Emotional And Cognitive Predictors Of Retention In A Web-based Physical Activity Intervention

While there is research suggesting adult cancer survivors are generally interested in digital physical activity (PA) interventions, it is unclear what psycho-social factors are associated with successful completion of a digital intervention. PURPOSE: To assess if fear of cancer recurrence (FCR) or cognitive function (CF) predict retention in a year-long, digital PA intervention. METHODS: Survivors of physical inactivity-related cancers were randomized into two website groups for one year: 1) a PA group that was provided an online intervention promoting more PA and less sedentary time, or 2) a balance and flexibility control group. Participants (n = 415 survivors, 94% female, mean age = 62 years (SD = 8.46)) ≥6 months post-treatment were randomized into the study. FCR was measured using the validated 7-item Fear of Cancer Recurrence Inventory (FCR7), CF was measured using the self-reported PROMIS items. The outcome, “retention” in the intervention, is defined as completing at least 60% of the post-survey and returning the accelerometer at one year. Logistic regression models were used to assess the associations between FCR and CF with retention in the intervention, adjusting for age, sex, BMI, and group assignment. Five (1.2%) participants were excluded from analyses for missing CF and FCR7 scores, leaving 410 participants in this analysis. RESULTS: A total of 30 (7.3%) participants withdrew from the intervention (12 withdrew within 3 months, 6 withdrew between 3-6 months, and 12 withdrew in the last 6 months of the study). FCR7 scores were above the 75th percentile (score of 20) was defined as a high level of FCR. There was a borderline significant association that participants with a low FCR were more likely to remain in the intervention than those with higher FCR (OR = 2.28, 95% CI: 0.99-5.13). 114 (27%) survivors had a CF score indicating mild-to-severe cognitive impairment. Compared to participants with poorer CF, participants with normal cognitive function were two times more likely (OR = 2.12, 95% CI: 1.16-5.55) to remain in the intervention. CONCLUSION: Cancer survivors with low FCR and normal CF were more likely to remain in the intervention than survivors with high FCR and poor CF.