ASPO Abstracts
A pilot randomized controlled trial of a digital health intervention to increase physical activity during chemotherapy for colorectal cancer: feasibility and acceptability
Category: Behavioral Science & Health Communication
Conference Year: 2021
Abstract Body:
Purpose: We conducted a pilot randomized controlled trial of a digital health intervention to increase moderate
to vigorous physical activity (MVPA) among CRC patients during chemotherapy.
Methods: Eligible patients were expected to receive ≥12 wks of chemotherapy; had provider approval of
unsupervised MVPA; English proficient; able to receive email/text messages; and self-reported of <150 min/wk
MVPA. Patients were randomized 1:1 to a 12-wk intervention (Fitbit Flex, text messages) vs. usual care. At 0-
and 12-wks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size
measurements, and an optional 6-min walk test. Here we report the primary outcomes: adherence (e.g., Fitbit
wear, text response rate) and acceptability of the intervention. A priori, the intervention would be considered
feasible if we observed ≥80% complete follow-up and ≥70% adherence and satisfaction.
Results: In 2018 to 2020, we screened 240 patients; 55% were ineligible and 27% declined. Forty-four patients
were randomized to intervention (n=22) or control (n=22). These patients were 57% female; 71% non-Hispanic
white; 26% Asian American/Pacific Islander; 64% had colon cancer; 36% had rectal cancer; 50% had stage III
and 39% had stage IV. Mean age and BMI were 54±13 y and 26.2±6.9 kg/m^2. Forty patients completed ≥1
study task at 12 wks (91% follow-up). In the intervention arm, patients wore Fitbits a median of 67 of 84 study
days (80%) and responded to a median 13 out of 27 questions sent via text message (48%). Among the 19 of
22 intervention patients who completed the feedback survey, 89% were satisfied with the Fitbit and 63% were
satisfied with the text messages; 68% said the text messages motivated them to exercise; 74% said the
frequency of text messages (1-3 days) was ideal; 79% said receiving text messages in the morning and
evening was ideal.
Conclusion: We achieved our a priori goals for retention and Fitbit adherence, but satisfaction and response
rates with the text messages was lower than 70%. Participant feedback indicated a desire for more tailored text
message content. Studies with more racially/ethnically and socioeconomically diverse CRC patients are also
needed.
ClinicalTrials.gov Identifier: NCT03524716
Keywords: Fitbit, text messages, behavior, exercise