Staying in Motion: Using Technology to Support Physical Activity Maintenance in Exercise Oncology
Creators: name: Ester, Manuel
Publisher: name: Graduate Studies
Year: 2023
Subjects: subject: Exercise
subject: Oncology
subject: Physical Activity
subject: Behavior Change
subject: Maintenance
subject: Technology
subject: Exercise Oncology
subject: eHealth
subject: mHealth
subject: mobile apps
subject: Exercise Psychology
subject: Psychology--Behavioral
subject: Oncology

description: Given the broad range of physical and psychosocial health benefits of physical activity (PA) for individuals living with cancer, experts recommend regular PA as well as structured exercise (aerobic, strength, flexibility, and balance) to improve overall well-being among this population. However, most individuals living with and beyond cancer remain insufficiently active, struggling to maintain consistent PA habits post-diagnosis. Exercise oncology behavior change interventions have been shown to increase PA post-intervention, yet challenges remain to ensure that participants stay physically active long-term (i.e. PA maintenance: continued PA up to and beyond 6 months after initial PA behavior change), and thereby continue to reap the benefits of PA. Individuals living with and beyond cancer face significant challenges to PA maintenance, including cost, lack of time, lack of equipment or access to facilities, lack of motivation, and lack of support. Those living in rural and remote locations may experience a greater impact of these PA maintenance barriers, and usually lack access to in-person exercise oncology programs, which are primarily delivered in urban settings. Some of these barriers may be addressed via PA behavior change interventions delivered using electronic health technology (eHealth). Despite increased research, few studies have explored the potential of eHealth to support PA maintenance, especially among rural cancer populations who may need greater PA support given their lower PA levels and greater PA barriers. The present PhD project addressed this knowledge gap, developing novel insights to better understand the potential of eHealth to support PA maintenance among individuals living with and beyond cancer. First, the effectiveness of eHealth to support PA behaviors in exercise oncology was systematically reviewed. Next, a survey of exercise oncology program participants explored technology use, literacy, and perceptions on the value of technology to support PA habits. The review and survey were then followed by a participant-oriented tailoring process to customize an existing self-monitoring app for use in a PA maintenance intervention. Finally, the effectiveness of the self-monitoring app to support PA maintenance was tested in a randomized controlled trial, which was evaluated using quantitative (i.e. self-report and objective PA levels) and qualitative (i.e. semi-structured 1-1 interviews) methods. The project contributed new knowledge to better understand the potential value of eHealth to support PA maintenance among individuals living with cancer, especially those in rural and remote locations, and highlighted important next steps to optimize and comprehensively evaluate its positive impact on PA behavior change.