Abstract
BackgroundOver 1.3 million people live with colorectal cancer in the United States. Physical activity is associated with lower risk of colorectal cancer recurrence and mortality. Interventions are needed to increase physical activity in colorectal cancer survivors.MethodsWe conducted a 2-arm non-blinded pilot randomized controlled trial at the University of California, San Francisco among 42 individuals who had completed curative-intent treatment for colorectal cancer to determine the feasibility and acceptability of a 12-week (84 days) physical activity intervention using a Fitbit Flex™ and daily text messages. Participants were randomized 1:1 to receive the intervention with print educational materials or print educational materials alone. We explored the impact of the intervention versus usual care on physical activity using ActiGraph GT3X+ accelerometers pre−/post-intervention.ResultsWe screened 406 individuals and randomized 42 to intervention (n = 21) or control (n = 21) groups. During the 12-week study, the intervention arm wore their Fitbits a median of 74 days [88% of days in study period, interquartile range: 23–83 days] and responded to a median of 34 (out of 46) text messages that asked for a reply (interquartile range: 13–38 text messages). Among the 16 intervention participants who completed the feedback survey, the majority (88%) reported that the intervention motivated them to exercise and that they were satisfied with their experience. No statistically significant difference in change in moderate-to-vigorous physical activity was found from baseline to 12 weeks between arms.ConclusionA 12-week physical activity intervention with a Fitbit and text messages was feasible and acceptable among colorectal cancer patients after curative treatment. Larger studies are needed to determine whether the intervention increases physical activity.Trial registrationClinicaltrials.gov Identifier NCT02966054. Registered 17 November 2016, retrospectively registered.
Highlights
Over 1.3 million people live with colorectal cancer in the United States
Statistical analysis To determine if the intervention was feasible, we calculated the proportion of the intervention group who wore their Fitbit Flex N days out of the total 84 study days and the proportion who responded to N text messages out of a total of 46 text messages that asked for a reply
The two patients who did not complete the 12-week accelerometer assessment in the control arm withdrew from the study
Summary
Over 1.3 million people live with colorectal cancer in the United States. Physical activity is associated with lower risk of colorectal cancer recurrence and mortality. Interventions are needed to increase physical activity in colorectal cancer survivors. Over 1.3 million individuals currently live with colorectal cancer in the United States (US), representing nearly 10% of all US cancer survivors [1]. Evidence from prospective studies strongly suggests that physical activity after colorectal cancer diagnosis reduces the risk of cancer-specific and overall mortality [2,3,4]. Interventions that increase physical activity and improve outcomes among colorectal cancer survivors could provide a great public health benefit. A growing number of digital health behavioral interventions have included cancer patients [8], yet colorectal cancer survivors are underrepresented in these studies. No studies focused on colorectal cancer, and fewer than 30 individuals with colorectal cancer were included in any one study that enrolled multiple cancer types [8]
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