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      Designing iCanFit: A Mobile-Enabled Web Application to Promote Physical Activity for Older Cancer Survivors

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          Abstract

          Background

          Most older cancer survivors (OCS) do not engage in regular physical activity (PA) despite well-known health benefits. With the increased use of mobile technologies among older adults, mobile tools may be an effective method to deliver PA promotion programs for OCS.

          Objective

          To document the process of designing an OCS-friendly mobile-enabled Web application of PA promotion program.

          Methods

          Mixed methods encompassing group discussions, individual interviews, and brief surveys with community leaders, OCS, cancer care providers, and software professionals were used in this formative research.

          Results

          The varied stakeholders welcomed the idea of developing an online tool to promote PA in OCS. Our formative research revealed several major barriers to regular PA including limited access to senior-friendly PA resources, lack of motivation and social support, and insufficient knowledge and skills on building safe and appropriate workout plans. This feedback was incorporated into the development of iCanFit, a mobile-enabled Web application, designed specifically for OCS. The iCanFit online tools allow users to locate PA resources, set and track goals for PA, network with peer OCS in a secure online space, and receive practical and evidence-informed healthy tips.

          Conclusions

          Our mixed-method formative research led to the design of iCanFit protocol to promote PA and well-being of OCS. The involvement of stakeholders is critical in the planning and design of the mobile application in order to enhance program relevance, appeal, and match with the needs of target users.

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          Most cited references25

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          Cancer treatment and survivorship statistics, 2012.

          Rebecca Siegel, Carol DeSantis, Katherine Virgo … (2012)
          Although there has been considerable progress in reducing cancer incidence in the United States, the number of cancer survivors continues to increase due to the aging and growth of the population and improvements in survival rates. As a result, it is increasingly important to understand the unique medical and psychosocial needs of survivors and be aware of resources that can assist patients, caregivers, and health care providers in navigating the various phases of cancer survivorship. To highlight the challenges and opportunities to serve these survivors, the American Cancer Society and the National Cancer Institute estimated the prevalence of cancer survivors on January 1, 2012 and January 1, 2022, by cancer site. Data from Surveillance, Epidemiology, and End Results (SEER) registries were used to describe median age and stage at diagnosis and survival; data from the National Cancer Data Base and the SEER-Medicare Database were used to describe patterns of cancer treatment. An estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012, and by January 1, 2022, that number will increase to nearly 18 million. The 3 most prevalent cancers among males are prostate (43%), colorectal (9%), and melanoma of the skin (7%), and those among females are breast (41%), uterine corpus (8%), and colorectal (8%). This article summarizes common cancer treatments, survival rates, and posttreatment concerns and introduces the new National Cancer Survivorship Resource Center, which has engaged more than 100 volunteer survivorship experts nationwide to develop tools for cancer survivors, caregivers, health care professionals, advocates, and policy makers. Published 2012 American Cancer Society, Inc.
          Article 0 comments Cited 227 times – based on 0 reviews     Review now
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            Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis.

            Kathryn H Schmitz, Jeremy Holtzman, Kerry Courneya … (2005)
            Approximately 9.8 million cancer survivors are alive in the United States today. Enthusiasm for prescribing physical activity for cancer survivors depends on evidence regarding whether physical activity during or after completion of treatment results in improved outcomes such as cardiorespiratory fitness, fatigue, symptoms, quality of life, mental health, or change in body size. A systematic qualitative and quantitative review of the English language scientific literature identified controlled trials of physical activity interventions in cancer survivors during and after treatment. Data from 32 studies were abstracted, weighted mean effect sizes (WMES) were calculated from the 22 high-quality studies, and a systematic level of evidence criteria was applied to evaluate 25 outcomes. There was qualitative and quantitative evidence of a small to moderate effect of physical activity interventions on cardiorespiratory fitness (WMES = 0.51 and 0.65 during and after treatment respectively, P < 0.01), physiologic outcomes and symptoms during treatment (WMES = 0.28, P < 0.01 and 0.39, P < 0.01, respectively), and vigor posttreatment (WMES = 0.83, P = 0.04). Physical activity was well tolerated in cancer survivors during and after treatment, but the available literature does not allow conclusions to be drawn regarding adverse events from participation. Physical activity improves cardiorespiratory fitness during and after cancer treatment, symptoms and physiologic effects during treatment, and vigor posttreatment. Additional physical activity intervention studies are needed to more firmly establish the range and magnitude of positive effects of physical activity among cancer survivors.
            Article 0 comments Cited 118 times – based on 0 reviews     Review now
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              Randomized controlled trial of weight training and lymphedema in breast cancer survivors.

