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Open Access 01-04-2021 | Review

Acceptability of online exercise-based interventions after breast cancer surgery: systematic review and narrative synthesis

Authors: Mariya B. Sotirova, Eilís M. McCaughan, Lucia Ramsey, Carrie Flannagan, Daniel P. Kerr, Sean R. O’Connor, Nicole E. Blackburn, Iseult M. Wilson

Published in: Journal of Cancer Survivorship | Issue 2/2021

Abstract

Purpose

eHealth and mHealth approaches are increasingly used to support cancer survivors. This review aimed to examine adherence, acceptability and satisfaction with Internet-based self-management programmes for post-surgical cancer rehabilitation and to identify common components of such interventions.

Methods

Nine electronic databases were searched from inception up to February 15, 2020, for relevant quantitative and qualitative studies evaluating Internet-based cancer rehabilitation interventions. Studies were required to include an exercise or physical activity–based self-management intervention and a measure of adherence, acceptability or user satisfaction with the programme. Two independent reviewers performed all data extraction and quality assessment procedures. Data were synthesized using a narrative approach.

Results

Six hundred ninety-six potential papers were identified and screened. Eleven met the inclusion criteria. Interventions had wide variations in levels of adherence, but the majority were reported as being acceptable to the users. Increased acceptability and user satisfaction were associated with interventions which were seen as time and cost-efficient, requiring acquisition of minimal or no new skills, which used coherent language, or which provided tailored information. The majority contained behaviour change components such as goal setting.

Conclusions

Despite high levels of heterogeneity between studies, Internet-based approaches may be an acceptable method for the delivery of self-management interventions in post-surgical cancer rehabilitation.

Implications for Cancer Survivors

There is a need for further studies exploring factors associated with increased user engagement and usage of digital interventions in cancer rehabilitation settings. These findings should be used to help develop interventions prior to testing their effectiveness in adequately powered randomized controlled trials.

Cancer Research UK. Cancer survival statistics. Cancer Research UK. 2014. https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival#heading-Zero Accessed 15 January 2020.

National Cancer Registration & Analysis Service and Cancer Research UK: “Chemotherapy, radiotherapy and tumour resections in England: 2013-2014” workbook. London: NCRAS. 2017. http://www.ncin.org.uk/cancer_type_and_topic_specific_work/topic_specific_work/main_cancer_treatments. Accessed 25 September 2019.

Silver J, Baima J, Newman R, Galantino M, Shockney L. Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society. Work. 2013;46(4):455–72. https://doi.org/10.3233/WOR-131755.CrossRefPubMed

Bouknight R, Bradley C, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24(3):345–53. https://doi.org/10.1200/JCO.2004.00.4929.CrossRefPubMed

Short P, Vasey J, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. J Cancer. 2005;103(6):1292–301. https://doi.org/10.1002/cncr.20912.CrossRef

Hewitt M, Greenfield S, Stoval M, editors. From cancer patient to cancer survivor. Washington, D.C.: National Academies Press; 2006.

Macmillan Cancer Support. Cancer rehabilitation pathways. In Cancer rehabilitation pathways. Macmillan Cancer Support. 2018. https://www.macmillan.org.uk/assets/macmillan-cancer-rehabilitation-pathways.pdf. Accessed 22 November 2019.

Cascella M, Thompson NS, Muzio MR, Forte CA, Cuomo A. The underestimated role of psychological and rehabilitation approaches for management of cancer pain. A brief commentary. Recenti Prog. Med. 2016;107(8):418–21 http://www.recentiprogressi.it/allegati/02332_2016_08/fulltext/05_Rassegna%20-%20Cascella.pdf. Accessed 2 December 2019.PubMed

Saggini R, Bellomo RG, Carmignano SM, Saggini A. Cancer pain—the role of an integrated, comprehensive rehabilitation program in its management. Updates on Cancer Treatment. 2015;61:116 https://www.intechopen.com/books/updates-on-cancertreatment/cancer-pain-the-role-of-an-integrated-comprehensiverehabilitation-program-in-its-management. Accessed 25 September 2019. https://doi.org/10.5772/60548.CrossRef

10.

