exposed to the same lifestyle and environmental factors that have led to the drastic increase in obesity and diabetes in Western societies over the last four decades. In addition, survivors' cardiovascular health is significantly impaired due to cancer treatment. Research has shown that physical activity improves quality of life in cancer survivors, ameliorates treatment-related side effects reduces the risk of cancer recurrence, and extends overall survival. Despite these advantages, most cancer patients are sedentary. The early survivor period is a teachable moment to improve healthy behaviors. Social Cognitive Theory argues that to change exercise behavior, we must increase behavior change self-efficacy of participants (i.e., confidence), increase their outcome expectations that changing their behavior will lead to better health, enhance motivation to exercise, enhance their ability to regulate their behavior (self-regulation), teach them tangible behavior change skills, and help them overcome barriers to behavior change. In this study validated patient-reported outcomes will be performed at baseline and at 12 weeks - FACIT-F to document general cancer symptoms with additional questions on fatigue, the Beck Depression Inventory (BDI-II), and the modified Godin-Leisure Questionnaire as a measure of activity level. The investigators will also perform baseline and 3 month weight / BMI and 6-minute walk testing as a second well-validated objective measure of fitness. At enrollment and at 3 months, patients will be queried as to barriers to behavior change. At 3 months, patients will be asked by 5-point Likert scale how helpful the program was in increasing their physical activity. Six months after enrollment (+/- 4 weeks), level of physical activity and use of Fitbit will be determined.

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • North Carolina
      • Durham, North Carolina, United States, 27710
        • Duke Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Eligible participants must be / have

  1. age 18 or older,
  2. a diagnosis of any hematologic or solid malignancy
  3. a life expectancy of at least 12 months
  4. ECOG < /=2
  5. in active cancer treatment or have completed active cancer treatment within one year of obtaining consent (with the exception of adjuvant hormonal therapy),
  6. not scheduled for any major surgery during the anticipated study period,
  7. able to read and understand English
  8. sedentary defined as participating in 2 or less days of dedicated physical activity per week,
  9. consistent daily access to a smartphone
  10. a text messaging plan that includes a minimum of 150 text messages a month at no additional cost
  11. capable of providing informed consent.

Exclusion Criteria:

  1. Significant cardiac disease (i.e., left ventricular ejection fraction of <50%, unstable angina, placement of cardiac stents and myocardial infarction within previous 6 months)
  2. Contraindications to a 6-minute walk test as recommended by the American Thoracic Society: (a) acute myocardial infarction (3-5 days), (b) unstable angina, (c) uncontrolled arrhythmias causing symptoms or hemodynamic compromise, (d) syncope, (e) acute endocarditis, (f) acute myocarditis or pericarditis, (g) uncontrolled heart failure, (h) acute pulmonary embolus or pulmonary infarction, (i) thrombosis of lower extremities, (j) suspected dissecting aneurysm, (k) uncontrolled asthma, (l) pulmonary edema, (m) room air desaturation at rest ≤85%, (n) respiratory failure, (o) acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise, (p) mental impairment leading to inability to cooperate, and (q) extensive bone metastases
  3. ECOG >2
  4. Participates in 3 or more days of dedicated physical activity per week
  5. Known allergic reaction to nickel
  6. No access to a smart phone or text messaging plan less than 150 messages per month
  7. Physical or psychological contraindication to participation at the discretion of the treating physician.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Cohort 1

Cohort 1 will include 15 sedentary participants who have completed all cancer therapy except adjuvant hormonal therapy.

All participants will be provided a Fitbit. Participants will then be provided daily SMS text messaging tailored to their activity level for 12 weeks..

Active Comparator: Cohort 2
Cohort 2 will include 15 sedentary participants in active treatment. All participants will be provided a Fitbit. Participants will then be provided daily SMS text messaging tailored to their activity levels for 12 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Feasibility, as measured by the percentage of eligible patients who can be enrolled
Time Frame: 6 months
6 months
Feasibility, as measured by accrual rate
Time Frame: 6 months
6 months
Change in daily step count, as measured by Fitbit
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks
Change in minutes of weekly exercise, as measured by Fitbit
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks
Change in fatigue, as measured by questionnaire
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks
Change in depression, as measured by questionnaire
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks
Change in general activity, as measured by questionnaire
Time Frame: Baseline, 6 months
Baseline, 6 months
Change in quality of life, as measured by questionnaire
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks
Change in body mass index (BMI)
Time Frame: Baseline, 12 weeks
Baseline, 12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean difference in daily step count, as measured by Fitbit
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in minutes of weekly exercise, as measured by Fitbit
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in fatigue, as measured by questionnaire
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in depression, as measured by questionnaire
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in general activity, as measured by questionnaire
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in quality of life, as measured by questionnaire
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks
Mean difference in body mass index (BMI)
Time Frame: Baseline, 12 weeks
This will be addressed by calculating the mean difference (with 80% confidence interval) between the two treatment cohorts in change across time.
Baseline, 12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Bridget Koontz, MD, Duke University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 4, 2016

Primary Completion (Actual)

February 6, 2018

Study Completion (Actual)

May 21, 2018

Study Registration Dates

First Submitted

December 8, 2015

First Submitted That Met QC Criteria

December 8, 2015

First Posted (Estimate)

December 10, 2015

Study Record Updates

Last Update Posted (Actual)

June 10, 2021

Last Update Submitted That Met QC Criteria

June 7, 2021

Last Verified

June 1, 2021

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Pro00068978

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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