Assessing the Benefits and Use of Gain-Framed Text Messaging to Improve Physical Activity in Advanced Stage Lung Cancer

Abstract

SESSION TITLE: Late-Breaking Abstracts SESSION TYPE: Late-Breaking Abstract Slide PRESENTED ON: Wednesday, November 1, 2017 at 02:45 PM - 04:15 PM PURPOSE: Physical activity (PA) is a potential therapy to improve quality of life (QoL) in patients with advanced stage lung cancer (LC). Many regimens have been studied, but no PA regimen has been shown to be both beneficial and sustainable. We have previously used weekly phone calls to deliver PA goals. We hypothesize that a walking-based PA regimen using gain-framed text messaging will improve PA levels more effectively than weekly phone calls. METHODS: In patients with advanced stage LC, we implemented a Patient-Centered Activity Regimen (PCAR) utilizing a FitBit Flex® (San Francisco, CA) accelerometer, an educational session at enrollment, individualized walking goals, and twice daily gain-framed text messages. Feedback surveys were collected at the end of the intervention. Over a 4 week period, activity levels were compared between the PCAR group (n=15) and prior efforts using weekly phone calls (n=29). Data collection and likelihood of increasing PA were compared, and a repeated measures, mixed-effects model was constructed. RESULTS: Compared to those receiving weekly phone calls, subjects receiving twice daily gain-framed text messages more frequently used the device (100% vs 76%), increased their step count (67% vs 34%), and less frequently had missing data (12% vs 37%). Scatterplots revealed “more active” and “less active” groups. Participants were grouped into “more active” and “less active” groups based on above- or below-average step counts at baseline. The “less active” group improved their PA level whereas the “more active” group became less active. Most subjects (92%) found the intervention helpful and would participate in another activity study. Most subjects would prefer individualized (rather than group) PA interventions (83%) and to be motivated via daily text messages (55%) that are sent at noon (55%). CONCLUSIONS: In this small cohort, compared to weekly phone calls, twice daily gain-framed text messaging (1) improves data collection, (2) is more likely than weekly phone calls to improve PA (especially in “less active” subjects), and (3) has high patient satisfaction scores. Gain-framed text messaging appears to be an effective way to motivate patients with advanced stage LC to exercise. Future studies should further evaluate the benefits of walking-based PA in this group as well as the differences between the “more active” and “less active” groups. CLINICAL IMPLICATIONS: This study will help inform future efforts to motivate patients with advanced stage lung cancer toward exercise. DISCLOSURE: The following authors have nothing to disclose: Brett Bade, Alex Pastis, Lindsey Owens, J. Hyer, Gerard Silvestri No Product/Research Disclosure Information