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Im EO, Chee W, Paul S, Choi MY, Kim SY, Yeo S, Ulrich CM, Schapira MM, Nguyen GT, Meghani S, Mao JJ, Ma G, Inouye J, Deatrick JA, Shin D, Bao T. Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors. J Cancer Educ 2024; 39:335-348. [PMID: 38594385 DOI: 10.1007/s13187-024-02415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 04/11/2024]
Abstract
Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1 month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.
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Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA.
| | - Wonshik Chee
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | | | - Mi-Young Choi
- Emory University, Atlanta, USA
- Chungbuk National University, Cheongju, South Korea
| | - Seo Yun Kim
- Emory University, Atlanta, USA
- Department of Nursing, Gangneung-Wonju National University, Gangwon-do, South Korea
| | - SeonAe Yeo
- The University of North Carolina, Chapel Hill, Chapel Hill, USA
| | | | | | | | | | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Grace Ma
- Temple University, Philadelphia, USA
| | | | | | - David Shin
- The University of California, Los Angeles, Los Angeles, USA
| | - Ting Bao
- Integrative Breast Oncology, Dana-Farber Cancer Institute, Boston, USA
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Villinger K, Berli C, Scholz U. App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review. Health Psychol Rev 2024:1-23. [PMID: 38755755 DOI: 10.1080/17437199.2024.2349617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/25/2024] [Indexed: 05/18/2024]
Abstract
The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms.
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Affiliation(s)
| | - Corina Berli
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Urte Scholz
- Department of Psychology, University of Zurich, Zurich, Switzerland
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González Bermúdez A, Carramiñana D, Bernardos AM, Bergesio L, Besada JA. A fusion architecture to deliver multipurpose mobile health services. Comput Biol Med 2024; 173:108344. [PMID: 38574531 DOI: 10.1016/j.compbiomed.2024.108344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.
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Affiliation(s)
- Ana González Bermúdez
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain.
| | - David Carramiñana
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Ana M Bernardos
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Luca Bergesio
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
| | - Juan A Besada
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Spain
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Wolff J, Seidel S, Wuelfing P, Lux MP, zu Eulenburg C, Smollich M, Baumann F, Seitz S, Kuemmel S, Thill M, Tio J, Braun M, Hollaender H, Seitz A, Horn F, Harbeck N, Wuerstlein R. App-based support for breast cancer patients to reduce psychological distress during therapy and survivorship - a multicentric randomized controlled trial. Front Oncol 2024; 14:1354377. [PMID: 38699636 PMCID: PMC11064693 DOI: 10.3389/fonc.2024.1354377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up. Methods PINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy and molecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as a waiting-list comparison to "standard of care." The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app's effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not. Results Efficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations. Conclusion Patients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699).
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Affiliation(s)
- Josefine Wolff
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Svenja Seidel
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Pia Wuelfing
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Michael Patrick Lux
- Department of Gynecology and Obstetrics, Frauenklinik St. Louise and St. Josefs-Krankenhaus, St. Vincenz Klinik GmbH, Paderborn, Germany
| | - Christine zu Eulenburg
- Department for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Freerk Baumann
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | | | - Marc Thill
- Markus Hospital, Breast Center, Frankfurt, Germany
| | - Joke Tio
- Department of Gynecology and Obstetrics, University Hospital of Münster, Münster, Germany
| | - Michael Braun
- Department of Gynecology, Breast Center, Red Cross Hospital, Munich, Germany
| | - Hannah Hollaender
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
| | - Angenla Seitz
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Felicitas Horn
- Department Clinical Research, PINK! Gegen Brustkrebs GmbH, Hamburg, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
| | - Rachel Wuerstlein
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Ludwig-Maximilian University Munich (LMU) University Hospital, Munich, Germany
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Anders C, Moorthy P, Svensson L, Müller J, Heinze O, Knaup P, Wallwiener M, Deutsch TM, Le TV, Weinert L. Usability and User Experience of an mHealth App for Therapy Support of Patients With Breast Cancer: Mixed Methods Study Using Eye Tracking. JMIR Hum Factors 2024; 11:e50926. [PMID: 38441959 PMCID: PMC10951836 DOI: 10.2196/50926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Early identification of quality of life (QoL) loss and side effects is a key challenge in breast cancer therapy. Digital tools can be helpful components of therapeutic support. Enable, a smartphone app, was used in a multicenter, prospective randomized controlled trial in 3 breast cancer centers. The app simultaneously serves as a therapy companion (eg, by displaying appointments), a tool for documenting QoL (eg, by enabling data collection for QoL questionnaires), and documentation of patient-reported side effects. The need for digital tools is continually rising. However, evidence of the effects of long-term use of mobile health (mHealth) apps in aftercare for patients with breast cancer is limited. Therefore, evaluating the usability and understanding the user experience of this mHealth app could potentially contribute valuable insights in this field. OBJECTIVE A usability study was conducted to explore how patients with breast cancer receiving neoadjuvant, adjuvant, or palliative outpatient treatment rated their engagement with the app , the user experience, and the benefits of using the app. METHODS A mixed methods approach was chosen to combine subjective and objective measures, including an eye-tracking procedure, a standardized usability questionnaire (mHealth App Usability Questionnaire), and semistructured interviews. Participants were surveyed twice during the study period. Interviews were transcribed verbatim and analyzed using thematic analysis. Analysis of the eye-tracking data was carried out using the tracker-integrated software. Descriptive analysis was conducted for the quantitative data. RESULTS The mHealth App Usability Questionnaire results (n=105) indicated good overall usability for 2 different time points (4 wk: mean 89.15, SD 9.65; 20 wk: mean 85.57, SD 12.88). The qualitative analysis of the eye-tracking recordings (n=10) and interviews (n=16) showed that users found the Enable app easy to use. The design of the app, information about therapies and side effects, and usefulness of the app as a therapy companion were rated positively. Additionally, participants contributed requests for additional app features and suggestions for improving the content and usability of the app. Relevant themes included optimization of the appointment feature, updating the app's content regularly, and self-administration. In contrast to the app's current passive method of operation, participants expressed a desire for more active engagement through messaging, alarms, or emails. CONCLUSIONS The results of this study demonstrate the good usability of the Enable app as well as the potential for further development. We concluded from patients' feedback and requests that mHealth apps could benefit from giving patients a more active role (eg, being able to actively document side effects as they occur). Additionally, regular updates of app content could further contribute to encouraging continued use of mHealth apps. Our findings may also assist other researchers in tailoring their mHealth apps to the actual needs of patients undergoing breast cancer therapy.
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Affiliation(s)
- Carolin Anders
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Preetha Moorthy
- Department of Biomedical Informatics at the Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Oliver Heinze
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Knaup
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas M Deutsch
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thao-Vy Le
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Vardar O, Serçekuş P. The effect of a mobile application for patients living with gynaecological cancer on their physical and psychosocial adaptation. Int J Palliat Nurs 2024; 30:128-137. [PMID: 38517850 DOI: 10.12968/ijpn.2024.30.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Education of patients with cancer and patient self-management allow better clinical outcomes using e-health or mobile health applications. AIMS To develop a mobile application to increase the physical and psychosocial adaptation for patients with gynecological cancer who are receiving chemotherapy and to investigate the effectiveness of the mobile application. METHODS This study was planned as a parallel, single-blind, pre-post test randomised controlled experimental study in which two groups (intervention-control) will be compared. A total of 52 gynecological cancer patients were planned to be included in the study. FINDINGS This study is in the protocol stage. Therefore, the results of the study have not yet been reported. CONCLUSIONS Evidence-based information within JineOnkolojik Destek provides rich data on coping with chemotherapy. In addition, the visual and auditory elements, real patient stories and videos, and the ability to ask questions and receive counselling from the research team can positively affect the physical and psychosocial health of the cancer survivors.
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Affiliation(s)
- Okan Vardar
- Lecturer, Faculty of Health Sciences, Pamukkale University, Türkiye
| | - Pınar Serçekuş
- Professor, Faculty of Health Sciences, Pamukkale University, Türkiye
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Lund-Jacobsen T, Schwarz P, Martino G, Pappot H, Piil K. Development of an App for Symptom Management in Women With Breast Cancer Receiving Maintenance Aromatase Inhibitors: Protocol for a Mixed Methods Feasibility Study. JMIR Res Protoc 2024; 13:e49549. [PMID: 38358787 PMCID: PMC10905362 DOI: 10.2196/49549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer often experience a reduced quality of life after primary treatment. The disease and treatment trajectory consists of surgery followed by chemotherapy or radiation therapy. Upon this, maintenance hormone therapy with an aromatase inhibitor can result in several physical and psychosocial symptoms. Optimal symptom control during maintenance therapy is central to maintaining the patient's quality of life. OBJECTIVE This study aims to (1) develop an electronic symptom management tool for patients with postmenopausal early breast cancer receiving maintenance aromatase inhibitors with an endocrine aspect and (2) assess the feasibility, acceptability, and usability of the pilot version of the Bone@BC app. Furthermore, longitudinally, symptom prevalence and quality of life for patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will be explored. METHODS This study follows a multistage research plan. In stage 1, a systematic literature review to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer will be completed. In stage 2, a comprehensive overview of symptoms related to aromatase inhibitors (letrozole, exemestane, and anastrozole) will be performed (eg, by reviewing medical leaflets and guidelines). In stage 3, an electronic app with a user-friendly Patient Concern Inventory list to comprise symptoms and concerns will be developed. Last, in stage 4, a convergent mixed methods feasibility study of the pilot version of the Bone@BC app will be conducted. A total of 45 patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will use the app daily for symptom identification and respond to 6 serial patient-reported outcome measurements for 12 weeks. Finally, semistructured interviews will be performed. The primary outcome includes consent rate, attrition rate, retention rates, technical issues, and adherence, assessed using preestablished criteria on feasibility and a mixed methods approach for exploring acceptability. A patient advisory board consisting of 5 women with breast cancer is recruited to include their perspectives and experiences in the planning, organization, implementation, and dissemination of the research throughout the project. RESULTS At the time of submitting this paper (January 2024), a total of 23 patients have been included in the stage 2 medical audit over the recruitment period of 3 months (November 2022 to February 2023), and 19 patients have been enrolled in stage 2, the semistructured patient interviews. CONCLUSIONS This protocol describes a study investigating the feasibility, acceptability, and usability of the symptom management tool Bone@BC developed for patients with breast cancer with an endocrine aspect. TRIAL REGISTRATION ClinicalTrails.gov NCT05367830; https://clinicaltrials.gov/ct2/show/NCT05367830. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49549.
