A qualitative exploration of perceptions of the value of wearable activity monitors among prostate cancer survivors undergoing androgen deprivation therapy.
Authors: Noorvash Brandon , Nguyen Tyra , Jarman Aubrey , Bellerose Haleigh , Barnhill Katherine , Raines Carolina , Sandler Howard M. , Posadas Edwin Melencio , Gong Jun , Freedland Stephen J. , Gresham Gillian , Shirazipour Celina H. 
Published: June 2024

e17068 Background: Prostate cancer (PC) survivors undergoing androgen deprivation therapy (ADT) commonly experience debilitating symptoms from this treatment and cancer, including muscle loss and sleep disturbances. Wearable activity monitors may support 24-hour tracking of physical activity (PA) and sleep patterns, inform treatment interventions, and support patient health and well-being. This study explores PC survivors’ perspectives on the use of wearable activity monitors and their capabilities to support health behavior change. Methods: Virtual semi-structured qualitative interviews were conducted with PC survivors undergoing ADT recruited from two medical centers (one large academic and one Veterans Affairs (VA) medical center). Participation was open to those enrolled in the DigiPRO trial that seeks to develop a model that combines wearable activity monitors and patient-reported outcomes to predict physical function decline (NCT04575402). Participants wore an activity monitor (Fitbit) for the duration of the main 12-week study. Interview data were analyzed using inductive thematic analysis. Results: 30 men participated in the interviews (Mage: 68 years (SD: 8.8), 60% White/40% Black, 62% veteran status). Three themes were identified representing diverse perspectives on Fitbits to support health behavior change. All participants (100%) were adherent to wearing the device for the 12-week period. The first theme, representing the majority of participants, reflected positive perceptions of Fitbit usage with the PA and sleep data empowering participants to improve their health behaviors. Ease of access to PA and sleep data increased self-awareness that motivated behavior modifications, exemplified by participants increasing their step count or prioritizing sleep. A second theme represented neutral perceptions regarding Fitbit usage and its potential value in supporting PA and health outcomes. Many of these participants were active prior to the study and had already adopted similar technology. They were content with their health behavior and found Fitbit’s features complementary to their past routines. The final theme represented significant functional barriers to Fitbit usage, such as charging or syncing, and were disinterested in further usage of wearable activity monitors. Conclusions: Findings demonstrate that perspectives vary among PC survivors on the value of wearable activity monitors more broadly. This study highlights the need for tailored approaches accounting for participant motivation, needs, PA and sleep history, and facility with new technology. This approach may assist clinicians and researchers in leveraging the unique capabilities of wearable activity monitors to enhance the health and well-being of PC survivors in clinical research interventions and clinical practice. Clinical trial information: NCT04575402 .