Optimization Of Mhealth Behavioral Intervention For Families With Hereditary Breast And Ovarian Cancers: The Health4families Study

PURPOSE: Individuals with hereditary breast and ovarian cancer (HBOC) or Lynch syndrome (LS) have higher lifetime cancer risks than the general population. Physical activity, diet, and weight management are potential risk-reducing strategies for those with hereditary cancer syndromes. Using the Multiphase Optimization Strategy approach, we identified effective and scalable mHealth intervention components for behavior change and weight loss among individuals with HBOC and LS and their family members. METHODS: The HEALTH4Families study provided 16 weekly educational sessions about exercise, diet, and weight management, along with a Fitbit. Participants were randomly assigned to one of 24 combinations of behavioral change strategies: telephone vs. email vs. no coaching; text message reminder vs. none; daily vs. weekly self-monitoring for weight and dietary intake; family vs. individual intervention. Weight, moderate-to-vigorous physical activity (MVPA), quality of life, and dietary intake were assessed at baseline and follow-up. The effectiveness of intervention components on weight loss was examined using full factorial analysis of variance. Changes in outcomes by intervention components were tested using repeated linear mixed models. Program satisfaction and retention were assessed. RESULTS: Of the 116 participants enrolled, 90 completed the program (78%) and were included in the analysis (mean age 47.5 yrs; 68% female; 89% White; 20% and 39% with a pathogenic variant for HBOC or Lynch syndrome, respectively). We observed significant weight loss (-5.4 kg; P < .001), increase in MVPA (+68 min/wk; P = .006), reduction in total daily calorie (-329.8 kcal/day; P < .001) and added sugar (-5.4 tsp/day; P < .001), and increase in fruit intake (+0.2 cup/day; P = .028) in overall. Daily self-monitoring was effective for weight loss than weekly self-monitoring (P = .013). There was greater increase in fruit intake in the telephone coaching group (P = .015). The mean score of program satisfaction was 3.8 ± 0.6 out of 5. CONCLUSIONS: mHealth interventions effectively improved weight loss, physical activity, and dietary behaviors among individuals with HBOC and LS and their families. These findings suggest mHealth interventions can be a feasible strategy for lifestyle behavior change in high-risk populations. Supported by: This study was supported by Womens Moon Shot program, Colorectal Cancer Moon Shot Program, and Ardmore Institute of Health.