A Home-Based Mobile Health Intervention to Replace Sedentary Time With Light Physical Activity in Older Cancer Survivors: Randomized Controlled Pilot Trial.
A Home-Based Mobile Health Intervention to Replace Sedentary Time With Light Physical Activity in Older Cancer Survivors: Randomized Controlled Pilot Trial.
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作者：
Blair CK;Harding E;Wiggins C;Kang H;Schwartz M;Tarnower A;Du R;Kinney AY
老年癌症幸存者有发生或恶化年龄和治疗相关发病率的风险。久坐不动的行为会增加或加剧这些慢性疾病的风险。轻度体力活动（LPA）在老年人中更常见，与更好的健康和福祉有关。因此，用LPA代替久坐时间可能会提供一种更成功的策略来减少久坐时间并增加身体活动。本研究的主要目的是评估基于家庭的移动的健康（mHealth）干预的可行性，可接受性和初步疗效，以中断和替代久坐时间与LPA（站立和踏步）。本研究的第二个目的是检查身体活动，身体表现和自我报告的生活质量的客观指标的变化。总体而言，54名癌症幸存者（年龄在60-84岁之间）以1：1：1的比例随机分配到技术支持干预组、技术支持加健康指导干预组或候补对照组。干预参与者收到了Jawbone UP 2活动监测器，用于他们的智能手机应用程序13周。在为期13周的干预期间，通过5个电话提供技术支持和健康指导。在干预前后7天，使用activPAL监测仪客观测量久坐行为和身体活动。参与者包括乳腺癌（21/54，39%），前列腺癌（16/54，30%）和各种其他癌症类型的幸存者;自癌症诊断以来，平均4.4年（SD 1.6）已经过去。参与者平均年龄为70岁（SD 4.8），55%（30/54）为女性，24%（13/54）为西班牙裔，81%（44/54）为超重或肥胖。在干预组中，有三分之一的人发生了Jawbone追踪器故障，导致招募停止在54名参与者，而不是最初的60名参与者目标。尽管存在这些技术问题，但干预措施的保留率很高（47/54，87%）。佩戴追踪器（29/29，100%）和每天检查应用程序（28/29，96%）的依从性较高，但与追踪器和应用程序的久坐功能相关的特定方面的依从性较低（21%-25%）。干预措施的可接受性中等偏高（81%）。两组之间在总的久坐时间、休息次数或长时间久坐次数方面没有显著差异。在体力活动方面没有显著的组间差异。唯一显著的组内变化发生在健康教练组，增加了1675个每日步数（95% CI 444-2906; P= 0.009）。这种增加是由中等强度的踏步而不是光强度的踏步引起的（每天+15.2分钟; 95% CI 4.1-26.2; P= 0.008）。一个以家庭为基础的移动健康计划，以打破和取代久坐不动的时间与步进是可行的，并接受老年癌症幸存者。未来的研究需要评估在这一人群中用站立和/或体力活动取代久坐行为的最佳方法。ClinicalTrials.gov NCT 03632694; https://clinicaltrials.gov/ct2/show/NCT03632694
Older cancer survivors are at risk of the development or worsening of both age- and treatment-related morbidity. Sedentary behavior increases the risk of or exacerbates these chronic conditions. Light-intensity physical activity (LPA) is more common in older adults and is associated with better health and well-being. Thus, replacing sedentary time with LPA may provide a more successful strategy to reduce sedentary time and increase physical activity. This study primarily aims to evaluate the feasibility, acceptability, and preliminary efficacy of a home-based mobile health (mHealth) intervention to interrupt and replace sedentary time with LPA (standing and stepping). The secondary objective of this study is to examine changes in objective measures of physical activity, physical performance, and self-reported quality of life. Overall, 54 cancer survivors (aged 60-84 years) were randomized in a 1:1:1 allocation to the tech support intervention group, tech support plus health coaching intervention group, or waitlist control group. Intervention participants received a Jawbone UP2 activity monitor for use with their smartphone app for 13 weeks. Tech support and health coaching were provided via 5 telephone calls during the 13-week intervention. Sedentary behavior and physical activity were objectively measured using an activPAL monitor for 7 days before and after the intervention. Participants included survivors of breast cancer (21/54, 39%), prostate cancer (16/54, 30%), and a variety of other cancer types; a mean of 4.4 years (SD 1.6) had passed since their cancer diagnosis. Participants, on average, were 70 years old (SD 4.8), 55% (30/54) female, 24% (13/54) Hispanic, and 81% (44/54) overweight or obese. Malfunction of the Jawbone trackers occurred in one-third of the intervention group, resulting in enrollment stopping at 54 rather than the initial goal of 60 participants. Despite these technical issues, the retention in the intervention was high (47/54, 87%). Adherence was high for wearing the tracker (29/29, 100%) and checking the app daily (28/29, 96%) but low for specific aspects related to the sedentary features of the tracker and app (21%-25%). The acceptability of the intervention was moderately high (81%). There were no significant between-group differences in total sedentary time, number of breaks, or number of prolonged sedentary bouts. There were no significant between-group differences in physical activity. The only significant within-group change occurred within the health coaching group, which increased by 1675 daily steps (95% CI 444-2906; P=.009). This increase was caused by moderate-intensity stepping rather than light-intensity stepping (+15.2 minutes per day; 95% CI 4.1-26.2; P=.008). A home-based mHealth program to disrupt and replace sedentary time with stepping was feasible among and acceptable to older cancer survivors. Future studies are needed to evaluate the optimal approach for replacing sedentary behavior with standing and/or physical activity in this population. ClinicalTrials.gov NCT03632694; https://clinicaltrials.gov/ct2/show/NCT03632694
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DOI：
10.1007/s11764-015-0456-9
发表时间：
2016-02
期刊：
Journal of cancer survivorship : research and practice
影响因子：
--
作者：
Blair CK;Robien K;Inoue-Choi M;Rahn W;Lazovich D
通讯作者：
Lazovich D
影响因子：
16.2
作者：
Dunstan DW;Kingwell BA;Larsen R;Healy GN;Cerin E;Hamilton MT;Shaw JE;Bertovic DA;Zimmet PZ;Salmon J;Owen N
通讯作者：
Owen N
影响因子：
5
作者：
Chia, Gladys Lai Cheng;Anderson, Angelika;McLean, Louise Anne
通讯作者：
McLean, Louise Anne
影响因子：
2
作者：
Duncan, Mitch;Murawski, Beatrice;Kirwan, Morwenna
通讯作者：
Kirwan, Morwenna
影响因子：
12.7
作者：
Campbell, MK;Demark-Wahnefried, W;McClelland, JW
通讯作者：
McClelland, JW