Feasibility of Using mHealth Activity and Dietary Trackers in Combination with Social Media to Enhance Survivorship Care and Improve Lifestyle Factors associated with Cardiovascular Disease

Authors: Chow EJ, Doody DR, Di C, Armenian SH, Baker KS, Bricker JB, Gopal AK, Hagen A, Ketterl TG, Reding KW, Schenk JM, Syrjala KL, Taylor SL, Wang G, Neuhouser ML, Mendoza JA

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020

Abstract Body:
PURPOSE: Hematopoietic cell transplant survivors have an increased risk of cardiovascular disease (CVD) compared with the general population due to treatment-related exposures. METHODS: Pilot randomized control trial testing the feasibility and preliminary efficacy of a 4mo mobile health intervention consisting of physical activity (Fitbit) and diet (Healthwatch360) trackers, individualized goal setting (daily steps, sodium, saturated fat, added sugar intake), and a private social media (Facebook) peer support group. Control participants had access to physical activity and diet trackers without coaching or peer support. All participants received standardized survivorship counseling with tailored advice by telephone from an oncology nurse practitioner. Eligible participants were 18-55y and 5-10y post-transplant. Baseline and follow-up assessments of physical activity and diet were obtained via Actigraph (sedentary and moderate-vigorous activity time [MVPA]) and food frequency questionnaire (sodium, saturated fat, total added sugar, 2015 Healthy Eating Index [HEI]), respectively. RESULTS: We enrolled 21 participants (median age 42y [range 20-55]; 38.1% male; 12 intervention; 9 control). Fitbit (≥500 steps/d) and Healthwatch (≥500 calories/d) use was more common among intervention vs controls subjects (83 vs 50% and 50 vs 22%, respectively). Most intervention participants (75%) viewed, liked, or commented on Facebook posts. With limited sample size (n=20; 9 controls), no comparisons between groups met statistical significance. However, when change from baseline was analyzed, the intervention was associated with greater reductions in daily average (±SD) sodium (-978±1495 vs -550±1281mg), saturated fat (-8.2±12.5 vs -5.8±11.7g), total added sugars (-19.9±32.4 vs -1.7±13.9g), and an improved HEI (2.0±7.3 vs. 0.6±7.9) vs controls. The intervention was also associated with greater reduction in sedentary time from baseline vs control (-41.6±108.4 vs -4.0±71.7min/d) but not change in MVPA (0.7±14.4 vs 3.5±7.9min/d). CONCLUSIONS: The addition of social media support and individualized goal-setting targeting CVD risk reduction was feasible among cancer survivors with promising outcomes for dietary change. A more robustly powered study is warranted to evaluate efficacy.

Keywords: physical activity, diet, survivorship, cardiovascular disease