              Douglas Yee, L Ahmed, Douglas Yee … (2006)
              Lymphedema is a common condition that breast cancer survivors face. Despite a lack of supporting evidence from prospective observational studies, occupational and leisure time physical activity are feared to be possible risk factors for lymphedema onset or exacerbation. We examined effects of supervised upper- and lower-body weight training on the incidence and symptoms of lymphedema in 45 breast cancer survivors who participated in the Weight Training for Breast Cancer Survivors study. Participants were on average 52 years old, 4 to 36 months post-treatment, and had axillary dissection as part of their treatment. Thirteen women had prevalent lymphedema at baseline. The intervention was twice-a-week weight training over a period of 6 months. Lymphedema was monitored at baseline and 6 months by measuring the circumference of each arm, and by self-report of symptoms and clinical diagnosis. None of the intervention-group participants experienced a change in arm circumferences > or = 2.0 cm after a 6-month exercise intervention. Self-reported incidence of a clinical diagnosis of lymphedema or symptom changes over 6 months did not vary by intervention status (P = .40 and P = .22, respectively). This is the largest randomized controlled trial to examine associations between exercise and lymphedema in breast cancer survivors. The results of this study support the hypotheses that a 6-month intervention of resistance exercise did not increase the risk for or exacerbate symptoms of lymphedema. These results herald the need to start reevaluating common clinical guidelines that breast cancer survivors avoid upper body resistance activity for fear of increasing risk of lymphedema.
              Article 0 comments Cited 71 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yan Hong:
                Department of Health Promotion and Community Health ScienceSchool of Rural Public HealthTexas A&M Health Science Center1266 TAMUCollege Station, TX, 77843United States1 979 862 17001 979 458 4264yhong@srph.tamhsc.edu
                Journal
                Journal ID (nlm-ta): JMIR Res Protoc
                Journal ID (iso-abbrev): JMIR Res Protoc
                Journal ID (publisher-id): ResProt
                Title: JMIR Research Protocols
                Publisher: JMIR Publications Inc. (Toronto, Canada )
                ISSN (Electronic): 1929-0748
                Publication date Collection: Jan-Jun 2013
                Publication date (Electronic): 14 February 2013
                Volume: 2
                Issue: 1
                Electronic Location Identifier: e12
                Affiliations
                [1] 1Department of Health Promotion and Community Health Science School of Rural Public Health Texas A&M Health Science Center College Station, TXUnited States
                [2] 2Texas Life Science Foundation Austin, TXUnited States
                [3] 3Scott & White Healthcare Temple, TXUnited States
                [4] 4Texas AgriLife Extension Agency Texas A&M University System College Station, TXUnited States
                Author notes
                Corresponding Author: Yan Hong yhong@ 123456srph.tamhsc.edu
                Article
                Publisher ID: v2i1e12
                DOI: 10.2196/resprot.2440
                PMC ID: 3628153
                PubMed ID: 23612053
                SO-VID: a62065a8-0f73-4bf6-a316-01e466c3a522
                Copyright © ©Yan Hong, Deborah Vollmer Dahlke, Marcia Ory, Angela Hochhalter, Jana Reynolds, Ninfa Pena Purcell, Divya Talwar, Nola Eugene. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.02.2013.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                Date received : 14 November 2012
                Date revision requested : 18 January 2013
                Date revision received : 23 January 2013
                Date accepted : 25 January 2013
                Categories
                Subject: Original Paper

                Keywords: older cancer survivors,physical activity, survivorship, mhealth, website design,user-computer interface,protocol development,formative research
                Data availability:
                Keywords: older cancer survivors, physical activity, survivorship, mhealth, website design, user-computer interface, protocol development, formative research

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