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Affiliation(s)
- Trine Lund-Jacobsen
- Department of Endocrinology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Schwarz
- Department of Endocrinology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Shalchi Oghli S, Sadeghi R, Omranipour R, Rahimi Foroushani A, Ashoorkhani M, Tedadi Y. Comparison of the Effect of 2 Virtual Education Methods: Family-based Versus Peer-Support on Perceived Stress and Stress Coping in Women with Breast Cancer: A Randomized Controlled Trial. Med J Islam Repub Iran 2024; 38:16. [PMID: 38586499 PMCID: PMC10999010 DOI: 10.47176/mjiri.38.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Indexed: 04/09/2024] Open
Abstract
Background Stress is an overwhelming feeling in patients with breast cancer (BC). However, The effect of virtual education has not been fully regulated. Hence, this study intends to compare the impact of 2 virtual education methods on perceived stress and stress coping in women with BC. Methods A 3-armed randomized clinical trial was conducted among 315 women with BC who were referred to the Cancer Institute in Tehran. They were randomly assigned to 3 groups: (a) Family-based, receiving family-based training package; (b) peer-support, receiving peer-support educational package; and (c) control, receiving routine hospital care. Data were collected through demographic and disease characteristics, the Perceived Stress Scale (PSS-14), and Coping Inventory for Stressful Situations (CISS-21) questionnaires before and 3 months after the intervention. Results The effect of the group factor after controlling the before-intervention scores in perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were P < 0.0001, P = 0.015, P < 0.0001, and P = 0.111, respectively. Also, the effect of the confounding factor of BC disease stage in the dependent variables was P = 0.527, P = 0.275, P = 0.358, and P = 0.609, respectively. The effect size test showed that before the intervention, the mean scores of perceived stress, problem-oriented, emotion-oriented, and avoidance-oriented strategies were 32.00 ± 7.03, 19.36 ± 4.68, 25.10 ± 5.90, and 17.65 ± 6.64 respectively, but after the intervention showed a decrease in mean scores of perceived stress, emotion-oriented, and avoidance strategies. Conclusion What is vibrant in virtual family-based education is far more effective than peer support when problem-oriented coping increases. Conversely, reducing perceived stress in women with BC receiving enough information and family support should be considered.
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Affiliation(s)
- Somayyeh Shalchi Oghli
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramesh Omranipour
- Breast Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Ashoorkhani
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Community-Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Tedadi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Masiero M, Filipponi C, Fragale E, Pizzoli SFM, Munzone E, Milani A, Guido L, Guardamagna V, Marceglia S, Prandin R, Prenassi M, Caruso A, Manzelli V, Savino C, Conti C, Rizzi F, Casalino A, Candiani G, Memini F, Chiveri L, Vitali AL, Corbo M, Grasso R, Didier F, Ferrucci R, Pravettoni G. Support for Chronic Pain Management for Breast Cancer Survivors Through Novel Digital Health Ecosystems: Pilot Usability Study of the PainRELife Mobile App. JMIR Form Res 2024; 8:e51021. [PMID: 38306176 PMCID: PMC10873797 DOI: 10.2196/51021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Chronic pain is one of the most common and critical long-term effects of breast cancer. Digital health technologies enhance the management of chronic pain by monitoring physical and psychological health status and supporting pain self-management and patient treatment decisions throughout the clinical pathway. OBJECTIVE This pilot study aims to evaluate patients' experiences, including usability, with a novel digital integrated health ecosystem for chronic pain named PainRELife. The sample included patients with breast cancer during survivorship. The PainRELife ecosystem comprises a cloud technology platform interconnected with electronic health records and patients' devices to gather integrated health care data. METHODS We enrolled 25 patients with breast cancer (mean age 47.12 years) experiencing pain. They were instructed to use the PainRELife mobile app for 3 months consecutively. The Mobile Application Rating Scale (MARS) was used to evaluate usability. Furthermore, pain self-efficacy and participation in treatment decisions were evaluated. The study received ethical approval (R1597/21-IEO 1701) from the Ethical Committee of the European Institute of Oncology. RESULTS The MARS subscale scores were medium to high (range: 3.31-4.18), and the total app quality score was 3.90. Patients with breast cancer reported reduced pain intensity at 3 months, from a mean of 5 at T0 to a mean of 3.72 at T2 (P=.04). The total number of times the app was accessed was positively correlated with pain intensity at 3 months (P=.03). The engagement (P=.03), information (P=.04), and subjective quality (P=.007) subscales were positively correlated with shared decision-making. Furthermore, participants with a lower pain self-efficacy at T2 (mean 40.83) used the mobile app more than participants with a higher pain self-efficacy (mean 48.46; P=.057). CONCLUSIONS The data collected in this study highlight that digital health technologies, when developed using a patient-driven approach, might be valuable tools for increasing participation in clinical care by patients with breast cancer, permitting them to achieve a series of key clinical outcomes and improving quality of life. Digital integrated health ecosystems might be important tools for improving ongoing monitoring of physical status, psychological burden, and socioeconomic issues during the cancer survivorship trajectory. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/41216.
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Affiliation(s)
- Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Chiara Filipponi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Elisa Fragale
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Elisabetta Munzone
- Division of Medical Senology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Alessandra Milani
- Nursing School, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Luca Guido
- Division of Palliative Care and Pain Therapy, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Vittorio Guardamagna
- Division of Palliative Care and Pain Therapy, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Sara Marceglia
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Roberto Prandin
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Marco Prenassi
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
| | - Annamaria Caruso
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Milan, Italy
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | - Vania Manzelli
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | - Chiara Savino
- Nuvyta, Società a Responsabilità Limitata, Cologno Monzese, Italy
| | | | | | | | - Giulia Candiani
- Agenzia di comunicazione scientifica Zadig, Società a Responsabilità Limitata, Società benefit, Milan, Italy
| | - Francesca Memini
- Agenzia di comunicazione scientifica Zadig, Società a Responsabilità Limitata, Società benefit, Milan, Italy
| | - Luca Chiveri
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Andrea Luigi Vitali
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Massimo Corbo
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Florence Didier
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Roberta Ferrucci
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Alhuwail D, Alhouti A, Alsarhan L. Assessing the Quality, Privacy, and Security of Breast Cancer Apps for Arabic Speakers: Systematic Search and Review of Smartphone Apps. JMIR Cancer 2024; 10:e48428. [PMID: 38227353 PMCID: PMC10828940 DOI: 10.2196/48428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Breast cancer is a widespread disease, and its incidence is rapidly increasing in the Middle East and North Africa region. With the increasing availability of smartphone apps for various health purposes, breast cancer apps have emerged as tools for raising awareness, providing support, and empowering women affected by this disease. These apps offer many features, including information on breast cancer risk factors, self-examination guides, appointment reminders, and community support groups or hotlines. Using apps raises the risk of privacy and security issues, and we hope that examining these features of the apps will contribute to the understanding of how technology can be used to improve these apps and provide insights for future development and improvement of breast cancer apps. OBJECTIVE This study aims to critically review the quality, privacy, and security of breast cancer apps available to Arabic speakers. METHODS Similar to several recent studies, we used a systematic search for apps available in Google Play and Apple App stores using both the web interface and the built-in native stores installed on smartphones. The search was conducted in mid-December 2022 in Arabic using the following keywords: سرطان الثدي - فحص سرطان الثدي - علاج سرطان الثدي - مرض سرطان الثدي - أعراض سرطان الثدي - فحص الثدي (breast cancer, breast cancer treatment, breast cancer disease, breast cancer symptoms, breast cancer screening, and breast test). These preidentified search terms are based on earlier work concerning the top searched breast cancer topics by Arabic speakers through Google's search engine. We excluded apps that did not have an Arabic interface, were developed for non-Arabic speakers, were paid, needed a subscription, or were directed toward health care workers. The Mobile App Rating Scale was used to evaluate the quality of the apps concerning their engagement, functionality, aesthetics, and information. A risk score was calculated for the apps to determine their security risk factors. RESULTS Only 9 apps were included, with most (6/9, 67%) being supported by advertisements and categorized as informational. Overall, the apps had low numbers of downloads (>10 to >1000). The majority of the included apps (8/9, 89%) requested dangerous access permissions, including access to storage, media files, and the camera. The average security score of the included apps was 3.22, while only 2 apps provided information about data security and privacy. The included apps achieved an overall average quality score of 3.27, with individual dimension scores of 4.75 for functionality, 3.04 for information, 3.00 for aesthetics, and 2.32 for engagement. CONCLUSIONS The limited availability of breast cancer apps available to Arabic speakers should be a call to action and prompt health care organizations and developers to join forces and collaboratively develop information-rich, usable, functional, engaging, and secure apps.
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Affiliation(s)
- Dari Alhuwail
- Information Science Department, College of Life Sciences, Kuwait University, Sabah AlSalem University City, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Dasman, Kuwait
| | - Aisha Alhouti
- Information Science Department, College of Life Sciences, Kuwait University, Sabah AlSalem University City, Kuwait
| | - Latifah Alsarhan
- Information Science Department, College of Life Sciences, Kuwait University, Sabah AlSalem University City, Kuwait
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11
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Carr AL, Vinod N, Farha P, Lu T, Farha MJ, Graves KD. An exploration of facilitators and barriers to patient navigator core functions with breast cancer patients: Implications for the development of a human-centered mHealth app. PEC Innov 2023; 3:100226. [PMID: 37859864 PMCID: PMC10583173 DOI: 10.1016/j.pecinn.2023.100226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
Objectives To understand the barriers to core functions and workflow among patient navigators (PN) who navigate people diagnosed with breast cancer (BC). To identify how a mobile health (mHealth) app could assist PNs in providing care to BC patients. Methods This qualitative research study used purposive sampling to recruit stakeholders (N = 33) from January to August 2021. We conducted individual semi-structured interviews with PNs (n = 11), oncology care providers (n = 12), and BC patients (n = 10). We used conventional content analysis to analyze the interview data. Results Participants identified the following sociotechnical systems barriers in PN workflows that negatively impact BC patient care: 1) resources, 2) insurance coverage, 3) communication challenges, and 4) impact of logistical tasks. Participants identified the user experience, app features, and interoperability customizations to enhance PNs' provision of patient care as important design elements to include in a mHealth app. Conclusion Feedback from stakeholders provided valuable insights into key design considerations, functions, and content areas for developing a mHealth app for PN use in BC care delivery. Innovation This is one of the first studies to incorporate the human-centered design and sociotechnical systems frameworks to understand barriers to PN workflow and provision of BC patient care across the cancer care continuum.
