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Examining sociodemographic and health-related characteristics as moderators of an mHealth intervention on physical activity outcomes in young adult cancer survivors

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Purpose This study explored whether sociodemographic and health-related characteristics moderated mHealth PA intervention effects on total and moderate-to-vigorous physical activity (MVPA) at 6 months, relative to a self-help condition among young adult cancer survivors (YACS). Methods We conducted exploratory secondary analyses of data from a randomized controlled trial among 280 YACS. All participants received digital tools; intervention participants also received lessons, adaptive goals, tailored feedback, text messages, and Facebook prompts. Potential moderators were assessed in baseline questionnaires. PA was measured at baseline and 6 months with accelerometers. Linear model repeated measures analyses examined within- and between-group PA changes stratified by levels of potential moderator variables. Results Over 6 months, the intervention produced MVPA increases that were ≥ 30 min/week compared with the self-help among participants who were males (28.1 vs. -7.7, p = .0243), identified with racial/ethnic minority groups (35.2 vs. -8.0, p = .0006), had baseline BMI of 25–30 (25.4 vs. -7.2, p = .0034), or stage III/IV cancer diagnosis (26.0 vs. -6.8, p = .0041). Intervention participants who were ages 26–35, college graduates, married/living with a partner, had a solid tumor, or no baseline comorbidities had modest MVPA increases over 6 months compared to the self-help (ps = .0163-.0492). Baseline characteristics did not moderate intervention effects on total PA. Conclusions The mHealth intervention was more effective than a self-help group at improving MVPA among subgroups of YACS defined by characteristics (sex, race, BMI, cancer stage) that may be useful for tailoring PA interventions. Implications for cancer survivors These potential moderators can guide future optimization of PA interventions for YACS. ClinicalTrials.gov identifier NCT03569605.
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Journal of Cancer Survivorship
https://doi.org/10.1007/s11764-024-01577-4
Introduction
Nearly 84,000 young adults, ages 18–39, are diagnosed with
cancer in the US annually [1, 2], and there is high demand
for physical activity (PA) interventions among young adult
cancer survivors (YACS) [3, 4]. Given the benets of regu-
lar PA for cancer survivors, including improved tness and
health-related quality of life (HRQOL) [5], it is critical to
address these needs among YACS who may face several
decades at risk for long-term and late eects of cancer
[6]. Yet few PA interventions have been designed for and
evaluated among YACS [4, 7]. Most have been short-term
pilot studies among small samples and demonstrated mixed
Carmina G. Valle
carmina.valle@unc.edu
1 Department of Nutrition, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill, Chapel
Hill, NC, USA
2 Lineberger Comprehensive Cancer Center, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
3 Department of Medical Social Sciences, Feinberg School of
Medicine, Northwestern University, Chicago, IL, USA
4 College of Nursing, University of South Carolina, Columbia,
SC, USA
5 Department of Health Behavior and Policy, School of
Population Health, Virginia Commonwealth University,
Richmond, VA, USA
Abstract
Purpose This study explored whether sociodemographic and health-related characteristics moderated mHealth PA interven-
tion eects on total and moderate-to-vigorous physical activity (MVPA) at 6 months, relative to a self-help condition among
young adult cancer survivors (YACS).
Methods We conducted exploratory secondary analyses of data from a randomized controlled trial among 280 YACS. All
participants received digital tools; intervention participants also received lessons, adaptive goals, tailored feedback, text
messages, and Facebook prompts. Potential moderators were assessed in baseline questionnaires. PA was measured at base-
line and 6 months with accelerometers. Linear model repeated measures analyses examined within- and between-group PA
changes stratied by levels of potential moderator variables.
Results Over 6 months, the intervention produced MVPA increases that were 30 min/week compared with the self-help
among participants who were males (28.1 vs. -7.7, p = .0243), identied with racial/ethnic minority groups (35.2 vs. -8.0,
p = .0006), had baseline BMI of 25–30 (25.4 vs. -7.2, p = .0034), or stage III/IV cancer diagnosis (26.0 vs. -6.8, p = .0041).
Intervention participants who were ages 26–35, college graduates, married/living with a partner, had a solid tumor, or no
baseline comorbidities had modest MVPA increases over 6 months compared to the self-help (ps = .0163-.0492). Baseline
characteristics did not moderate intervention eects on total PA.
Conclusions The mHealth intervention was more eective than a self-help group at improving MVPA among subgroups of
YACS dened by characteristics (sex, race, BMI, cancer stage) that may be useful for tailoring PA interventions.
Implications for cancer survivors These potential moderators can guide future optimization of PA interventions for YACS.
ClinicalTrials.gov identier NCT03569605.
Keywords Young adults · Cancer survivors · Physical activity · Digital health · mHealth · Interventions · Moderators
Received: 23 January 2024 / Accepted: 28 March 2024
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024
Examining sociodemographic and health-related characteristics as
moderators of an mHealth intervention on physical activity outcomes
in young adult cancer survivors
Carmina G.Valle1,2· Hillary M.Heiling2· Allison M.Deal2· Molly A.Diamond2· Derek P.Hales1· Brooke T.Nezami1·
Christine M.Rini3· Bernardine M.Pinto4· Jessica GokeeLaRose5· Deborah F.Tate1,2
1 3
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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