TY - JOUR
T1 - Feasibility and acceptability of a remotely delivered, web-based behavioral intervention for men with prostate cancer
T2 - Four-arm randomized controlled pilot trial
AU - Chan, June M.
AU - van Blarigan, Erin L.
AU - Langlais, Crystal S.
AU - Zhao, Shoujun
AU - Ramsdill, Justin W.
AU - Daniel, Kimi
AU - Macaire, Greta
AU - Wang, Elizabeth
AU - Paich, Kellie
AU - Kessler, Elizabeth R.
AU - Beer, Tomasz M.
AU - Lyons, Karen S.
AU - Broering, Jeanette M.
AU - Carroll, Peter R.
AU - Kenfield, Stacey A.
AU - Winters-Stone, Kerri M.
N1 - Funding Information:
The authors would like to acknowledge all the participants and Esther Moe, Carol-Ann Mullin, and Jade Moon for their assistance in managing and implementing the study. The authors also thank the Movember Foundation for supporting this project as part of its global TrueNTH initiative. This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), Grant Numbers UL1 TR001872 and UL1TR002369, and other National Institutes of Health grants P30DK098722, P30 CA069533-21, and NCI K07CA197077. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The project was also supported by the Steven and Christine Burd-Safeway Distinguished Professorship (JC) and the Helen Diller Family Chair in Population Science for Urologic Cancer (SK).
Publisher Copyright:
© June M Chan, Erin L Van Blarigan, Crystal S Langlais, Shoujun Zhao, Justin W Ramsdill, Kimi Daniel, Greta Macaire, Elizabeth Wang, Kellie Paich, Elizabeth R Kessler, Tomasz M Beer, Karen S Lyons, Jeanette M Broering, Peter R Carroll, Stacey A Kenfield, Kerri M Winters-Stone. Originally published in the Journal of Medical Internet Research (http://www.jmir.org),31.12.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
PY - 2020/12
Y1 - 2020/12
N2 - Background: Diet and exercise may be associated with quality of life and survival in men with prostate cancer. Objective: This study aimed to determine the feasibility and acceptability of a remotely delivered web-based behavioral intervention among men with prostate cancer. Methods: We conducted a multi-site 4-arm pilot randomized controlled trial of a 3-month intervention (TrueNTH Community of Wellness). Eligibility included self-reported prostate cancer diagnosis, having a personal device that connected to the internet, age ≥18 years, and ability to read English and receive text messages and emails. Men receiving chemotherapy or radiation, or those who reported contraindications to exercise, could participate with physician clearance. Participants were randomized (1:1:1:1) to additive intervention levels: website; website and personalized diet and exercise prescription; website, personalized prescription, Fitbit, and text messages; and website, personalized prescription, Fitbit, text messages, and 2 30-minute phone calls-one with an exercise trainer and one with a registered dietician. Primary outcomes were feasibility (accrual and attrition) and acceptability (survey data and website use). We described self-reported diet and exercise behavior at the time of enrollment, 3 months, and 6 months as secondary outcomes. Results: In total, 202 men consented and were randomized between August 2017 and September 2018 (level 1: 49, level 2: 51, level 3: 50, level 4: 52). A total of 160 men completed the onboarding process and were exposed to their randomly assigned intervention (38, 38, 42, and 42 in levels 1, 2, 3, and 4, respectively). The follow-up rate was 82.7% (167/202) at 3 months and 77.2% (156/202) at 6 months. Participants had a median age of 70 years and were primarily White and college educated. Website visit frequency over the 3-month intervention period increased across levels (median: 2, 9, 11, and 16 visits for levels 1, 2, 3, and 4, respectively). Most were satisfied or very satisfied with the intervention (20/39, 51%; 27/42, 64%; 23/44, 52%; and 27/42, 64% for levels 1, 2, 3, and 4, respectively). The percentage of men who reported being very satisfied was highest among level 4 participants (10/42, 24% vs 4/39, 10%; 5/42, 12%; and 5/44, 11% for levels 1, 2, and 3, respectively). Dissatisfaction was highest in level 1 (5/39, 13% vs 1/42, 2%; 3/44, 7%; and 2/42, 5% for levels 2, 3, and 4, respectively). We observed small improvements in diet and physical activity at 3 months among men in level 4 versus those in level 1. Conclusions: A web-based, remotely delivered, tailored behavioral intervention for men with prostate cancer is feasible. Future studies are warranted to increase the effect of the intervention on patient behavior while maintaining sustainability and scalability as well as to design and implement interventions for more diverse populations.
AB - Background: Diet and exercise may be associated with quality of life and survival in men with prostate cancer. Objective: This study aimed to determine the feasibility and acceptability of a remotely delivered web-based behavioral intervention among men with prostate cancer. Methods: We conducted a multi-site 4-arm pilot randomized controlled trial of a 3-month intervention (TrueNTH Community of Wellness). Eligibility included self-reported prostate cancer diagnosis, having a personal device that connected to the internet, age ≥18 years, and ability to read English and receive text messages and emails. Men receiving chemotherapy or radiation, or those who reported contraindications to exercise, could participate with physician clearance. Participants were randomized (1:1:1:1) to additive intervention levels: website; website and personalized diet and exercise prescription; website, personalized prescription, Fitbit, and text messages; and website, personalized prescription, Fitbit, text messages, and 2 30-minute phone calls-one with an exercise trainer and one with a registered dietician. Primary outcomes were feasibility (accrual and attrition) and acceptability (survey data and website use). We described self-reported diet and exercise behavior at the time of enrollment, 3 months, and 6 months as secondary outcomes. Results: In total, 202 men consented and were randomized between August 2017 and September 2018 (level 1: 49, level 2: 51, level 3: 50, level 4: 52). A total of 160 men completed the onboarding process and were exposed to their randomly assigned intervention (38, 38, 42, and 42 in levels 1, 2, 3, and 4, respectively). The follow-up rate was 82.7% (167/202) at 3 months and 77.2% (156/202) at 6 months. Participants had a median age of 70 years and were primarily White and college educated. Website visit frequency over the 3-month intervention period increased across levels (median: 2, 9, 11, and 16 visits for levels 1, 2, 3, and 4, respectively). Most were satisfied or very satisfied with the intervention (20/39, 51%; 27/42, 64%; 23/44, 52%; and 27/42, 64% for levels 1, 2, 3, and 4, respectively). The percentage of men who reported being very satisfied was highest among level 4 participants (10/42, 24% vs 4/39, 10%; 5/42, 12%; and 5/44, 11% for levels 1, 2, and 3, respectively). Dissatisfaction was highest in level 1 (5/39, 13% vs 1/42, 2%; 3/44, 7%; and 2/42, 5% for levels 2, 3, and 4, respectively). We observed small improvements in diet and physical activity at 3 months among men in level 4 versus those in level 1. Conclusions: A web-based, remotely delivered, tailored behavioral intervention for men with prostate cancer is feasible. Future studies are warranted to increase the effect of the intervention on patient behavior while maintaining sustainability and scalability as well as to design and implement interventions for more diverse populations.
KW - Cancer
KW - Diet
KW - Exercise
KW - Internet
KW - Lifestyle
KW - Physical activity
KW - Survivorship
KW - Text messages
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U2 - 10.2196/19238
DO - 10.2196/19238
M3 - Article
C2 - 33382378
AN - SCOPUS:85099174021
SN - 1439-4456
VL - 22
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 12
M1 - e19238
ER -