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Affiliation(s)
- Alaina L. Carr
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Naomi Vinod
- Department of Psychology, Howard University, Washington, DC, USA
| | | | - Tan Lu
- Avident Health LLC, Baltimore, MD, USA
- Department of Surgery, MedStar Union Memorial and Good Samaritan Hospitals, Baltimore, MD, USA
| | - Maen J. Farha
- Avident Health LLC, Baltimore, MD, USA
- Department of Surgery, MedStar Union Memorial and Good Samaritan Hospitals, Baltimore, MD, USA
| | - Kristi D. Graves
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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12
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Donkor A, Ayitey JA, Adotey PN, Ofori EO, Kitson-Mills D, Vanderpuye V, Opoku SY, Luckett T, Agar MR, Engel-Hills P. Mobile-Based Application Interventions to Enhance Cancer Control and Care in Low- and Middle-Income Countries: A Systematic Review. Int J Public Health 2023; 68:1606413. [PMID: 38125709 PMCID: PMC10732306 DOI: 10.3389/ijph.2023.1606413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Objective: To identify and appraise mobile-based application (mAPP) interventions that have been used to support cancer control and care in low- and middle-income countries (LMICs). Methods: Four electronic databases were systematically searched for studies that reported primary research findings related to mAPP interventions applied in oncology settings in LMICs. A narrative synthesis was performed using the Mhealth Index and Navigation Database as an analytical framework. Results: Twenty studies reporting 18 cancer control and care mAPPs were included in this review. Among these mAPPs, ten focused on prevention, screening and early detection of cancer, five provided information to optimise supportive and palliative care, two provided support to assist treatment-shared decision-making and one covered information for follow-up and survivorship care. Conclusion: Cancer mAPP interventions are gradually gaining attention in LMICs as they provide unique resources for empowering and strengthening the role of people with cancer in their own care. To enhance cancer control, a focus on prevention and early detection is important; however, more mAPP interventions related to cancer treatment, follow-up and survivorship are also needed to enable more cost-effective cancer care.
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Affiliation(s)
- Andrew Donkor
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jennifer Akyen Ayitey
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Nyansah Adotey
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Esther Oparebea Ofori
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Doris Kitson-Mills
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Tim Luckett
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Meera R. Agar
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Penelope Engel-Hills
- Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
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13
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Taramasco C, Rimassa C, Noël R, Bravo Storm ML, Sánchez C. Co-design of a Mobile App for Engaging Breast Cancer Patients in Reporting Health Experiences: Qualitative Case Study. J Med Internet Res 2023; 25:e45968. [PMID: 38010791 PMCID: PMC10714266 DOI: 10.2196/45968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/30/2023] [Accepted: 10/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The World Health Organization recommends incorporating patient-reported experience measures and patient-reported outcome measures to ensure care processes. New technologies, such as mobile apps, could help report and monitor patients' adverse effects and doubts during treatment. However, engaging patients in the daily use of mobile apps is a challenge that must be addressed in accordance with the needs of people. OBJECTIVE We present a qualitative case study documenting the process of identifying the information needs of breast cancer patients and health care professionals during the treatment process in a Chilean cancer institution. The study aims to identify patients' information requirements for integration into a mobile app that accompanies patients throughout their treatment while also providing features for reporting adverse symptoms. METHODS We conducted focus groups with breast cancer patients who were undergoing chemotherapy (n=3) or who completed chemotherapy between 3 months and 1 year (n=1). We also surveyed health care professionals (n=9) who were involved in patient care and who belonged to the oncology committee of the cancer center where the study took place. Content analysis was applied to the responses to categorize the information needs and the means to satisfy them. A user interface was designed according to the findings of the focus groups and was assessed by 3 trained information system and user interaction design experts from 2 countries, using heuristic evaluation guidelines for mobile apps. RESULTS Patients' information needs were classified into 4 areas: an overview of the disease, information on treatment and day-to-day affairs, assistance on the normality and abnormality of symptoms during treatment, and symptoms relevant to report. Health care professionals required patients to be provided with information on the administrative and financial process. We noted that the active involvement of the following 4 main actors is required to satisfy the information needs: patients, caregivers, social network moderators, and health professionals. Seven usability guidelines were extracted from the heuristic evaluation recommendations. CONCLUSIONS A mobile app that seeks to accompany breast cancer patients to report symptoms requires the involvement of multiple participants to handle the reports and day-to-day information needs. User interfaces must be designed with consideration of the patient's social conventions and the emotional load of the disease information.
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Affiliation(s)
- Carla Taramasco
- Instituto de Tecnologías para la Innovación en Salud y Bienestar, Facultad de Ingeniería, Universidad Andrés Bello, Viña del Mar, Chile
- Centro para la Prevención y el Control del Cáncer, Santiago, Chile
| | - Carla Rimassa
- Instituto de Tecnologías para la Innovación en Salud y Bienestar, Facultad de Ingeniería, Universidad Andrés Bello, Viña del Mar, Chile
- Facultad de Medicina, Escuela de Fonoaudiología, Campus San Felipe, Universidad de Valparaíso, San Felipe, Chile
| | - René Noël
- Escuela de Ingeniería Informática, Facultad de Ingeniería, Universidad de Valparaíso, Valparaíso, Chile
| | - María Loreto Bravo Storm
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - César Sánchez
- Departamento de Hematología y Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Sarlak E, Ansari J, Moradzadeh R, Nejat N. The Effect of a Supportive Educational Intervention Through Virtual Social Networks on Sleep Quality and Insomnia of Patients with Cancer. J Cancer Educ 2023; 38:1675-1682. [PMID: 37382798 DOI: 10.1007/s13187-023-02321-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 06/30/2023]
Abstract
Sleep disturbances are very common among cancer patients, and they need more support in this regard. More access to technology has provided opportunities to use virtual teaching methods to educate and support cancer patients. This study aimed to investigate the effect of supportive educational intervention (SEI) through virtual social networks (VSNs) on the sleep quality and the severity of insomnia of cancer patients. The study was conducted on 66 patients with cancer: intervention (n = 33) and control (n = 33) groups (CONSORT). Intervention group received supportive educational intervention on sleep for 2 months through virtual social networks (VSNs). All participants completed the Pittsburgh Sleep Quality Index and insomnia severity index (ISI) before and after the intervention. The mean scores of sleep quality (p = .001) and insomnia severity (p = .001) in the intervention group had a statistically significant decrease. Moreover, quality, latency, duration, efficiency, disturbances of sleep, and daytime dysfunction showed significant improvement in the intervention group, every two times after the intervention (p < .05). However, the participants' sleep quality deteriorated progressively in the control group (p = .001). Supportive educational intervention (SEI) through VSNs can be an effective method to improve sleep quality and decrease insomnia severity of patients with cancer.Trial registration number: RCT20220528055007N1Date of registration: 2022-08-31(retrospectively registered).
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Affiliation(s)
- Elahe Sarlak
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | | | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Nazi Nejat
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Basij Sq., Medical Sciences University Complex, Blue Wing, Third Floor, Arak, Iran.
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Cathcart-Rake EJ, Tevaarwerk AJ, Haddad TC, D'Andre SD, Ruddy KJ. Advances in the care of breast cancer survivors. BMJ 2023; 382:e071565. [PMID: 37722731 DOI: 10.1136/bmj-2022-071565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Breast cancer survivors may experience significant after effects from diagnoses of breast cancer and cancer directed therapies. This review synthesizes the evidence about optimal management of the sequelae of a diagnosis of breast cancer. It describes the side effects of chemotherapy and endocrine therapy and evidence based strategies for management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. In addition, this review examines models of survivorship care and ways in which digital tools may facilitate communication between clinicians and patients. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life.
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Martin-Payo R, Leirós-Díaz C, Armes J, Fu MR, Cachero-Rodríguez J, del Mar Fernandez-Alvarez M. The "Breast-4Y" web app for breast cancer prevention at young age: Development, evaluation, and validation. Internet Interv 2023; 33:100651. [PMID: 37555074 PMCID: PMC10404991 DOI: 10.1016/j.invent.2023.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Improving knowledge of risk factors, signs and symptoms positively influence an individual's intention to acquire healthy lifestyle behaviors to prevent breast cancer, to identify breast cancer risk early and seek health advice early. The aim of the present study was to develop and to assess the usability and quality of a web-app (Breast-4Y) designed specifically for younger women to improve their knowledge about breast cancer risk factors and symptoms as well as protective behaviors to reduce their risk. METHODS The development of the Breast-4Y web-app, based on Health Belief Model and the Behaviour Change Wheel, comprised four steps: i) analysis of scientific literature regarding breast cancer risk factors, symptoms and preventive lifestyle behaviors; ii) design of web-app; iii) content review by experts; iv) quality and usability assessment by the end-users (n = 20). Web-app usability was evaluated using the Spanish version of the System Usability Scale for the Assessment of Electronic Tools and the quality using the Spanish version of uMARS. RESULTS The contents were rated 4.25 or above, indicating high content quality. The mean usability score was 84.9 (SD 12.4), the mean rating for objective quality and subjective quality dimensions mean were 4.2 (SD 0.4) and 3.4 (0.777) respectively, indicating excellent usability and quality. Positive associations (p < .05) were observed between numbers of app used and attitudes to change (r = 0.479), and intention to change (r = 0.539). Strong positive associations (p < .001) were also observed between usability satisfaction and attitudes to change (r = 0.584), intention to change (r = 0.656), and help-seeking (r = 0.656). CONCLUSIONS This study provided evidence that Breast-4Y has adequate contents, high quality, and usability. Breast-4Y can be tested in pragmatic trials to assess their effectiveness to reduce the risk of breast cancer, raise women's awareness of breast cancer risk factors, increase women's knowledge of breast cancer symptoms, and adopt protective lifestyle behaviors.
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Affiliation(s)
- Ruben Martin-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - Claudia Leirós-Díaz
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Spain
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, United Kingdom
| | - Mei Rosemary Fu
- The Dorothy and Dale Thompson School of Nursing, University of Missouri-Kansas, United States of America
| | - Judit Cachero-Rodríguez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
| | - María del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Spain
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Weis J, Wolf LR, Boerries M, Kassahn D, Boeker M, Dresch C. Identification of the Needs and Preferences of Patients With Cancer for the Development of a Clinic App: Qualitative Study. JMIR Cancer 2023; 9:e40891. [PMID: 37498653 PMCID: PMC10415940 DOI: 10.2196/40891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) tools were developed during the past decades and are increasingly used by patients in cancer care too. Scientific research in the development of mHealth services is required in order to meet the various needs of patients and test usability. OBJECTIVE The aim of this study is to assess patients' needs, preferences, and usability of an app (My University Clinic [MUC] app) developed by the Comprehensive Cancer Center Freiburg (CCCF) Germany. METHODS Based on a qualitative cross-sectional approach, we conducted semistructured interviews with patients with cancer, addressing their needs, preferences, and usability of the designed MUC app. Patients treated by the CCCF were recruited based on a purposive sampling technique focusing on age, sex, cancer diagnoses, and treatment setting (inpatient, outpatient). Data analysis followed the qualitative content analysis according to Kuckartz and was performed using computer-assisted software (MAXQDA). RESULTS For the interviews, 17 patients with cancer were selected, covering a broad range of sampling parameters. The results showed that patients expect benefits in terms of improved information about the disease and communication with the clinic staff. Demands for additional features were identified (eg, a list of contact persons and medication management). The most important concerns referred to data security and the potential restriction of personal contacts with health care professionals of the clinical departments of the CCCF. In addition, some features for improving the design of the MUC app with respect to usability or for inclusion of interacting tools were suggested by the patients. CONCLUSIONS The results of this qualitative study were discussed within the multidisciplinary team and the MUC app providers. Patients' perspectives and needs will be included in further development of the MUC app. There will be a second study phase in which patients will receive a test version of the MUC app and will be asked about their experiences with it. TRIAL REGISTRATION Deutsches Register Klinischer Studien DRKS00022162; https://drks.de/search/de/trial/DRKS00022162.
