Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial

Carmina G Valle, Bernardine M Pinto, Jessica Gokee LaRose, Molly Diamond, Lindsey N Horrell, Brooke T Nezami, Karen E Hatley, Erin M Coffman, Kristen Polzien, Derek P Hales, Allison M Deal, Christine M Rini, Donald L Rosenstein, Deborah F Tate, Carmina G Valle, Bernardine M Pinto, Jessica Gokee LaRose, Molly Diamond, Lindsey N Horrell, Brooke T Nezami, Karen E Hatley, Erin M Coffman, Kristen Polzien, Derek P Hales, Allison M Deal, Christine M Rini, Donald L Rosenstein, Deborah F Tate

Abstract

Introduction: Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS.

Purpose: To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS.

Methods: A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures.

Conclusions: IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.

Keywords: Adaptive interventions; Physical activity; Social media; Tailored feedback; Technology; Young adult cancer survivors.