title: Pilot and Feasibility Test of a Mobile Health-Supported Behavioral Counseling Intervention for Weight Management Among Breast Cancer Survivors.
abstract: Health behavior and weight management interventions for cancer survivors have the potential to prevent future cancer recurrence and improve long-term health; however, their translation can be limited if the intervention is complex and involves high participant burden. Mobile health (mHealth) offers a delivery modality to integrate interventions into daily life routines.
  
  
  
  The objective of this study was to evaluate the effects of a one-group trial with a pre-post evaluation design on engagement (use and acceptability), physiological (weight), behavioral (diet and physical activity), and other secondary outcomes.
  
  
  
  The 10-week intervention consisted of mHealth components (self-monitoring of selected diet behaviors via daily text messages, wireless devices to automatically track weight and steps) and 4 motivational interviewing-based technology-assisted phone sessions with a nonprofessionally trained counselor. Participants were overweight breast cancer survivors who had completed treatment and owned a smartphone. Weight was measured objectively; diet and physical activity were measured with brief self-reported questionnaires.
  
  
  
  Ten women participated; they had a mean age of 59 years (SD 6), 50% belonged to a racial or ethnic minority group, 50% had some college or less, and 40% reported using Medicaid health insurance. Engagement was high: out of 70 days in total, the mean number of days recording steps via the wristband pedometer was 64 (SD 7), recording a weight via the scale was 45 (SD 24), and responding to text messages was 60 (SD 13); 100% of participants completed all 4 calls with the counselor. Most (90%) were very likely to participate again and recommend the program to others. Mean weight in pounds decreased (182.5 to 179.1, mean change -3.38 [SD 7.67]), fruit and vegetable daily servings increased (2.89 to 4.42, mean change 1.53 [SD 2.82]), and self-reported moderate physical activity increased in metabolic equivalent of task (MET) minutes per week (2791 to 3336, mean change 545 [SD 1694]).
  
  
  
  Findings support the conduct of a fully powered trial to evaluate the efficacy of mHealth as a feasible intervention modality for breast cancer survivors. Future research should employ accelerometer-based physical activity assessment and consider development of an all-in-one app to integrate devices, messaging, and educational content and other mHealth approaches to support behavioral counselors conducting weight management interventions.
  
  
  
  ClinicalTrials.gov NCT02387671; https://clinicaltrials.gov/ct2/show/NCT02387671 (Archived by WebCite at http://www.webcitation.org/6hGEuttbZ).
authors.affiliation: Boston University, Department of Medicine, Section of General Internal Medicine, Boston, MA, United States.
authors.forename: Lisa M
authors.identifier: 0000-0002-3328-6768
authors.initials: LM
authors.lastname: Quintiliani
authors.affiliation: Boston University, Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston, MA, United States.
authors.forename: Devin M
authors.identifier: 0000-0002-2099-0852
authors.initials: DM
authors.lastname: Mann
authors.affiliation: Boston University, Department of Medicine, Section of General Internal Medicine, Boston, MA, United States.
authors.forename: Marissa
authors.initials: M
authors.lastname: Puputti
authors.affiliation: Boston University, School of Public Health, Data Coordinating Center, Boston, MA, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Quinn
authors.affiliation: University of Washington, School of Medicine, Department of Bioethics & Humanities, Seattle, WA, United States.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
keywords: body weight; breast neoplasms; health behavior; survivors; telemedicine