Chasen M, et al. Curr Oncol. 2008;15(3):117 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442766/ Accessed 3 February 2020.CrossRefPubMedPubMedCentral

11.

Department of Health, Macmillan Cancer Support, NHS Improvement. National cancer survivorship initiative vision. Department of Health. 2010. www.ncsi.org.uk/wp-content/uploads/NCSI-Vision-Document.pdf. Accessed 15 January 2020.

12.

Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Petrella T, et al. Exercise for people with cancer: a clinical practice guideline. Curr Oncol. 2017;24(1):40–6. https://doi.org/10.3747/co.24.3376.CrossRefPubMedPubMedCentral

13.

Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):242–74. https://doi.org/10.3322/caac.21142.CrossRef

14.

Schmitz K, Courneya K, Matthews C, Demark-Wahnefried W, GALVÃO D, Pinto B, et al. American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26. https://doi.org/10.1249/MSS.0b013e3181e0c112.CrossRefPubMed

15.

Thorsen L, Gjerset G, Loge J, Kiserud C, Skovlund E, Fløtten T, et al. Cancer patients’ needs for rehabilitation services. Acta Oncol. 2011;50(2):212–22. https://doi.org/10.3109/0284186X.2010.531050.CrossRefPubMed

16.

Goode A, Lawler S, Brakenridge C, Reeves M, Eakin E. Telephone, print, and web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review. J Cancer Surviv. 2015;9(4):660–82. https://doi.org/10.1007/s11764-015-0442-2.CrossRefPubMed

17.

Rogers M, Lemmen K, Kramer R, Mann J, Chopra V. Internet-delivered health interventions that work: systematic review of meta-analyses and evaluation of website availability. J Med Internet Res. 2017;19(3):e90. https://doi.org/10.2196/jmir.7111.CrossRefPubMedPubMedCentral

18.

Yardley L, Spring B, Riper H, Morrison L, Crane D, Curtis K, et al. Understanding and promoting effective engagement with digital behavior change interventions. Am J Prev Med. 2016;51(5):833–42. https://doi.org/10.1016/j.amepre.2016.06.015.CrossRefPubMed

19.

Morrison L, Moss-Morris R, Michie S, Yardley L. Optimizing engagement with Internet-based health behaviour change interventions: comparison of self-assessment with and without tailored feedback using a mixed methods approach. Br J Health Psychol. 2014;19(4):839–55. https://doi.org/10.1111/bjhp.12083.CrossRefPubMed

20.

Krebs P, Prochaska J, Rossi J. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med. 2010;51(3–4):214–21. https://doi.org/10.1016/j.ypmed.2010.06.004.CrossRefPubMedPubMedCentral

21.

Hennemann S, Beutel M, Zwerenz R. Drivers and barriers to acceptance of web-based aftercare of patients in inpatient routine care: a cross-sectional survey. J Med Internet Res. 2016;18(12):e337. https://doi.org/10.2196/jmir.6003.CrossRefPubMedPubMedCentral

22.

van der Vaart R, Atema V, Evers A. Guided online self-management interventions in primary care: a survey on use, facilitators, and barriers. BMC Fam Pract. 2016;17(1). https://doi.org/10.1186/s12875-016-0424-0.

23.

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions version 6.0 (2019). Cochrane Database Syst Rev 2019; www.training.cochrane.org/handbook. Accessed 25 January 2020.

24.

Moher D. 14. Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9. https://doi.org/10.7326/0003-4819-151-4-200908180-00135.CrossRefPubMed

25.

Bennett GG, Glasgow RE. The delivery of public health interventions via the Internet: actualizing their potential. Annu Rev Public Health. 2009;30:273–92. https://doi.org/10.1146/annurev.publhealth.031308.100235.CrossRefPubMed

26.

Kelders S, Kok R, Ossebaard H, Van Gemert-Pijnen J. Persuasive system design does matter: a systematic review of adherence to web-based interventions. J Med Internet Res. 2012;14(6):e152. https://doi.org/10.2196/jmir.2104.CrossRefPubMedPubMedCentral

27.