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Affiliation(s)
- Joachim Weis
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Lucy Raphaela Wolf
- Chair for Self-Help Research, Comprehensive Cancer Center, Medical Faculty, University Clinic Freiburg, Freiburg, Germany
| | - Melanie Boerries
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Daniela Kassahn
- Institut für Medizinische Bioinformatik und Systemmedizin, Medical Faculty University Freiburg, University Clinic Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute of Artificial Intelligence and Informatics in Medicine, Medical Center rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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18
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Saevarsdottir SR, Gudmundsdottir SL. Mobile Apps and Quality of Life in Patients With Breast Cancer and Survivors: Systematic Literature Review. J Med Internet Res 2023; 25:e42852. [PMID: 37494111 PMCID: PMC10416803 DOI: 10.2196/42852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Side effects of breast cancer treatment may persist long into survivorship, reducing quality of life (QOL) in patients with breast cancer and survivors. There is growing evidence for the use of digital health technologies, such as mobile apps, to support self-management, decrease symptom burden, and improve QOL in patients with cancer. However, an updated overview of the effects of mobile apps on QOL and well-being in patients with breast cancer and survivors is needed. OBJECTIVE The aim of this review was to provide an overview of breast cancer-specific, mobile app-driven lifestyle or behavioral interventions in patient care through to survivorship and their impact on QOL and mental well-being. METHODS A systematic search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. The inclusion criteria were limited to original studies involving a trial of a mobile app-driven lifestyle or behavioral intervention for patients with breast cancer or survivors and using QOL or well-being measures. The results of the studies that met the inclusion criterion were then synthesized in text and table format. The quality of the evidence was assessed with the Cochrane risk-of-bias tool. RESULTS A total of 17 studies with the number of participants ranging from 23 to 356 met the inclusion criterion. Of the 17 reviewed studies, 7 (41%) delivered an app-only intervention, and 10 (59%) combined an app with additional supporting materials, such as SMS text messaging, telecoaching, wearables, or printed materials. Among the 17 reviewed studies, 6 (35%) focused on aiding patients with breast cancer during the active treatment phase (excluding ongoing hormone therapy), whereas the remaining 11 (65%) focused on survivorship. The majority of the studies (14/17, 82%) observed some positive effects on QOL or well-being measures. CONCLUSIONS The results of the review indicate that mobile apps are a promising avenue for improving QOL and well-being in breast cancer care. Positive effects were observed in patients undergoing active treatment in all reviewed studies, but effects were less clear after chemotherapy and in long-term survivors. Although lifestyle and behavioral digital interventions are still being developed, and further research should still be pursued, the available data suggest that current mobile health apps aid patients with breast cancer and survivors.
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Affiliation(s)
- Saeunn Rut Saevarsdottir
- University of Iceland, Department of Health Promotion, Sport & Leisure Studies, Reykjavik, Iceland
| | - Sigridur Lara Gudmundsdottir
- University of Iceland, Department of Health Promotion, Sport & Leisure Studies, Reykjavik, Iceland
- Sidekick Health, Kopavogur, Iceland
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Wasserman S, Ould Brahim L, Attiya A, Belzile E, Lambert SD. An Evaluation of Interactive mHealth Applications for Adults Living with Cancer. Curr Oncol 2023; 30:7151-7166. [PMID: 37622999 PMCID: PMC10453401 DOI: 10.3390/curroncol30080518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
This study evaluated the quality and usefulness of interactive mobile health (mHealth) applications (apps) for adults with cancer. The PRISMA guidelines were followed to add rigor to the search, as well as to the data collection and analysis. The apps available in the most used app stores (Google Play and Apple) with interactive tailored features were identified. To supplement this, a Google web search was also conducted. The apps were evaluated for their quality using the validated Mobile App Rating Scale (MARS) and for their usefulness using a checklist of end users' desired features derived from the literature. The searches returned 3046 apps and 17 were retained for evaluation. The average quality score of the apps across the sample was 3.62/5 (SD 0.26, range: 3.14-4.06), with Outcomes4me scoring the highest. On average, the apps scored 50% (SD 2.5, range: 31-88%) on the usefulness checklist, with Cancer.net scoring the highest. The lowest-scoring categories were communications features on the usefulness checklist and "information" on the MARS, indicating areas for future work. The findings identified the apps of an acceptable quality and usefulness that could be recommended to those with cancer.
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Affiliation(s)
- Sydney Wasserman
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Lydia Ould Brahim
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Ameer Attiya
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada;
| | - Eric Belzile
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
| | - Sylvie D. Lambert
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
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Suchodolska G, Koelmer A, Puchowska M, Senkus E. Are All Societies Ready for Digital Tools? Feasibility Study on the Use of Mobile Application in Polish Early Breast Cancer Patients Treated with Perioperative Chemotherapy. Healthcare (Basel) 2023; 11:2114. [PMID: 37510555 PMCID: PMC10379019 DOI: 10.3390/healthcare11142114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/12/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The population of individuals affected by breast cancer is growing, and with advances in cancer treatment implemented into usual care, there is an urgent need to improve the recognition, monitoring and treatment of therapy-induced adverse effects. This study aims to explore the use of an in-app electronic questionnaire to assess and monitor chemotherapy-related symptoms in early breast cancer patients treated with perioperative chemotherapy. METHOD Between December 2019 and June 2021, 72 female study participants used the mobile app Centrum Chorób Piersi UCK and completed an in-app questionnaire about the 14 most common chemotherapy-related symptoms. Replies including symptoms with a critical value triggered automatic email alerts to the nursing team. RESULTS Acceptance of the study was higher among younger women and patients originating from rural areas, while possible digital exclusion among patients >60 years was observed during the enrolment process. A total of 55 participants completed the electronic questionnaire at least once and generated 553 responses with 1808 specific problems reported. Fatigue (n = 428) was the most common problem, and fever (n = 5) the least reported problem. A total of 21 participants triggered alerts with responses containing symptoms with critical value assessment (n = 89). Significant negative correlation was observed between the number of responses and time from the first chemotherapy administration; however, the number of responses was not determined by any sociodemographic or medical factors. Significant positive correlations were identified between the number of communicated problems and participants' age. The usage of our electronic symptom assessment questionnaire decreased substantially after the period of active encouragement during the study enrolment. CONCLUSIONS Not all societies are ready for innovative eHealth solutions. Patients' age should be carefully considered when app-based interventions are introduced to usual cancer care. Additional support is suggested for older patients to improve their awareness and participation in eHealth interventions. More research involving older participants is needed to explore and address their particular needs and perspectives on eHealth solutions.
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Affiliation(s)
- Grażyna Suchodolska
- Department of Oncology & Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland
| | - Anna Koelmer
- Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdańsk, Dębinki 1, 80-211 Gdańsk, Poland
| | - Monika Puchowska
- Department of Non-Commercial Clinical Research, Clinical Research Support Centre, Medical University of Gdańsk, Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
| | - Elżbieta Senkus
- Department of Oncology & Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland
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Roh S, Lee YS, Kenyon DB, Elliott AJ, Petereit DG, Gaba A, Lee HY. Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study. JMIR Form Res 2023; 7:e47851. [PMID: 37471115 PMCID: PMC10401399 DOI: 10.2196/47851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains. OBJECTIVE This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure. METHODS Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention. RESULTS A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences. CONCLUSIONS This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations. TRIAL REGISTRATION ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.
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Affiliation(s)
- Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, SD, United States
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, United States
| | - DenYelle B Kenyon
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States
| | - Amy J Elliott
- Avera Research Institute, Avera Health, Sioux Falls, SD, United States
| | - Daniel G Petereit
- Monument Health Cancer Care Institute, Rapid City, SD, United States
| | - Anu Gaba
- Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND, United States
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, United States
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22
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Granda-Cameron C, Kates J, Wen KY. mHealth Interventions to Improve the Breast Cancer Continuum of Care from Prevention to Survivorship of Hispanic Women: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01658-7. [PMID: 37365425 DOI: 10.1007/s40615-023-01658-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Breast cancer is the leading cause of cancer mortality in Hispanic women in the USA. Current interventions to improve breast cancer care include the use of mHealth, but its application in Hispanic women is limited. This scoping review aimed to describe the extent of research literature on the use of mHealth throughout the breast cancer care continuum (prevention, early detection, and treatment) in Hispanic women. METHODS A scoping review guided by the Arksey and O'Malley methodological framework and the Joanna Briggs Institute scoping review reporting protocol. Literature search of peer-reviewed research articles from 2012 to 2022 in PubMed, Scopus, and CINAHL® was conducted in March and June 2022. RESULTS Of the 10 articles selected, seven included Hispanic breast cancer survivors and three included Hispanic women at risk for developing breast cancer. Seven articles involved mobile applications and three articles used text messaging and/or cell phone voicemail. Overall, the use of mHealth for breast cancer care in Hispanics was favorable but generalizability was limited given the type of design and small samples. All interventions were tailored to Hispanic culture. CONCLUSION Scarcity of research on mHealth in Hispanic breast cancer care highlights healthcare disparities in this population. Evidence from this review suggests the use of mHealth to be beneficial to improving breast cancer care in Hispanics, but more research is needed involving randomized clinical trials and larger samples.
