Know and Own Your Movement-related Metrics Via Wearable Devices (Project KNOWN)

Personalized Feedback of Wearable Biological Sensor Data to Promote Active Living in Cancer Survivors

This study aims to promote daily physical activity in cancer survivors who are at high risk for type 2 diabetes (T2D) by using a personalized biological-based feedback strategy. T2D is one of the most common co-occurring conditions in cancer survivors and can worsen cancer-related health outcomes, especially in those who are insufficiently active. The investigators hypothesize that seeing the immediate impacts of exercise on their biological status will motivate cancer survivors to exercise. The investigators will use real-time data from continuous glucose monitor to demonstrate the acute impact of physical activity and measure daily activity levels using wearable trackers. As wearable sensor technology is constantly advancing, this study is the first step to exploring how researchers can use wearable sensors to help people make a direct connection between their daily behaviors and health outcomes.

Study Overview

• Status: Completed
• Conditions: Cancer; Survivorship
• Intervention / Treatment: Behavioral: Standard feedback; Behavioral: Glucose-based biofeedback

Detailed Description

Physical activity plays an important role in energy balance and obesity, which is an independent risk factor for cancer recurrence and mortality. It has been estimated that cancer survivors who increased their physical activity from pre- to post-diagnosis by any level had a 39% risk reduction in total mortality. This study will use an innovative approach to motivate cancer survivors to adopt and maintain an active lifestyle and will explore a novel mediator (daily glucose pattern) of the association between physical activity and cancer-related biomarkers. Study participants will be randomly assigned into (1) a group that receives personalized biological feedback related to physical activity behaviors; and (2) a control group that receives standard educational material. The feasibility and preliminary efficacy of this wearable sensor-based, biofeedback-enhanced 12-week physical activity intervention will be evaluated. This study will provide data regarding the preliminary efficacy of using biological feedback to increase physical activity and identifying daily glucose patterns that might link to cancer-related biomarkers.

The overall goals for this study are: (1) to test the preliminary effect of a remotely delivered physical activity intervention that incorporates personalized biological-based feedback on daily physical activity levels, and (2) to explore the association between daily glucose patterns and cancer-related insulin pathway and inflammatory biomarkers in cancer survivors who are at high risk for type 2 diabetes.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Arlington, Texas, United States, 76010
      • The University of Texas at Arlington

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• be 18 years or older
• have had a diagnosis of cancer
• have completed curative-intended treatment for at least 3 months (except hormone therapy or long-term maintenance chemotherapy)
• be at high-risk for type 2 diabetes based on the American Diabetes Association Type 2 Diabetes Risk Test
• currently insufficiently active
• capable of participating in moderate-vigorous intensity unsupervised exercise
• have no current diagnosis or history of type 1 or 2 diabetes
• able to speak, read, and write in English
• have a smartphone with daily internet access

Exclusion Criteria:

• currently taking oral antidiabetic agents (OADs)
• current treatment with any insulin regimen other than basal insulin, e.g. prandial or pre-mixed insulin
• currently pregnant
• on dialysis
• have self-reported health issues that limit physical activity
• work overnight shifts
• unwilling to use the study devices
• current participation in other exercise or weight loss-related program or intervention
• currently on a low-carb diet
• current use of other implanted medical devices such as pacemakers
• do not have a smartphone that is compatible with the Fitbit and the LibreLink apps

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Biofeedback Group	Behavioral: Glucose-based biofeedback; Participants will wear a Fitbit activity tracker and receive personalized text messages over a 12-week period. During the first 4 weeks of the study period, participants will also wear a continuous glucose monitor to check their glucose levels in real-time and receive text messages based on their activity and glucose data.
Active Comparator: Standard Care Group	Behavioral: Standard feedback; Participants will wear a Fitbit activity tracker and receive non-personalized text messages over a 12-week period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of delivering personalized glucose-based feedback	The intervention will be considered feasible if ≥ 80% of participants in the intervention group are adherent to the self-monitoring protocol and ≥ 80% of participants complete the post-intervention assessment.	Through study completion, an average of 3 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in daily physical activity level	A blinded accelerometry device will be used to measure physical activity before and after the intervention.	Through study completion, an average of 3 months.

Collaborators and Investigators

• Sponsor: The University of Texas at Arlington
• Collaborators: American Institute for Cancer Research
• Investigators: Principal Investigator: Yue Liao, MPH, PhD, University of Texas at Arlington

Publications and helpful links

General Publications

• Liao Y, Schembre SM, Brannon GE, Pan Z, Wang J, Ali S, Beg MS, Basen-Engquist KM. Using wearable biological sensors to provide personalized feedback to motivate behavioral changes: Study protocol for a randomized controlled physical activity intervention in cancer survivors (Project KNOWN). PLoS One. 2022 Sep 13;17(9):e0274492. doi: 10.1371/journal.pone.0274492. eCollection 2022.

Study record dates

Study Major Dates

• Study Start (Actual): March 29, 2023
• Primary Completion (Actual): December 10, 2025
• Study Completion (Actual): December 10, 2025

Study Registration Dates

• First Submitted: August 1, 2022
• First Submitted That Met QC Criteria: August 3, 2022
• First Posted (Actual): August 5, 2022

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 10, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms
• Other Study ID Numbers: 2022-0177

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