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Principal Investigator: Siobhan Marie Phillips
Organization: NORTHWESTERN UNIVERSITY AT CHICAGO
Fiscal Year: 2024
Award: $596,996
Funding agency: National Cancer Institute
PROJECT SUMMARY/ABSTRACT FROM THE PARENT GRANT APPLICATION
Increased moderate to vigorous intensity physical activity (MVPA) is associated with reductions in treatment-
related side effects, cancer recurrence and mortality and increased QOL and survival in breast and
endometrial cancer survivors. However, the majority (~70%) of survivors do not meet cancer-specific MVPA
recommendations (i.e. 150 mins/week). MVPA support is not part of standard care, resulting in few survivors
having access to efficacious MVPA programs. Failure to translate MVPA programs into care is a result of most
interventions being intense, on-site programs that deliver multiple components simultaneously to all
participants. This “one-size-fits-all” approach does not account for individual needs, nor can it realistically be
implemented into survivorship care. mHealth tools (i.e. smartphone applications, Fitbits, text messages), are
inexpensive and have demonstrated efficacy for increasing MVPA in other populations. Thus, they may be a
more scalable, less resource-intensive strategy to increase MVPA in more survivors. The ability to integrate
wearable MVPA monitor data into the electronic health record (EHR) further enhances the potential for a
technology-supported MVPA intervention to be integrated into cancer care. However, responses to these tools
is heterogeneous and may vary as part of a gradually progressing (in terms of weekly goal mins) MVPA
program. While a minimal intervention including the Fitbit integrated into the EHR (Fitbit+EHR) may be
sufficient for some cancer survivors to increase their MVPA, others will need more support. Further, some
survivors may need this additional support early on, while others may succeed early, but fail later when the
MVPA goal increases. Evidence is lacking to determine: a) whether the best augmentation tactic for non-
responders is to offer another mHealth component (i.e. online exercise videos) or a more traditional component
(i.e., telephone coaching) and b) when to classify a survivor as a non-responder. Thus, we propose to utilize a
novel experimental approach, the SMART (Sequential Multiple Assignment Randomized Trial) to determine the
optimal: 1) augmentation component(s) to address non-response and 2) time is to identify non-responders.
Breast and endometrial cancer survivors (n=320) will be randomized to early (4 weeks) or delayed (8 weeks)
non-response evaluation groups. Those who do not respond to the Fitbit + EHR intervention as evidenced by
failure to sufficiently increase their MVPA will be re-randomized to one of two subsequent augmentation
tactics, either: (1) online gym or (2) online gym and coaching calls. Responders will continue with the
Fitbti+EHR for 6 months. The project is significant because it aims to develop an effective and scalable MVPA
intervention for cancer survivors that will move from a one-size-fits-all approached to a dynamic, tailored
approach for MVPA promotion by identifying non-responders at the right time and providing them with the
additional intervention components necessary to increase MVPA and improve health and disease outcomes.
Terms: <Accelerometer><Accountability><Active Follow-up><Address><American Cancer Society><Android App><Android Application><Applications Grants><Breast><Breast Cancer><Cancer Prognosis><Cancer Survivor><Cancer Survivorship><Cancers><Caring><Cell Phone Application><Cell phone App><Cellular Phone App><Cellular Phone Application><Characteristics><Chronic Disease><Chronic Illness><Classification><Clinic><Clinic Visits><Communication><Data><Development><Disease><Disease Outcome><Disorder><Dose><E-Mail><Electronic Health Record><Electronic Mail><Email><Endometrial Cancer><Endometrial Carcinoma><Endometrium Cancer><Endometrium Carcinoma><Ensure><Evaluation><Exercise><Failure><Fatigue><Feedback><Goals><Grant Proposals><Health><Human><Individual><Intervention><Intervention Strategies><Knowledge><Lack of Energy><Malignant Breast Neoplasm><Malignant Neoplasms><Malignant Tumor><Measures><Modern Man><Morbidity><Morbidity - disease rate><Participant><Patients><Performance><Personalized medical approach><Persons><Physical activity><Population><QOL><Quality of life><Randomized><Recommendation><Recurrent Malignant Neoplasm><Recurrent Malignant Tumor><Research Resources><Resource Allocation><Resources><Self Efficacy><Sequential Multiple Assignment Randomized Trial><Site><Smart Phone App><Smart Phone Application><Smartphone App><Survivors><Symptom Burden><Symptoms><Systematics><Technology><Testing><Text Messaging><Time><Translating><Transportation><Treatment Side Effects><Treatment-related side effects><Visit><Woman><accelerometry><active followup><activity monitor><activity tracker><adaptive intervention><barrier to translation><behavior change><burden of disease><burden of illness><cancer care><cancer recurrence><cell phone based app><chronic disorder><coaching calls><cost><design><designing><developmental><disease burden><disease risk><disorder risk><electronic communication><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><exercise intervention><fitbit><follow up><follow-up><followed up><followup><functional status><iOS app><iOS application><iPhone App><iPhone Application><improve symptom><improved><individualized approach><innovate><innovation><innovative><intervention effect><interventional strategy><lack of physical activity><m-Health><mHealth><malignancy><malignant breast tumor><mobile health><mobile phone app><mortality><neoplasm/cancer><novel><obstacle to translation><parent grant><patient health information><patient health record><patient medical record><patient portal><personalized approach><phone coach><physical activity intervention><physical inactivity><precision approach><primary outcome><programs><randomisation><randomization><randomly assigned><responders and non-responders><responders from non-responders><responders or non-responders><responders versus non-responders><responders vs non-responders><responders/nonresponders><response><short message service><smartphone application><smartphone based app><smartphone based application><standard care><standard treatment><success><survivorship><symptom improvement><symptomatic improvement><tailored approach><telephone based coaching><telephone coaching><telephone counseling><texting><tool><translation barrier><translation obstacle><translational barrier><translational obstacle><vigorous intensity><wearable><wearable device><wearable electronics><wearable system><wearable technology><wearable tool><wearables>