TY - JOUR
T1 - Web-based lifestyle interventions for prostate cancer survivors
T2 - Qualitative study
AU - Wang, Elizabeth Y.
AU - Graff, Rebecca E.
AU - Chan, June M.
AU - Langlais, Crystal S.
AU - Broering, Jeanette M.
AU - Ramsdill, Justin W.
AU - Kessler, Elizabeth R.
AU - Winters-Stone, Kerri M.
AU - van Blarigan, Erin L.
AU - Kenfield, Stacey A.
N1 - Funding Information:
We conducted a four-arm study called TrueNTH’s Community of Wellness (NCT03406013) of men with prostate cancer (N=202) who were randomized to receive progressive levels of behavioral support. The details of the design of the pilot study have been previously published [36], and select screenshots from the website are presented in Figure 1. Men in level 1 had access to prostate cancer–specific diet and exercise resources through a static, informational website. Men in level 2 had access to the website and received individualized diet and exercise recommendations based on a self-report survey completed at the start of the study. Men in level 3 had access to the website and received individualized diet and exercise recommendations and also received a Fitbit device and text messages. Men in level 4 had access to the website and received individualized diet and exercise recommendations, received a Fitbit device and text messages, and were offered a 30-min phone call with an exercise trainer and a 30-min phone call with a registered dietitian. Of note, the Community of Wellness is one of many TrueNTH programs funded by the Movember Foundation, and some men participated in multiple TrueNTH programs concurrently. Reporting in this study is consistent with the consolidated criteria for reporting qualitative research [38].
Publisher Copyright:
©Elizabeth Y Wang, Rebecca E Graff, June M Chan, Crystal S Langlais, Jeanette M Broering, Justin W Ramsdill, Elizabeth R Kessler, Kerri M Winters-Stone, Erin L Van Blarigan, Stacey A Kenfield.
PY - 2020/7
Y1 - 2020/7
N2 - Background: Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population. Objective: This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits. Methods: TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods. Results: In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention. Conclusions: These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.
AB - Background: Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population. Objective: This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits. Methods: TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods. Results: In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention. Conclusions: These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.
KW - Cancer survivorship
KW - Digital health
KW - Internet-based intervention
KW - Technology-based intervention
KW - Usability
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U2 - 10.2196/19362
DO - 10.2196/19362
M3 - Article
AN - SCOPUS:85097882425
SN - 2369-1999
VL - 6
JO - JMIR Cancer
JF - JMIR Cancer
IS - 2
M1 - e19362
ER -