Evaluating the Impact of Weekly Physical Performance Reports on Daily Physical Activity and Symptoms Among Cancer Survivors: Secondary Analysis of a Randomized Controlled Trial

<b>Background/Objectives:</b> Many cancer survivors continue to experience persistent symptoms such as pain, fatigue, and depression. Exercise and increasing physical activity (PA) are recommended as methods that can help alleviate these symptoms. However, maintaining regular exercise can be difficult due to the challenge of maintaining motivation. This secondary analysis uses data from a randomized controlled pilot study that examines the feasibility of the technology-enhanced combined exercise and other nonpharmacological interventions, such as the TEHEplus program, in managing symptoms. The program used mobile technologies and sent weekly physical performance reports to maintain engagement. In this study, we aimed to examine the impact of weekly physical performance reports on daily symptoms and PA and explored characteristics as moderators. <b>Methods:</b> This secondary analysis included participants who completed the 12-week TEHEplus program. Daily data of steps (PA), sleep duration, and symptoms (rated on a 4-point scale) were collected for 84 days. Mixed-effects and lagged regression models were used to assess the impact of weekly physical performance reports and the moderating effects of baseline characteristics. <b>Results:</b> Seventy-seven survivors of solid tumor cancer (mean age, 59.79, <i>SD</i> = 12.17) were analyzed. During this 84-day period, participants reported a reduction in low energy (<i>B</i> = -0.003, <i>p</i> = 0.004). Step counts increased by an average of 141 steps immediately after each weekly report (<i>B</i> = 140.857, <i>p</i> = 0.027). An increase of 5000 steps on the prior day was related to decreasing pain (<i>B</i> = -0.047, <i>p</i> < 0.001) and fatigue/low energy (<i>B</i> = -0.082, <i>p</i> < 0.001). Two additional hours of prior-night sleep worsened pain (<i>B</i> = 0.029, <i>p</i> = 0.001) and fatigue/low energy (<i>B</i> = 0.027, <i>p</i> = 0.002). Gender, employment, race, caregiver, and type of treatments moderate the relationship between daily PA, sleep (<i>B</i> = -0.131~0.078, <i>p_s</i> < 0.05). <b>Conclusions:</b> Weekly physical performance reports promoted PA, which possibly led to self-reported improvement of symptoms. Higher PA was associated with better self-report symptoms, but longer sleep duration was associated with worsened symptoms, suggesting the need for future studies. The moderating effects suggested that tailoring interventions to individual profiles may enhance the program's effectiveness.