A Real-Time Mobile Intervention to Reduce Sedentary Behavior Before and After Cancer Surgery: Usability and Feasibility Study.
A Real-Time Mobile Intervention to Reduce Sedentary Behavior Before and After Cancer Surgery: Usability and Feasibility Study.
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一种实时的移动干预措施，以减少癌症手术前后的久坐行为：可用性和可行性研究。
DOI：
10.2196/17292
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发表时间：
2020-03-23
影响因子：
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通讯作者：
Jakicic JM
中科院分区：
文献类型：
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作者：
Low CA;Danko M;Durica KC;Kunta AR;Mulukutla R;Ren Y;Bartlett DL;Bovbjerg DH;Dey AK;Jakicic JM
久坐行为（SB）在癌症手术后很常见，可能会对恢复和生活质量产生负面影响，但术后症状（如疼痛）可能是患者达到推荐的身体活动水平的重大障碍。我们进行了一项单臂试验，评估实时移动干预的可用性和可接受性，该干预可以检测围手术期延长的SB，并根据每日自我报告的症状负担提供行走提示。本研究的目的是开发和测试一种移动技术支持的干预措施，以减少癌症手术前后的SB，并评估干预措施的可用性和可行性。共有15名计划接受腹部癌症手术的患者同意这项研究，该研究涉及在围手术期（从手术前至少2周到出院后30天）使用Fitbit智能手表和配套的智能手机应用程序。参与者在任何SB超过预设阈值后都会收到提示，该阈值根据患者报告的症状严重程度而每天变化。参与者还完成了每周的半结构化访谈，以收集应用程序和智能手机的可用性、可接受性和使用体验方面的信息；此外，研究人员还检查了智能手表日志，以评估参与者对研究的依从性。在接近的符合条件的患者中，79%（15/19）同意参与。流失率很低（1/ 15.7%），原因是健康状况不佳和住院时间过长。参与者对智能手机和智能手表应用程序的评分（0-100分）为非常简单（平均分别为92.3分和93.2分）和使用愉快（平均分别为93.0分和93.2分）。整个系统的总体满意度为89.9，平均系统可用性量表得分为83.8分（满分100分）。总体症状报告依从性为51%（469/927天），从术前（264/ 364.73%）到住院恢复（32/ 143.22%）和出院后（173/420,41%）显著下降。总体Fitbit依从性为70%（653/927天），但从术前（330/ 364,91%）到住院（51/ 143,36%）和出院后（272/420,65%）也有所下降。围手术期癌症患者愿意使用基于智能手表和智能手机的实时干预来减少SB，他们认为这些应用程序使用起来非常简单和愉快。术后对干预的依从性明显下降。干预对术后活动模式、恢复和生活质量的影响将在一项正在进行的随机试验中进行评估。
Sedentary behavior (SB) is common after cancer surgery and may negatively affect recovery and quality of life, but postoperative symptoms such as pain can be a significant barrier to patients achieving recommended physical activity levels. We conducted a single-arm pilot trial evaluating the usability and acceptability of a real-time mobile intervention that detects prolonged SB in the perioperative period and delivers prompts to walk that are tailored to daily self-reported symptom burden. The aim of this study is to develop and test a mobile technology-supported intervention to reduce SB before and after cancer surgery, and to evaluate the usability and feasibility of the intervention. A total of 15 patients scheduled for abdominal cancer surgery consented to the study, which involved using a Fitbit smartwatch with a companion smartphone app across the perioperative period (from a minimum of 2 weeks before surgery to 30 days postdischarge). Participants received prompts to walk after any SB that exceeded a prespecified threshold, which varied from day to day based on patient-reported symptom severity. Participants also completed weekly semistructured interviews to collect information on usability, acceptability, and experience using the app and smartphone; in addition, smartwatch logs were examined to assess participant study compliance. Of eligible patients approached, 79% (15/19) agreed to participate. Attrition was low (1/15, 7%) and due to poor health and prolonged hospitalization. Participants rated (0-100) the smartphone and smartwatch apps as very easy (mean 92.3 and 93.2, respectively) and pleasant to use (mean 93.0 and 93.2, respectively). Overall satisfaction with the whole system was 89.9, and the mean System Usability Scale score was 83.8 out of 100. Overall compliance with symptom reporting was 51% (469/927 days), decreasing significantly from before surgery (264/364, 73%) to inpatient recovery (32/143, 22%) and postdischarge (173/420, 41%). Overall Fitbit compliance was 70% (653/927 days) but also declined from before surgery (330/364, 91%) to inpatient (51/143, 36%) and postdischarge (272/420, 65%). Perioperative patients with cancer were willing to use a smartwatch- and smartphone-based real-time intervention to reduce SB, and they rated the apps as very easy and pleasant to use. Compliance with the intervention declined significantly after surgery. The effects of the intervention on postoperative activity patterns, recovery, and quality of life will be evaluated in an ongoing randomized trial.