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JMIR Cancer. 2017 Sep 21;3(2):e13. doi: 10.2196/cancer.7495.

A Lifestyle Intervention via Email in Minority Breast Cancer Survivors: Randomized Parallel-Group Feasibility Study.

Author information

1
Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL, United States.
2
Center for Health Equity and Evaluation Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
3
Texas Health Resources, Texas Health Harris Methodist Hospital, Fort Worth, TX, United States.
4
School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States.
5
Institute of Healthy Aging, University of North Texas Health Science Center, Forth Worth, TX, United States.
6
Department of Health Promotion and Behavior Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.
7
Department of Mexican American & Latina/o Studies, The University of Texas at Austin, Austin, TX, United States.
8
Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
9
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada.
10
Turnaround Health, a division of NutritionQuest, Berkeley, CA, United States.
11
School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
12
School of Public Health, Texas A&M Health Science Center, Bryan, TX, United States.

Abstract

BACKGROUND:

Our data have indicated that minority breast cancer survivors are receptive to participating in lifestyle interventions delivered via email or the Web, yet few Web-based studies exist in this population.

OBJECTIVE:

The aim of this study was to examine the feasibility and preliminary results of an email-delivered diet and activity intervention program, "A Lifestyle Intervention Via Email (ALIVE)," delivered to a sample of racial and ethnic minority breast cancer survivors.

METHODS:

Survivors (mean age: 52 years, 83% [59/71] African American) were recruited and randomized to receive either the ALIVE program's 3-month physical activity track or its 3-month dietary track. The fully automated system provided tools for self-monitoring and goal setting, tailored content, and automated phone calls. Descriptive statistics and mixed-effects models were computed to examine the outcomes of the study.

RESULTS:

Upon completion, 44 of 71 survivors completed the study. Our "intention-to-treat" analysis revealed that participants in the physical activity track made greater improvements in moderate to vigorous activity than those in the dietary track (+97 vs. +49 min/week, P<.001). Similarly, reductions in total sedentary time among those in the physical activity track (-304 vs. -59 min/week, P<.001) was nearly 5 times greater than that for participants in the dietary track. Our completers case analysis indicated that participants in the dietary track made improvements in the intake of fiber (+4.4 g/day), fruits and vegetables (+1.0 cup equivalents/day), and reductions in saturated fat (-2.3 g/day) and trans fat (-0.3 g/day) (all P<.05). However, these improvements in dietary intake were not significantly different from the changes observed by participants in the physical activity track (all P>.05). Process evaluation data indicated that most survivors would recommend ALIVE to other cancer survivors (97%), were satisfied with ALIVE (82%), and felt that ALIVE was effective (73%). However, survivors expressed concerns about the functionality of the interactive emails.

CONCLUSIONS:

ALIVE appears to be feasible for racial and ethnic minority cancer survivors and showed promising results for larger implementation. Although survivors favored the educational content, a mobile phone app and interactive emails that work on multiple email domains may help to boost adherence rates and to improve satisfaction with the Web-based platform.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02722850; https://clinicaltrials.gov/ct2/show/NCT02722850 (Archived by WebCite at http://www.webcitation.org/6tHN9VsPh).

KEYWORDS:

African Americans; Internet; breast neoplasm; computer tailoring; diet; email; feasibility study; physical activity; posture; program evaluation

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