Fit2ThriveMIND: Optimizing a mHealth Physical Activity Intervention with Mindful Awareness Lessons in Breast Cancer Survivors

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PROJECT SUMMARY/ABSTRACT There are approximately 4 million breast cancer survivors (BCS) in the U.S., and this population is expected to increase by 1 million in the next ten years. Increased moderate-to-vigorous intensity physical activity (MVPA) is consistently associated with reductions in treatment-related side effects, cancer recurrence and mortality, and increased QOL in BCS. Yet, the majority of BCS (~70%) do not meet MVPA recommendations (i.e., 150 mins/week). Existing studies of MVPA in BCS are largely resource-intensive, costly, and deliver multiple components (i.e., coaching calls, supervised exercise) simultaneously limiting scalability. Three evidence- based strategies have been identified that may be particularly useful for overcoming these barriers and increasing MVPA in BCS: 1) electronic delivery of a MVPA program, 2) social support, and 3) mindfulness training. However, little is known about the unique roles of social support and mindfulness in MVPA promotion. More granular information about the discrete effects of these components is needed to optimize intervention configuration in order to maximize an effective and scalable MVPA program for BCS. The purpose of this study is to apply the Multiphase Optimization Strategy (MOST), to determine which types of social support and mindfulness training intervention components optimally increase and maintain MVPA in a 6-month mHealth MVPA intervention with a 6-month follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated, or replaced to improve efficiency. Inactive BCS (n=304) will receive a core intervention consisting of the FIt2ThriveMIND app and Fitbit and be randomly assigned to four components under consideration for inclusion in the optimized intervention: 1) general mindfulness training; 2) MVPA-specific mindfulness training; 3) text-coaching; and 4) engagement of a buddy. We will also examine the effects of increasing MVPA on symptom burden, other intensity activities (i.e. light and sedentary), and sleep quality and duration and potential mediators and moderators of component effects. All components with have a 6-month duration except text coaching which will include “boosters” personalized to an individual's MVPA goal- attainment during the 6-month follow-up period. The proposed study represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention in BCS that incorporates mindfulness and specifically tests a maintenance strategy. Knowledge gained from this study will inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS. This study will lead to an improved understanding of how to effectively change and maintain BCS' MVPA and inform the development of more effective and scalable interventions to improve health and disease outcomes among BCS.