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Affiliation(s)
- Clara Granda-Cameron
- Thomas Jefferson University College of Nursing, 901 Walnut Street, Suite 703, Philadelphia, PA, 19107, USA.
| | - Jeannette Kates
- Thomas Jefferson University College of Nursing, 901 Walnut Street, Suite 703, Philadelphia, PA, 19107, USA
| | - Kuang-Yi Wen
- Medical Oncology Department, Population Science Division, 834 Chestnut Street, Suite 300, Franklin Building, Philadelphia, PA, 19107, USA
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Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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Amiri P, Ahmadian L, Khajouei R. The applications and the effectiveness of mHealth interventions to manage lung cancer patients: a systematic review. Health Technol 2023. [DOI: 10.1007/s12553-023-00735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Vercell A, Gasteiger N, Yorke J, Dowding D. Patient-facing cancer mobile apps that enable patient reported outcome data to be collected: A systematic review of content, functionality, quality, and ability to integrate with electronic health records. Int J Med Inform 2023; 170:104931. [PMID: 36462398 DOI: 10.1016/j.ijmedinf.2022.104931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/30/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Enabling cancer patients to self-manage symptoms through mobile applications can result in more informed, autonomous patients who are partners in their care, consequently reducing the burden on health services. Electronic patient reported outcomes completed before a clinical review can increase the frequency and quality of holistic assessments, while integration into electronic health records can maximise clinical utility. The ability of apps to integrate with electronic health records is key to providing a real-time interface between patient reports and healthcare response. This review identifies patient-facing cancer apps which can record patient reported outcomes, and explores their purpose, functionality, quality, and ability to integrate with electronic health records. METHODS A systematic app review and content synthesis was conducted on patient-facing cancer apps available in the United Kingdom. Where applicable, the review aligned with the Preferred Reporting Items for Systematic Reviews and meta-Analysis. Two validated scales assessed functionality and quality: The IMS Institute for Healthcare Informatics functionality score and the Mobile App Rating Scale. Flesch-Kincaid metrics explored readability. RESULTS Apple App and Google Play stores identified 405 apps, of which 12 met the eligibility criteria. All were free to download, 1 (8%) had in-app purchases/subscriptions. Nine (75%) were affiliated with a professional health body/charity. Six (50%) analysed inputted data and provided medical advice based on answers. The average Flesch Reading Ease score was 42.7 out of 100. The apps had an average of 7.3 functions each and a mean MARS score of 4/5. None integrated with electronic health records. CONCLUSION While many cancer apps exist, few enable patient reported outcomes to be recorded and shared with clinicians in real-time. Further research is warranted to explore the feasibility of integrating with electronic health records, as this function can improve patient experience and outcomes, and increase efficiency of hospital resources through more proactive care.
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Affiliation(s)
- Amy Vercell
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom.
| | - Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom; Division of Informatics, Imaging & Data Sciences, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Janelle Yorke
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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Lim JY, Kim Y, Yeo SM, Chae BJ, Yu J, Hwang JH. Feasibility and usability of a personalized mHealth app for self-management in the first year following breast cancer surgery. Health Informatics J 2023; 29:14604582231156476. [PMID: 36772832 DOI: 10.1177/14604582231156476] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
This study investigated the feasibility and usability of a personalized mobile health (mHealth) app for self-management during the year following breast cancer surgery. Twenty-nine participants were instructed to use an app and smart band immediately after discharge. Only 18 completed the study. Their perceived necessity and satisfaction for main domains and app were assessed at 1, 2, 4, 6, 9, and 12 months. A self-reporting questionnaire assessed usability at 12 months. Consequently, retention rate as measures of feasibility showed a mean of 75.8%. Exercise and diet management were the most accessed app domains. Perceived necessity was higher than satisfaction. The mean usability score was 80.2. Most participants found the app useful and effective as a delivery for healthcare. Further, 94% of them were willing to pay for and recommend it. Thus, mHealth app can help breast cancer patients improve their healthy behaviors and healthcare further. This study provides insights for designing long-term randomized controlled trials using mHealth interventions.
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Affiliation(s)
- Ji Young Lim
- Department of Physical Therapy, Graduate School of Medical Science, 34966Konyang University, Daejeon, Republic of Korea
| | - Yoon Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - Seung Mi Yeo
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Byung Joo Chae
- Breast Division, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jonghan Yu
- Breast Division, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Wanchai A, Anderson EA, Armer JM. A systematic review of m-health apps on managing side effects of breast cancer treatment. Support Care Cancer 2022; 31:86. [PMID: 36574048 DOI: 10.1007/s00520-022-07464-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/12/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE After breast cancer treatment, women with breast cancer may experience distress caused by treatment side effects, both in physical and psychological aspects. Technology use is increasing in favor among women. Therefore, it is essential to update the scientific evidence regarding mobile and web apps' effectiveness in managing the side effects of breast cancer treatments for breast cancer survivors. The purpose of this systematic review was to investigate the scientific evidence on the effectiveness of mobile and web apps in managing the side effects of breast cancer treatments among this group. METHODS A literature search was conducted using ScienceDirect, Scopus, PubMed, CINAHL, and Cochrane. Published papers in English focused on mobile and web apps and the side effects of breast cancer treatment in breast cancer survivors were selected. The search reviewed studies from January 2011 to December 2021. From a total of 925 retrieved manuscripts, 11 studies were included for analysis. RESULTS The findings showed that mobile apps were more frequently used and more likely to be an effective method for managing the side effects of breast cancer treatment among breast cancer survivors. The content in web or mobile apps for breast cancer survivors should include five categories: (1) information about cancer, (2) overview of cancer care, (3) opportunities for interaction with other people, (4) symptom management strategies, and (5) feedback about cancer treatment side effect management. However, a few studies examined the effects of a combination of mobile and web apps in managing breast cancer treatment side effects. Therefore, future research is needed to examine solo and combination use. In addition, more rigorous studies are warranted to examine these interventions. CONCLUSIONS Nurses may refer survivors to these resources to obtain more information and effectively manage the signs and symptoms of breast cancer and its treatment side effects.
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Affiliation(s)
- Ausanee Wanchai
- Boromarajonani College of Nursing Buddhachinaraj, Faculty of Nursing, Praboromarajchanok Institute, Phitsanulok, Thailand.
| | | | - Jane M Armer
- Sinclair School of Nursing, University of Missouri, Columbia, MO, 65211, USA.,American Lymphedema Framework Project, Columbia, MO, 65211, USA
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Akingbade O, Adediran V, Somoye IE, Alade AS, Chow KM. Perceived feasibility and usefulness of mHealth interventions for psychoeducational support among Nigerian women receiving chemotherapy for breast cancer: a focus group study. Support Care Cancer 2022; 30:9723-9734. [DOI: 10.1007/s00520-022-07403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Sánchez Antelo V, Szwarc L, Le Pera A, Fredjkes P, Saimovici D, Massaccesi S, Paolino M, Viswanath K, Arrossi S. Ten Steps to Design a Counseling App to Reduce the Psychosocial Impact of Human Papillomavirus Testing on the Basis of a User-Centered Design Approach in a Low- and Middle-Income Setting. JCO Glob Oncol 2022; 8:e2200168. [PMID: 36252163 PMCID: PMC9812480 DOI: 10.1200/go.22.00168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE This study describes the 10 steps followed to produce the information architecture of a user-centered design (UCD) counseling mobile application, the first phase to develop an app. The app aims to reduce the psychosocial impact of the human papillomavirus test result and improve women's knowledge of human papilloma virus and cervical cancer. METHODS We used a UCD approach to produce the information architecture of the app (ie, how to organize contents into features). We analyzed field notes, meeting agendas, and documentation produced during each stage of the design process. We described the goals, methods, and outcomes of each step. We also discussed the critical challenges and the strategies to address them. RESULTS The steps are (1) knowledge, attitudes, and beliefs mapping: reanalysis of team's research findings from prior studies; (2) environmental scanning of apps available on the market; (3) stakeholders' point of view: The International Advisory Committee; (4) potential user's profile: building archetypes through the Persona method; (5) women's interviews: user's preferences and experiences; (6) effective features: scoping review to select app's features that address psychosocial impact; (7) the user journey: ideal interaction with the gynecological service and the counseling app; (8) women's focus groups: using Personas and Scenarios to discuss app's mock-up; (9) women's design sessions: prototype test and card-sorting techniques; and (10) team's design session: translating results into visual objects and features. CONCLUSION We provide here detailed descriptions of the UCD process of an app for human papillomavirus-tested women for those venturing into the area of mHealth strategies work. Our experience can be used as a guide for future mHealth app development for a low- and middle-income setting.
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Affiliation(s)
- Victoria Sánchez Antelo
- Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Lucila Szwarc
- Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Anabella Le Pera
- Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Paula Fredjkes
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Diana Saimovici
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Silvia Massaccesi
- Instituto Provincial del Cáncer, Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Melisa Paolino
- Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA,Dana-Farber Cancer Institute, Harvard University, Boston, MA
| | - Silvina Arrossi
- Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina,Silvina Arrossi, PhD, Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, C1173 AAA, Buenos Aires, Argentina; Twitter: @silvi2020twit; e-mail:
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Akingbade O, Nguyen KT, Chow KM. Effect of mHealth interventions on psychological issues experienced by women undergoing chemotherapy for breast cancer: A systematic review and meta-analysis. J Clin Nurs 2022. [PMID: 36168199 DOI: 10.1111/jocn.16533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/16/2022] [Accepted: 08/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND A range of psychological issues often accompany breast cancer chemotherapy. Due to their ubiquity, mobile phones have been used to deliver supportive interventions addressing these issues. However, we currently lack sufficient evidence to guide the design of such interventions. AIM To analyse and synthesise available evidence on the effectiveness of mobile-phone-based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. METHODS A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta-analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. RESULTS The review included nine RCTs which covered 1457 patients. The meta-analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p = .01, I2 = 17%). No significant effects were found for anxiety (SMD = -0.01, 95% CI [-0.26, 0.25], p = .96, I2 = 53%) and depression (SMD = 0.02, 95% CI [-0.17, 0.20], p = .87, I2 = 0%). Individual studies suggest reduced symptom prevalence (p = .033, d = 0.27), symptom distress (p = .004, d = 0.34), symptom interference (p = .02, d = 0.51), supportive care needs (p < .05, d = 2.43); improved self-efficacy (p = .03, d = 0.53), self-esteem (p < .001, d = 0.87) and emotional functioning (p = .008, d = 0.30). The methodological quality ranged from low to moderate. CONCLUSION mHealth interventions might help address certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies. PROSPERO REGISTRATION NUMBER CRD42021224307.
