Experiences of a digital behaviour change intervention to prevent weight gain and promote risk reducing health behaviours for women aged 18-35 years at increased risk of breast cancer:A qualitative interview study

Background: <br/>Breast cancer is the most common form of cancer in women. Adult weight gain and modifiable health behaviours including smoking, alcohol intake and lack of physical activity are well known risk factors. The majority of weight gain in women occurs between the ages of 18 and 35 years. Digital interventions have the potential to address logistical challenges that arise in reaching women in this age range. We have designed a digital intervention targeting weight gain prevention and other modifiable health behaviours for young women at increased risk of breast cancer. Women aged 18-35 years were recruited to the single-arm intervention study over two months to test acceptability and usability of the intervention comprising an online group welcome event, app and private Facebook group.<br/>Objectives: <br/>This nested qualitative sub-study explored women’s views and experiences of being part of the digital health intervention to inform future intervention development for a feasibility study.<br/>Methods: <br/>Twenty women aged 23-35 years who were at increased risk of breast cancer were interviewed via telephone within one month after completing the intervention, between February and March 2023. Women were asked about their experiences of the digital intervention and the extent to which the intervention may have influenced their health behaviours. Data were analysed thematically and organised using a framework approach.<br/>Results: <br/>Interviews lasted for a median of 37 minutes. Overall, women perceived the digital health intervention comprising education, tracking and support to be an acceptable intervention for weight gain prevention. Four themes were generated. ‘A “missed opportunity” in breast cancer prevention services’ describes the lack of services that currently exist for young women at increased risk of breast cancer. ‘The pros and cons of being part of a community’ describes the divergent views that women had regarding engaging with other women at increased risk. ‘The importance of an interactive app’ focuses on features that women would want from the app to promote engagement with the intervention. ‘The different wants and needs of different age groups’ highlights that an intervention like this would need to be customisable to suit the needs of women during different life stages.<br/>Conclusions: <br/>There is an unmet need in prevention services for young women aged 18-35 years at increased risk of breast cancer. Women perceived the app to be an acceptable intervention for weight gain prevention, but emphasised that the intervention would need to be customisable to meet the needs of different age groups of women aged 18-35 years. The digital intervention could be a scalable behaviour change strategy for UK Family History Clinics. <br/>