Mobile devices help motivate cancer survivors to exercise, lower recurrence risk

Researchers in MD Anderson’s Center for Energy Balance in Cancer Prevention and Survivorship are using mobile technology to learn what motivates cancer survivors to increase and maintain physical activity

Physical activity is an effective way to lower cancer risk in healthy individuals, but it’s even more important for cancer survivors, explains Karen Basen-Engquist, Ph.D., professor of Behavioral Science and director of the Center for Energy Balance.

“Studies have shown that physical activity after cancer diagnosis helps reduce symptoms like pain and fatigue, and breast and colorectal cancer survivors who are more physically active have a lower risk of disease recurrence,” says Basen-Engquist.

Physical activity can also lower the risk for a number of other chronic health conditions. Still, many cancer survivors find it difficult to meet the recommended activity levels of 150 minutes of moderate activity each week due to increased weakness, pain, fatigue or other treatment-related side effects.

Mobile technologies can help, says Basen-Engquist.

“Mobile apps and wearables make self-monitoring easy, and they make setting goals and monitoring behavior fun and rewarding.”

Energy and mood play a role

Research led by Yue Liao, Ph.D., a postdoctoral fellow in Behavioral Science, showed that people who feel more energetic and less negative during physical activity are more likely to remain physically active. The study, published in the International Journal of Behavioral Medicine, was conducted by Liao at the University of Southern California.

Liao studied 82 healthy individuals who wore accelerometers to measure activity levels at the beginning of the study, then six and 12 months later. Study participants also received mobile phones that randomly surveyed study participants’ mood and energy levels. Responses were analyzed along with recorded physical activity levels six and 12 months into the study.

“Using this unique mobile technology-based, real-time assessment tool, we discovered, for the first time, this relationship between mood, feelings and future physical activity in a natural environment,” says Liao.

His study showed that feeling more energetic during periods of physical activity was associated with more physical activity six and 12 months later. Fewer negatives responses on mood questions was also associated with more physical activity after 12 months.

Although these findings are not specific to cancer survivors, they may still provide insight for improving activity in this population.

Tailoring technology to cancer survivors

A variety of mobile apps are available to guide and monitor physical activity in the general public, but there are limited apps designed specifically for cancer survivors. Working with survivor focus groups, MD Anderson researchers recently published preferences for such an app in the journal JMIR mHealth and uHealth.

“We see apps as a great opportunity to connect with and help cancer survivors become more active, but existing apps generally do not take into account the unique barriers cancer survivors can face, or incorporate empirically supported techniques for behavioral change,” says Michael Robertson, graduate researcher in Behavioral Science and lead author of the article.

The research team, led by Basen-Engquist, collected qualitative data from 35 cancer survivors about potential app features, motivational messages and physical activity suggestions.

“We identified many preferences of cancer survivors for an app to help increase physical activity, some of which were at odds with what most existing apps offer,” says Robertson. “In short, participants wanted short, to-the-point messages, tools for personal goal attainment, a prescription for physical activity, and a tailored experience.”

The researchers also discovered that participants’ activity goals were more likely to be based on personal values, such as being able to play with grandchildren, rather than quantifiable targets for strength or endurance.

The research team plans to develop a mobile app, taking into account these findings and evidence-based physical activity recommendations, tailored for the unique needs of cancer survivors.