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Affiliation(s)
- Oluwadamilare Akingbade
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Institute of Nursing Research, Osogbo, Nigeria
| | - Khanh Thi Nguyen
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Schliemann D, Tan MM, Hoe WMK, Mohan D, Taib NA, Donnelly M, Su TT. mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews. J Med Internet Res 2022; 24:e36316. [PMID: 35969450 PMCID: PMC9425170 DOI: 10.2196/36316] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer screening provision in resource-constrained settings tends to be opportunistic, and uptake tends to be low, leading to delayed presentation and treatment and poor survival. OBJECTIVE The aim of this study was to identify, review, map, and summarize findings from different types of literature reviews on the use of mobile health (mHealth) technologies to improve the uptake of cancer screening. METHODS The review methodology was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Ovid MEDLINE, PyscINFO, and Embase were searched from inception to May 2021. The eligible criteria included reviews that focused on studies of interventions that used mobile phone devices to promote and deliver cancer screening and described the effectiveness or implementation of mHealth intervention outcomes. Key data fields such as study aims, types of cancer, mHealth formats, and outcomes were extracted, and the data were analyzed to address the objective of the review. RESULTS Our initial search identified 1981 titles, of which 12 (0.61%) reviews met the inclusion criteria (systematic reviews: n=6, 50%; scoping reviews: n=4, 33%; rapid reviews: n=1, 8%; narrative reviews: n=1, 8%). Most (57/67, 85%) of the interventions targeted breast and cervical cancer awareness and screening uptake. The most commonly used mHealth technologies for increasing cancer screening uptake were SMS text messages and telephone calls. Overall, mHealth interventions increased knowledge about screening and had high acceptance among participants. The likelihood of achieving improved uptake-related outcomes increased when interventions used >1 mode of communication (telephone reminders, physical invitation letters, and educational pamphlets) together with mHealth. CONCLUSIONS mHealth interventions increase cancer screening uptake, although multiple modes used in combination seem to be more effective.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Min Min Tan
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Wilfred Mok Kok Hoe
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, University Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Tin Tin Su
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia.,Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Chua JYX, Shorey S. Effectiveness of mobile application-based perinatal interventions in improving parenting outcomes: A systematic review. Midwifery 2022; 114:103457. [PMID: 35985142 PMCID: PMC9364944 DOI: 10.1016/j.midw.2022.103457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
Objective Parents face many challenges during the perinatal period and are at risk for mental health issues, especially during the current coronavirus (COVID-19) pandemic. Mobile application-based interventions can help parents to improve their psychosocial well-being in a convenient and accessible manner. This review aims to examine the effectiveness of mobile application-based perinatal interventions in improving parenting self-efficacy, anxiety, and depression (primary outcomes), as well as stress, social support, and parent-child bonding (secondary outcomes) among parents. Methods Seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Thesis and Dissertations) were searched from their respective inception dates until August 2021. The Cochrane Risk of Bias-2 tool was used to conduct quality appraisals. Results were narratively synthesized due to the high heterogeneity of intervention and participant types. Findings A total of 6164 articles were retrieved from the seven electronic databases and citation searching. After excluding duplicate records and irrelevant titles/abstracts, 105 full texts were examined. Full-text screening excluded another 93 articles, leaving 12 included studies in this review. All studies were rated as having some concerns or a high overall risk of bias. Mobile application-based interventions were found to be feasible and promising in improving parents’ overall well-being post-intervention during the perinatal period. Further research would be needed to determine their long-term effects. Key conclusions and implications for practice Parental well-being was shown to improve using the following intervention components: educational resources on perinatal and infant care, psychotherapy, and support from peers and healthcare professionals. Hence, future interventions could aim to include these components and evaluate all inter-related parenting outcomes (parenting self-efficacy, stress, anxiety, depression, social support, and parent-child bonding). Parents could be provided with experiential learning exposure by using computer animations and virtual reality. Future research could be conducted on more fathers and parents from varied geographical regions.
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Affiliation(s)
- Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive 117597, Singapore.
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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Abedian Kasgari K, Tavakoli Sany SB, Mahdizadeh M, Tehrani H, Yazdani Charati J, Peyman N. Stakeholders' Experiences and Perspectives Regarding Care Quality for Women With Breast Cancer: A Systematic Review. Cancer Nurs 2022. [PMID: 35637166 DOI: 10.1097/NCC.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The considerable growth in the number of patients with breast cancer leads to substantial pressure on healthcare services; however, the main measures that will evaluate what is important to the key stakeholders in improving the quality of breast cancer care are not well defined. OBJECTIVE This study aimed to synthesize providers' and patients' experiences and perspectives regarding barriers and quality breast cancer care in health services. METHODS PubMed, Scopus, MEDLINE, Web of Knowledge, and the Cochrane Library databases were searched, and articles published in English up to August 2020 were screened. Two reviewers independently screened all articles. Data were obtained directly from different stakeholder groups including patients, health providers, and professionals. RESULTS The search strategy identified 21 eligible articles that met inclusion criteria and reported perspectives of 847 health providers and 24 601 patients regarding healthcare quality. Health providers and patients with breast cancer noted information needs, psychosocial support, responsibility for care, and coordination of care as important quality improvement characteristics of the healthcare system. CONCLUSION Shifting to high-quality breast cancer care would likely be a complicated process, and there is a need for the cancer care services to consider important characteristics of quality cancer care as a care priority, that is, to be responsive. IMPLICATION FOR PRACTICE Breast cancer survivorship care programs and interventions may need to consider the barriers or common challenges to care noted in this review, especially regarding information sharing and the need for social support and care cooperation.
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Batai K, Sanderson PR, Joshweseoma L, Burhansstipanov L, Russell D, Joshweseoma L, Hsu CH. Formative Assessment to Improve Cancer Screenings in American Indian Men: Native Patient Navigator and mHealth Texting. Int J Environ Res Public Health 2022; 19:6546. [PMID: 35682130 DOI: 10.3390/ijerph19116546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023]
Abstract
Cancer screening rates among American Indian men remain low, without programs specifically designed for men. This paper describes the Community-Based Participatory Research processes and assessment of cancer screening behavior and the appropriateness of the mHealth approach for Hopi men's promotion of cancer screenings. This Community-Based Participatory Research included a partnership with H.O.P.I. (Hopi Office of Prevention and Intervention) Cancer Support Services and the Hopi Community Advisory Committee. Cellular phone usage was assessed among male participants in a wellness program utilizing text messaging. Community surveys were conducted with Hopi men (50 years of age or older). The survey revealed colorectal cancer screening rate increased from 51% in 2012 to 71% in 2018, while prostate cancer screening rate had not changed (35% in 2012 and 37% in 2018). Past cancer screening was associated with having additional cancer screening. A cellular phone was commonly used by Hopi men, but not for healthcare or wellness. Cellular phone ownership increased odds of prostate cancer screening in the unadjusted model (OR 9.00, 95% CI: 1.11-73.07), but not in the adjusted model. Cellular phones may be applied for health promotion among Hopi men, but use of cellular phones to improve cancer screening participation needs further investigation.
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Huberty J, Bhuiyan N, Eckert R, Larkey L, Petrov M, Todd M, Mesa R. Insomnia as an Unmet Need in Chronic Hematologic Cancer Patients: A study design of a randomized controlled trial evaluating a consumer-based meditation app for treatment of sleep disturbance (Preprint). JMIR Res Protoc 2022; 11:e39007. [PMID: 35776489 PMCID: PMC9288097 DOI: 10.2196/39007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
Background To address the need for long-term, accessible, nonpharmacologic interventions targeting sleep in patients with chronic hematological cancer, we propose the first randomized controlled trial to determine the effects of a consumer-based mobile meditation app, Calm, on sleep disturbance in this population. Objective This study aims to test the efficacy of daily meditation delivered via Calm compared with a health education podcast control group in improving the primary outcome of self-reported sleep disturbance, as well as secondary sleep outcomes, including sleep impairment and sleep efficiency; test the efficacy of daily meditation delivered via Calm compared with a health education podcast control group on inflammatory markers, fatigue, and emotional distress; and explore free-living use during a 12-week follow-up period and the sustained effects of Calm in patients with chronic hematological cancer. Methods In a double-blinded randomized controlled trial, we will recruit 276 patients with chronic hematological cancer to an 8-week app-based wellness intervention—the active, daily, app-based meditation intervention or the health education podcast app control group, followed by a 12-week follow-up period. Participants will be asked to use their assigned app for at least 10 minutes per day during the 8-week intervention period; complete web-based surveys assessing self-reported sleep disturbance, fatigue, and emotional distress at baseline, 8 weeks, and 20 weeks; complete sleep diaries and wear an actigraphy device during the 8-week intervention period and at 20 weeks; and complete blood draws to assess inflammatory markers (tumor necrosis factor-α, interleukin-6, interleukin-8, and C-reactive protein) at baseline, 8 weeks, and 20 weeks. Results This project was funded by the National Institutes of Health National Cancer Institute (R01CA262041). The projects began in April 2022, and study recruitment is scheduled to begin in October 2022, with a total project duration of 5 years. We anticipate that we will be able to achieve our enrollment goal of 276 patients with chronic hematological cancers within the allotted project time frame. Conclusions This research will contribute to broader public health efforts by providing researchers and clinicians with an evidence-based commercial product to improve sleep in the long term in an underserved and understudied cancer population with a high incidence of sleep disturbance. Trial Registration ClinicalTrials.gov NCT05294991; https://clinicaltrials.gov/ct2/show/NCT05294991 International Registered Report Identifier (IRRID) PRR1-10.2196/39007
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Affiliation(s)
| | - Nishat Bhuiyan
- College of Health solutions, Arizona State University, Phoenix, AZ, United States
| | - Ryan Eckert
- Mays Cancer Center, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Megan Petrov
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Ruben Mesa
- Mays Cancer Center, University of Texas Health San Antonio, San Antonio, TX, United States
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Suchodolska G, Senkus E. Mobile applications for early breast cancer chemotherapy-related symptoms reporting and management: A scoping review. Cancer Treat Rev 2022; 105:102364. [DOI: 10.1016/j.ctrv.2022.102364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 11/20/2022]
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Hazard-Jenkins HW. Breast Cancer Survivorship—Mitigating Treatment Effects on Quality of Life and Improving Survival. Obstet Gynecol Clin North Am 2022; 49:209-218. [DOI: 10.1016/j.ogc.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jones E, Poyade M, Varsou O. Developing and evaluating a prototype public health mobile app on the UK NHS Abdominal Aortic Aneurysm Screening Programme. J Vis Commun Med 2022; 45:160-168. [DOI: 10.1080/17453054.2022.2037409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ella Jones
- University of Glasgow, Glasgow, UK
- Glasgow School of Art, Glasgow, UK
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Narrillos-Moraza Á, Gómez-Martínez-Sagrera P, Amor-García MÁ, Escudero-Vilaplana V, Collado-Borrell R, Villanueva-Bueno C, Gómez-Centurión I, Herranz-Alonso A, Sanjurjo-Sáez M. Mobile Apps for Hematological Conditions: Review and Content Analysis Using the Mobile App Rating Scale. JMIR Mhealth Uhealth 2022; 10:e32826. [PMID: 35171109 PMCID: PMC8892317 DOI: 10.2196/32826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/28/2021] [Accepted: 12/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background Hematological conditions are prevalent disorders that are associated with significant comorbidities and have a major impact on patient care. Concerning new tools for the care of these patients, the number of health apps aimed at hematological patients is growing. Currently, there are no quality analyses or classifications of apps for patients diagnosed with hematological conditions. Objective The aim of this study is to analyze the characteristics and quality of apps designed for patients diagnosed with hematological conditions by using the Mobile App Rating Scale (MARS). Methods We performed an observational, cross-sectional descriptive study of all smartphone apps for patients diagnosed with hematological conditions. A search was conducted in March 2021 using the following terms: anemia, blood cancer, blood disorder, hematological cancer, hematological malignancy, hematological tumor, hematology, hemophilia, hemorrhage, lymphoma, leukemia, multiple myeloma, thalassemia, thrombocytopenia, and thrombosis. The apps identified were downloaded and evaluated by 2 independent researchers. General characteristics were registered, and quality was analyzed using MARS scores. Interrater reliability was measured by using the Cohen κ coefficient. Results We identified 2100 apps in the initial search, and 4.19% (88/2100) of apps met the inclusion criteria and were analyzed. Of the 88 apps, 61% (54/88) were available on Android, 30% (26/88) were available on iOS, and 9% (8/88) were available on both platforms. Moreover, 7% (6/88) required payment, and 49% (43/88) were updated in the last year. Only 26% (23/88) of the apps were developed with the participation of health professionals. Most apps were informative (60/88, 68%), followed by preventive (23/88, 26%) and diagnostic (5/88, 6%). Most of the apps were intended for patients with anemia (23/88, 26%). The mean MARS score for the overall quality of the 88 apps was 3.03 (SD 1.14), ranging from 1.19 (lowest-rated app) to 4.86 (highest-rated app). Only 47% (41/88) of the apps obtained a MARS score of over 3 points (acceptable quality). Functionality was the best-rated section, followed by aesthetics, engagement, information, and app subjective quality. The five apps with the highest MARS score were the following: Multiple Myeloma Manager, Hodgkin Lymphoma Manager, Focus On Lymphoma, ALL Manager, and CLL Manager. The analysis by operating system, developer, and cost revealed statistically significant differences in MARS scores (P<.001, P<.001, and P=.049, respectively). The interrater agreement between the 2 reviewers was substantial (k=0.78). Conclusions There is great heterogeneity in the quality of apps for patients with hematological conditions. More than half of the apps do not meet acceptable criteria for quality and content. Most of them only provide information about the pathology, lacking interactivity and personalization options. The participation of health professionals in the development of these apps is low, although it is narrowly related to better quality.