Sekhon M, Cartwright M, Francis J. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17(1):88. https://doi.org/10.1186/s12913-017-2031-8.CrossRefPubMedPubMedCentral

28.

Boß L, Lehr D, Reis D, Vis C, Riper H, Berking M, et al. Reliability and validity of assessing user satisfaction with web-based health interventions. J Med Internet Res. 2016;18(8):e234. https://doi.org/10.2196/jmir.5952.CrossRefPubMedPubMedCentral

29.

Jonkman N, Schuurmans M, Jaarsma T, Shortridge-Baggett L, Hoes A, Trappenburg J. Self-management interventions: proposal and validation of a new operational definition. J Clin Epidemiol. 2016;80:34–42. https://doi.org/10.1016/j.jclinepi.2016.08.001.CrossRefPubMed

30.

Kmet L M, Lee R C, Cook L S. Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton: Alberta Heritage Foundation for Medical Research (AHFMR). AHFMR - HTA Initiative #13. 2004. https://doi.org/10.7939/R37M04F16.

31.

Lee L, Packer T, Tang S, Girdler S. Self-management education programs for age-related macular degeneration: a systematic review. Australas J Ageing. 2008;27(4):170–6. https://doi.org/10.1111/j.1741-6612.2008.00298.x.CrossRefPubMed

32.

Maharaj S, Harding R. The needs, models of care, interventions and outcomes of palliative care in the Caribbean: a systematic review of the evidence. BMC Palliat Care. 2016;15(1):9. https://doi.org/10.1186/s12904-016-0079-6.CrossRefPubMedPubMedCentral

33.

Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37–46. https://doi.org/10.1177/001316446002000104.CrossRef

34.

Cohen J. Weighted kappa: nominal scale agreement provision for scaled disagreement or partial credit. Psychol Bull. 1968;70(4):213–20. https://doi.org/10.1037/h0026256.CrossRefPubMed

35.

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme version, vol. 1. Bailrigg: Lancaster University; 2006. p. 1–92. https://doi.org/10.13140/2.1.1018.4643.CrossRef

36.

Kanera I, Willems R, Bolman C, Mesters I, Verboon P, Lechner L. Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial. Int J Behav Nutr Phys Act. 2017;14(1):19. https://doi.org/10.1186/s12966-017-0474-2.CrossRefPubMedPubMedCentral

37.

Willems R, Bolman C, Mesters I, Kanera I, Beaulen A, Lechner L. Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psychooncology. 2017;26(2):222–30. https://doi.org/10.1002/pon.4113.CrossRefPubMed

38.

Foster C, Grimmett C, May C, Ewings S, Myall M, Hulme C, et al. A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial. Support Care Cancer. 2016;24(6):2445–53. https://doi.org/10.1007/s00520-015-3044-7.CrossRefPubMed

39.

Kanera I, Bolman C, Willems R, Mesters I, Lechner L. Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer aftercare guide) intervention for cancer survivors: a randomized controlled trial. J Cancer Surviv. 2016;10(5):883–97. https://doi.org/10.1007/s11764-016-0535-6.CrossRefPubMedPubMedCentral

40.

Lee M, Yun Y, Park H, Lee E, Jung K, Noh D. A web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial. Int J Nurs Stud. 2014;51(12):1557–67. https://doi.org/10.1016/j.ijnurstu.2014.04.012.CrossRefPubMed

41.

Melissant H, Verdonck-de Leeuw I, Lissenberg-Witte B, Konings I, Cuijpers P, Van Uden-Kraan C. ‘Oncokompas’, a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors. Acta Oncol. 2018;57(7):924–34. https://doi.org/10.1080/0284186X.2018.1438654.CrossRefPubMed

42.

Paxton R, Hajek R, Newcomb P, Dobhal M, Borra S, Taylor W, et al. A lifestyle intervention via email in minority breast cancer survivors: randomized parallel-group feasibility study. JMIR Cancer. 2017;3(2):e13. https://doi.org/10.2196/cancer.7495.CrossRefPubMedPubMedCentral

43.

