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Journal of Cancer Survivorship

13-03-2024 | Chronic Lymphocytic Leukemia

Optimization of mHealth behavioral interventions for patients with chronic lymphocytic leukemia: the HEALTH4CLL study

Authors: Che Young Lee, Max J. Gordon, Melissa M. Markofski, Emily C. LaVoy, Susan K. Peterson, Liang Li, Sara Fares, Miranda Baum, Margaret Pace, Danielle Walsh, Alessandra Ferrajoli, Karen Basen-Engquist

Published in: Journal of Cancer Survivorship

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Abstract

Purpose

This pilot study of a diet and physical activity intervention (HEALTH4CLL) was conducted to reduce fatigue and improve physical function (PF) in patients with chronic lymphocytic leukemia (CLL).

Methods

The HEALTH4CLL study used a randomized factorial design based on the multiphase optimization strategy (MOST). Patients received diet, exercise, and body weight management instructional materials plus a Fitbit and were randomized to undergo one of 16 combinations of 4 evidence-based mHealth intervention strategies over 16 weeks. Patients’ fatigue, PF, health-related quality of life, behavior changes, and program satisfaction and retention were assessed. Paired t-tests were used to examine changes in outcomes from baseline to follow-up among patients. Factorial analysis of variance examined effective intervention components and their combinations regarding improvement in fatigue and PF scores.

Results

Among 31 patients, we observed significant improvements in fatigue (+ 11.8; t = 4.08, p = 0.001) and PF (+ 2.6; t = 2.75, p = 0.01) scores. The combination of resistance and aerobic exercise with daily self-monitoring was associated with improved fatigue scores (β = 3.857, SE = 1.617, p = 0.027). Analysis of the individual components of the MOST design demonstrated greater improvement in the PF score with resistance plus aerobic exercise than with aerobic exercise alone (β = 2.257, SE = 1.071, p = 0.048).

Conclusions

Combined aerobic and resistance exercise and daily self-monitoring improved PF and reduced fatigue in patients with CLL.

Implications for Cancer Survivors

This pilot study supported the feasibility of a low-touch mHealth intervention for survivors of CLL and provided preliminary evidence that exercising, particularly resistance exercise, can improve their symptoms and quality of life.
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Metadata
Title
Optimization of mHealth behavioral interventions for patients with chronic lymphocytic leukemia: the HEALTH4CLL study
Authors
Che Young Lee
Max J. Gordon
Melissa M. Markofski
Emily C. LaVoy
Susan K. Peterson
Liang Li
Sara Fares
Miranda Baum
Margaret Pace
Danielle Walsh
Alessandra Ferrajoli
Karen Basen-Engquist
Publication date
13-03-2024
Publisher
Springer US
Published in
Journal of Cancer Survivorship
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-024-01555-w
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