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Affiliation(s)
| | | | | | | | | | | | | | - Ana Herranz-Alonso
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Sanjurjo-Sáez
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Pereira DR, Silva ER, Carvalho-Maia C, Monteiro-Reis S, Lourenço C, Calisto R, Teixeira RJ, Carlson LE, Bart G, Vainio SJ, Sales MGF, Jerónimo C, Henrique R. The modulatory role of internet-supported mindfulness-based cognitive therapy on extracellular vesicles and psychological distress in people who have had cancer: a protocol for a two-armed randomized controlled study. Trials 2022; 23:118. [PMID: 35123569 PMCID: PMC8817152 DOI: 10.1186/s13063-022-06045-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/19/2022] [Indexed: 01/10/2023] Open
Abstract
Background Mindfulness-based interventions (MBIs) have been used in oncology contexts as a promising tool with numerous benefits for various health-related and psychosocial outcomes. Despite the increasing popularity of MBIs, few randomized controlled trials (RCTs) have examined their effects upon biological parameters. Specifically, no previous study has examined the effects of MBIs on extracellular vesicles (EVs), which are potentially important markers of health, disease, and stress. Moreover, the lack of RCTs is even more limited within the context of technology-mediated MBIs and long-term effects. Methods The current study protocol presents a two-arm, parallel, randomized controlled study investigating the effects of internet-supported mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU). Primary outcomes are psychological distress and EV cargo of distressed participants with previous breast, colorectal, or prostate cancer diagnoses. Secondary outcomes are self-reported psychosocial and health-related measures, and additional biological markers. Outcomes will be assessed at baseline, 4 weeks after baseline (mid-point of the intervention), 8 weeks after baseline (immediately post-intervention), 24 weeks after baseline (after booster sessions), and 52 weeks after baseline. Our goal is to recruit at least 111 participants who have been diagnosed with breast, prostate, or colorectal cancer (cancer stage I to III), are between 18 and 65 years old, and have had primary cancer treatments completed between 3 months and 5 years ago. Half of the participants will be randomized to the TAU group, and the other half will participate in an 8-week online MBCT intervention with weekly group sessions via videoconference. The intervention also includes asynchronous homework, an online retreat after the fifth week, and 4 monthly booster sessions after completion of the 8-week programme. Discussion This study will allow characterizing the effects of internet-based MBCT on psychosocial and biological indicators in the context of cancer. The effects on circulating EVs will also be investigated, as a possible neurobiological pathway underlying mind-body intervention effects. Trial registration ClinicalTrials.govNCT04727593 (date of registration: 27 January 2021; date of record verification: 6 October 2021). Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06045-x.
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Huberty J, Bhuiyan N, Neher T, Joeman L, Mesa R, Larkey L. Leveraging a Consumer-Based Product to Develop a Cancer-Specific Mobile Meditation App: Prototype Development Study. JMIR Form Res 2022; 6:e32458. [PMID: 35029528 PMCID: PMC8800087 DOI: 10.2196/32458] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/30/2021] [Accepted: 11/27/2021] [Indexed: 01/20/2023] Open
Abstract
Background Mobile meditation apps may offer a long-term, accessible, and effective solution for ongoing symptom management in cancer patients/survivors. However, there are currently no commercial cancer-specific meditation apps that reflect cancer specialist expertise, input from cancer patients/survivors, and features and content specific to cancer patients’/survivors’ needs. Objective The aim of this study was to gain insight (via surveys, daily journals, and focus groups) from cancer patients/survivors, health care providers, and current subscribers of Calm (a consumer-based mobile meditation app) who were patients/survivors to develop a prototype of a mobile meditation app specifically designed for cancer patients/survivors. Methods Participants were recruited via prior partnerships, word-of-mouth referrals, and recruitment posts on Facebook and Instagram. Cancer patients/survivors and health care providers were instructed to download and use the Calm app for at least 10 minutes a day for 7 days, complete an online daily journal for 7 days, and participate in a virtual focus group (one for cancer patients/survivors and one for providers). Current Calm subscribers who were cancer patients/survivors completed an online survey about different aspects of the Calm app and participated in a third virtual focus group. Data were qualitatively analyzed using a combination of deductive and inductive coding. Results A total of 27 participants (11 cancer patients/survivors, 10 health care providers, 6 current Calm subscribers) completed the study. Similar themes and subthemes were found across surveys, daily journals, and focus groups, and fell into two major categories, content and functionality, with cancer-specific and noncancer-specific themes identified within each category. The majority of content preferences and suggestions that arose were cancer-specific, such as content related to negative emotions or feelings (eg, anxiety, grief, trauma/posttraumatic stress disorder, fear of recurrence, isolation), positive feelings and finding meaning (eg, gratitude, storytelling, acceptance), scenarios and experiences (eg, waiting, treatment-specific mediations), type and stage of cancer journey, and movement modifications. Some of the noncancer-specific themes under app content included sleep, music, and visualizations. In terms of app functionality, the majority of participants expressed interest in having a section/tab/area of the app that was specifically geared toward cancer patients/survivors. Preferences and suggestions for cancer-specific functionality features included options based on symptoms or journey, being able to communicate with other patients or survivors to share suggestions for specific meditations, and having an emergency toolkit for patients/survivors. Conclusions Findings from cancer patients/survivors, health care providers, and current Calm subscribers who were patients/survivors to be incorporated into the development of the prototype fell into two major categories: (1) content of the app and (2) functionality of the app. The prototype’s form and function will be pilot-tested among 30 cancer patients/survivors in a 4-week study, and the resulting feasibility data will be used to inform the final app design and an efficacy study.
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Affiliation(s)
| | - Nishat Bhuiyan
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Taylor Neher
- Research Consultancy, Little Rock, AR, United States
| | - Lynda Joeman
- Lynda Joeman Research Consultancy, Tonbridge, United Kingdom
| | - Ruben Mesa
- Mays Cancer Center, University of Texas Health San Antonio MD Anderson Cancer Center, San Antonio, TX, United States
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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43
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Sanchez Antelo V, Szwarc L, Paolino M, Saimovici D, Massaccesi S, Viswanath K, Arrossi S. A Counseling Mobile App to Reduce the Psychosocial Impact of Human Papillomavirus Testing: Formative Research Using a User-Centered Design Approach in a Low-Middle-Income Setting in Argentina. JMIR Form Res 2022; 6:e32610. [PMID: 35023843 PMCID: PMC8796044 DOI: 10.2196/32610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/01/2021] [Accepted: 11/17/2021] [Indexed: 01/16/2023] Open
Abstract
Background Human papillomavirus (HPV) testing detects sexually transmitted infections with oncogenic types of HPV. For many HPV-positive women, this result has negative connotations. It produces anxiety, fear of cancer or death, and disease denial. Face-to-face counseling could present many difficulties in its implementation, but a counseling mobile app could be practical and may help HPV-positive women reduce the psychosocial impact of the result, improve their knowledge of HPV and cervical cancer, and increase adherence to follow-up. Objective This study aims to understand HPV-tested women’s perceptions about an app as a tool to receive information and support to reduce the emotional impact of HPV-positive results. We investigated their preferences regarding app design, content, and framing. Methods We conducted formative research based on a user-centered design approach. We carried out 29 individual online interviews with HPV-positive women aged 30 years and over and 4 focus groups (FGs) with women through a virtual platform (n=19). We shared a draft of the app's potential screens with a provisional label of the possible content, options menus, draft illustrations, and wording. This allowed us to give women understandable triggers to debate the concepts involved on each screen. The draft content and labels were developed drawing from the health belief model (HBM) and integrative behavioral model (IBM) variables and findings of mobile health literature. We used an FG guide to generate data for the information architecture (ie, how to organize contents into features). We carried out thematic analysis using constructs from the HBM and IBM to identify content preferences and turn them into app features. We used the RQDA package of R software for data processing. Results We found that participants required more information regarding the procedures they had received, what HPV-positive means, what the causes of HPV are, and its consequences on their sexuality. The women mentioned fear of the disease and stated they had concerns and misconceptions, such as believing that an HPV-positive result is a synonym for cancer. They accepted the app as a tool to obtain information and to reduce fears related to HPV-positive results. They would use a mobile app under doctor or health authority recommendation. The women did not agree with the draft organization of screens and contents. They believed the app should first offer information about HPV and then provide customized content according to the users’ needs. The app should provide information via videos with experts and testimonies of other HPV-positive women, and they suggested a medical appointment reminder feature. The app should also offer information through illustrations, or infographics, but not pictures or solely text. Conclusions Providing information that meets women’s needs and counseling could be a method to reduce fears. A mobile app seems to be an acceptable and suitable tool to help HPV-positive women.
