A Randomized Trial Testing An Automated Internet Program For Increasing Physical Activity Among Cancer Survivors

Physical activity (PA) can reduce cancer recurrence and improve long-term health challenges faced by cancer survivors (e.g., decreased quality of life and increased fatigue and anxiety), yet lower than average PA persists in this population. With rates of cancer survivorship on the rise, translatable programs for increasing PA are needed. PURPOSE: To examine the feasibility, acceptability, and preliminary efficacy of a web-based intervention for increasing PA among cancer survivors. METHODS: Inactive (<60 min/wk of self-reported PA over past 3 months) cancer survivors (n = 46, 55.0 ± 8.4 years old, 91.3% female, 78.3% breast cancer) who completed treatment in the past 12 months, or were stable on a maintenance treatment regimen, were randomized to: 1) the Energize! Exercise Program, a 12-week, fully automated program delivered via the Internet, or 2) a newsletter control condition. Weekly, Energize! participants were instructed to watch a behaviorally based video lesson, submit an exercise plan, report their exercise minutes, and complete assigned homework. The PA goal progressed from 75 to 200 min/wk and automated, personalized feedback was provided. Newsletters were focused on PA education and sent twice per month to control participants. Physical activity was assessed at baseline and 12 weeks via the Paffenbarger PA questionnaire and Actigraph accelerometer. RESULTS: Retention was 95.6% at 12 weeks. On average, Energize! participants viewed 87.7 ± 21.3% of video lessons, submitted 82.6 ± 25.8% of exercise plans, completed 77.2 ± 25.2% of homework assignments, and logged weekly exercise 85.9 ± 22.1% of the time. Program satisfaction was high (5.8 ± 1.6 out of 7) and greater than control (3.2 ± 1.6, p < 0.001). Energize! significantly increased self-reported PA by a median of 135 min/wk versus 22.5 min/wk in control (p = 0.04). The change in Actigraph-assessed, moderate-to-vigorous PA was 40.9 (IQR 98.5) min/wk in Energize! versus -7.0 (IQR 43.4) min/wk in control (p = 0.04). CONCLUSIONS: This fully automated PA program, which could be scaled to enroll many individuals at minimal cost, demonstrated high program engagement and satisfaction, with a modest, yet significant effect on PA. Participants will be followed until 24 weeks to assess the longer effects of the program. Legoretta Cancer Center at Brown University