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Affiliation(s)
- Victoria Sanchez Antelo
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucila Szwarc
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Melisa Paolino
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Saimovici
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Massaccesi
- Secretaria de Salud de Ituzaingó, Instituto Provincial del Cáncer, Ministerio de Salud de la Provincia de Buenos Aires, Ituzaingo, Argentina
| | - Kasisomayajula Viswanath
- McGraw-Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires, Argentina
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44
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Al-Azzam MK. Research on the Impact of mHealth Apps on the Primary Healthcare Professionals in Patient Care. Appl Bionics Biomech 2021; 2021:7611686. [PMID: 34912474 DOI: 10.1155/2021/7611686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022] Open
Abstract
The goal of this study was to develop and use a questionnaire in order to analyse the effects of eHealth apps on patient care using Jordanian population. A two-stage cross-sectional research was conducted. A questionnaire was developed in the beginning to evaluate its consistency and legitimacy using Cronbach's alpha coefficient, a multitrait connection atmosphere; the multivariate technique is component examination. In the study's another phase, correlation and regression are used to determine the influence of eHealth apps on patient care. The five major axes of the final surveys were healthcare efficiency, teaching, notices, consultation, and follow-up. Individuals from diverse demographic aspects, such as gender, age, job experience, and education level, have no differing perspectives on cell phone use in their amenities, according to a staff's viewpoint evaluation. In general, mobile health applications had a good influence on health services and healthcare, which would be an important setting for the operative use of mobile headphones in public policy; such a background would affect in workers' intents to practice and adopt mHealth.
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45
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Abstract
Mobile health applications (apps) have transformed the possibilities for health promotion and disease self-management; however, their promise is not fully realized owing to their reliance on commercial ecosystems for development and distribution. This review provides an overview of the types of mobile health apps and describes key stakeholders in terms of how apps are used, developed, and regulated. I outline key challenges facing consumers, public health professionals, and policy makers in evaluating the quality of health apps and summarize what is known about the impact of apps on health outcomes and health equity. I suggest that factors within the wider mobile ecosystem largely define the impact of health apps and, most notably, practices around the collection and commercialization of user data. Finally, I suggest that upstream public health strategies, grounded in an understanding of corporate influences on health, are necessary to promote healthy digital environments in which mobile health app innovation can flourish. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada;
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46
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Wang G, Wu B, Chen J, Yu G, Lin D, Wang G, Bai Z. A novel mHealth App (RyPros) for prostate cancer management: an accessibility and acceptability study. Transl Androl Urol 2021; 10:3723-3736. [PMID: 34804816 PMCID: PMC8575583 DOI: 10.21037/tau-21-459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022] Open
Abstract
Background Over the past decade, there has been a significant increase in research on the use of mobile health (mHealth) apps as disease management tools. However, very few apps are currently available for prostate cancer (PCa) patient management, and the available apps do not combine the needs of physicians with the requirements of patients. This study aimed to describe the development of a mHealth application for PCa survivors called RyPros, which includes dynamic visualization, intelligent reminders, and instant messaging to support decision-making regarding treatment and follow-up and test the initial accessibility and acceptability application. Methods The application was developed through a three-step procedure: logical structure design, application programming, and testing. Dynamic visualization, intelligent reminders, and instant messaging were the core functions of RyPros. Twenty-eight participants who had PCa were enrolled in four weeks of follow-up using the RyPros App. We initially evaluated participants' acceptance of RyPros based on their use of the app (login data, questionnaire completion) and a satisfaction survey. Results We successfully designed and tested the application. A total of 32 participants were enrolled, of whom 28 completed the 4-week follow-up, yielding a participation rate of 87.5%. Each participant logged on an average of 2.82 times and achieved an average of 0.89 questionnaires per week over the four weeks. Most participants (64%) liked the app, and most participants (71%) were satisfied, giving the RyPros app a rating of 4 or 5. More than half of the participants (61%) intended to use the RyPros app regularly, and the majority of participants agreed that the three core functionalities of RyPros were helpful (20/28, 71% for instant messaging; 16/28, 57% for visualization; and 18/28, 64% for reminders and assessments). Conclusions The mHealth application we developed for PCa survivor management provided dynamic visualization, reminders, assessments, and instant messaging to support decision-making based on multidisciplinary collaboration. PCa survivors showed high acceptance of the RyPros app.
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Affiliation(s)
- Gang Wang
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Bing Wu
- ChronoCloud Medical Information (Hainan) Co., Ltd, Haikou, China
| | - Jing Chen
- Department of Radiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Gang Yu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Danni Lin
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Guoren Wang
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Zhiming Bai
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
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47
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Chan RJ, Crichton M, Crawford-Williams F, Agbejule OA, Yu K, Hart NH, de Abreu Alves F, Ashbury FD, Eng L, Fitch M, Jain H, Jefford M, Klemanski D, Koczwara B, Loh K, Prasad M, Rugo H, Soto-Perez-de-Celis E, van den Hurk C, Chan A. The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews. Ann Oncol 2021; 32:1552-1570. [PMID: 34509615 DOI: 10.1016/j.annonc.2021.09.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews (SRs) was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators. METHODS PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. SRs that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021, were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research. RESULTS Twenty-nine SRs were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels. CONCLUSIONS This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.
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Affiliation(s)
- R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia.
| | - M Crichton
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, Australia
| | - F Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - O A Agbejule
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - K Yu
- Department of Pharmacy, National University of Singapore, Singapore
| | - N H Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Australia
| | - F de Abreu Alves
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - F D Ashbury
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Oncology, University of Calgary, Calgary, Canada
| | - L Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, Canada; University Health Network, University of Toronto, Toronto, Canada
| | - M Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - H Jain
- Adult Hematolymphoid Division, Medical Oncology, Tata Memorial Centre, Affiliated to Homi Bhabha National Institute, Mumbai, India
| | - M Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - D Klemanski
- Cancer Support Service Line, The Ohio State University Comprehensive Cancer Center - James Cancer Hospital, Columbus, USA
| | - B Koczwara
- Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - K Loh
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - M Prasad
- Paediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - H Rugo
- Division of Hematology and Oncology, University of California San Francisco, San Francisco, USA
| | - E Soto-Perez-de-Celis
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C van den Hurk
- Netherlands Comprehensive Cancer Organisation, Department of Research and Development, Utrecht, the Netherlands
| | - A Chan
- School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
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48
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Abstract
BACKGROUND eHealth can enhance the delivery of clinical cancer care by offering unique education opportunities for oncology nurses, patients, and family caregivers throughout the cancer trajectory. OBJECTIVES This article reviews eHealth technology that can be applied to oncology education, such as mobile health applications, text messaging, web-based education, and audio- and videoconferencing. METHODS Case studies provide exemplars of eHealth technologies used for delivering oncology education to nurses, patients, and caregivers. FINDINGS By using eHealth technologies to obtain and provide education, oncology nurses are well positioned to improve the lives of patients and caregivers.
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Affiliation(s)
| | | | | | - Robin M Lally
- University of Nebraska Medical Center and Fred and Pamela Buffett Cancer Center
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49
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Tarricone R, Listorti E, Tozzi V, Torbica A, Banks H, Ghislandi S, Altini M, Annicchiarico M, Ardizzoni A, Bordon P, Bossi P, Cascinu S, Numico G, Puglisi F, Fasola G. Transformation of Cancer Care during and after the COVID Pandemic, a point of no return. The Experience of Italy. J Cancer Policy 2021; 29:100297. [PMID: 34316437 PMCID: PMC8297965 DOI: 10.1016/j.jcpo.2021.100297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 10/25/2022]
Abstract
Policymakers everywhere struggle to introduce therapeutic innovation while controlling costs, a particular challenge for the universal Italian National Healthcare System (SSN), which spends only 8.8% of GDP to care for one of the world's oldest populations. Oncology provides a telling example, where innovation has dramatically improved care and survival, transforming cancer into a chronic condition. However, innovation has also increased therapy duration, adverse event management, and service demand. The SSN risks collapse unless centralized cancer planning changes gear, particularly with Covid-19 causing treatment delays, worsening patient prognosis and straining capacity. In view of the 750 billion Euro "Next Generation EU", released by the European Union to relieve Member States hit by the pandemic, the SSN tapped a multidisciplinary research team to identify key strategies for equitable uptake of innovations in treatment and delivery, with emphasis on data-driven technological and managerial advancements - and lessons from Covid-19.
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Affiliation(s)
- R Tarricone
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy.,Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - E Listorti
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - V Tozzi
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - A Torbica
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy.,Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - H Banks
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Via Sarfatti 10, 20136, Milan, Italy
| | - S Ghislandi
- Department of Social and Political Science, Bocconi University, Via Roentgen 1, 20135, Milan, Italy
| | - M Altini
- Istituto Romagnolo per lo studio dei Tumori "Dino Amadori", 47014, Meldola, Italy
| | | | | | | | - P Bossi
- University of Brescia, Brescia, Italy
| | - S Cascinu
- Vita-San Raffaele University, Milan, Italy
| | - G Numico
- Azienda Ospedaliera Santa Croce di Cuneo, Italy
| | - F Puglisi
- Centro di Riferimento Oncologico, Aviano, Italy
| | - G Fasola
- Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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50
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Poort H, Ryan A, MacDougall K, Malinowski P, MacDonald A, Markin Z, Pirl W, Greer J, Fasciano K. Feasibility and Acceptability of a Mobile Phone App Intervention for Coping With Cancer as a Young Adult: Pilot Trial and Thematic Analysis. J Med Internet Res 2021; 23:e25069. [PMID: 34114957 PMCID: PMC8235294 DOI: 10.2196/25069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/04/2021] [Accepted: 04/25/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Many young adult patients do not receive adequate psychosocial services to help them cope with cancer. OBJECTIVE This study aims to assess the feasibility and acceptability of a smartphone app (iaya) intervention that was designed to create an engaged community of young adult patients and help them learn emotional coping skills. METHODS For this single-group pilot trial, 25 young adult patients aged 18-39 years who were receiving active cancer treatment were asked to use the iaya app for 12 weeks. To collect app use data, we used Mixpanel, an analytics platform for apps. Feasibility was assessed through rates of app sessions and the number of coping exercises engaged, and intervention acceptability was evaluated by using an app usability questionnaire and through qualitative interviews at study completion. We collected patient-reported outcome data at baseline and at week 12 to explore self-efficacy for coping with cancer, self-efficacy for managing emotions, perceived emotional support, and quality of life. RESULTS Baseline patient-reported outcome data indicated that participants scored relatively low on perceived emotional support but reasonably high on self-efficacy for coping with cancer and managing emotions as well as quality of life. Participants had a mean of 13 app sessions (SD 14) and 2 coping exercises (SD 3.83) in 12 weeks. Only 9% (2/23) of participants met our combined feasibility definition of ≥10 app sessions and ≥3 coping skills from different categories. The participants' mean usability score was 73.7% (SD 10.84), which exceeded our predefined threshold of ≥70%, and qualitative feedback was generally positive. CONCLUSIONS Although perceived acceptable by patients, the iaya smartphone app did not meet the a priori feasibility criteria as a stand-alone app intervention. Future studies should screen participants for unmet coping needs and consider integrating the app as part of psychosocial care for young adult patients.
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Affiliation(s)
- Hanneke Poort
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Annelise Ryan
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Katelyn MacDougall
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Paige Malinowski
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Anna MacDonald
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | | | - William Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Joseph Greer
- Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital, Boston, MA, United States
| | - Karen Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
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