Cnossen I, van Uden-Kraan C, Eerenstein S, Jansen F, Witte B, Lacko M, et al. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction. Support Care Cancer. 2016;24(3):1261–8. https://doi.org/10.1007/s00520-015-2896-1.CrossRefPubMed

44.

Harder H, Holroyd P, Burkinshaw L, Watten P, Zammit C, Harris P, et al. A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment. J Cancer Surviv. 2017;11(6):732–42. https://doi.org/10.1007/s11764-017-0630-3.CrossRefPubMedPubMedCentral

45.

Myall M, May C, Grimmett C, May C, Calman L, Richardson A, et al. RESTORE: an exploratory trial of a web-based intervention to enhance self-management of cancer-related fatigue: findings from a qualitative process evaluation. BMC Med Inform Decis Mak. 2015;15(1):94. https://doi.org/10.1186/s12911-015-0214-y.CrossRefPubMedPubMedCentral

46.

Lee M, Park H, Yun Y, Chang Y. Development and formative evaluation of a web-based self-management exercise and diet intervention program with tailored motivation and action planning for cancer survivors. JMIR Res Protoc. 2013;2(1):e11. https://doi.org/10.2196/resprot.2331.CrossRefPubMedPubMedCentral

47.

Fridriksdottir N, Gunnarsdottir S, Zoëga S, Ingadottir B, Hafsteinsdottir E. Effects of web-based interventions on cancer patients’ symptoms: review of randomized trials. Support Care Cancer. 2018;26(2):337–51. https://doi.org/10.1007/s00520-017-3882-6.CrossRefPubMed

48.

Montori VM, Guyatt GH. Intention-to-treat principle. Can Med Assoc J. 2001;165(10):1339–41 https://www.cmaj.ca/content/165/10/1339.long. Accessed 3 March 2020.

49.

Page S, Persch A. Recruitment, retention, and blinding in clinical trials. Am J Occup Ther. 2013;67(2):154–61. https://doi.org/10.5014/ajot.2013.006197.CrossRefPubMedPubMedCentral

50.

Short C, Rebar A, James E, Duncan M, Courneya K, Plotnikoff R, et al. How do different delivery schedules of tailored web-based physical activity advice for breast cancer survivors influence intervention use and efficacy? J Cancer Surviv. 2017;11(1):80–91. https://doi.org/10.1007/s11764-016-0565-0.CrossRefPubMed

51.

Ryhänen A, Siekkinen M, Rankinen S, Korvenranta H, Leino-Kilpi H. The effects of Internet or interactive computer-based patient education in the field of breast cancer: a systematic literature review. Patient Educ Couns. 2010;79(1):5–13. https://doi.org/10.1016/j.pec.2009.08.005.CrossRefPubMed

52.

Nilsen ES, Myrhaug HT, Johansen M, Oliver S, Oxman AD. Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. Cochrane Database Syst Rev. 2006;3:CD004563. https://doi.org/10.1002/14651858.CD004563.pub2.CrossRef

53.

Yardley L, Morrison L, Bradbury K, Muller I. The person-based approach to intervention development: application to digital health-related behavior change interventions. J Med Internet Res. 2015;17(1):e30. https://doi.org/10.2196/jmir.4055.CrossRefPubMedPubMedCentral

54.

Duncan E, O'Cathain A, Rousseau N, Croot L, Sworn K, Turner K, et al. Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study. BMJ Open. 2020;10(4):e033516. https://doi.org/10.1136/bmjopen-2019-033516.CrossRefPubMedPubMedCentral

Title: Acceptability of online exercise-based interventions after breast cancer surgery: systematic review and narrative synthesis
Authors: Mariya B. Sotirova
Eilís M. McCaughan
Lucia Ramsey
Carrie Flannagan
Daniel P. Kerr
Sean R. O’Connor
Nicole E. Blackburn
Iseult M. Wilson
Publication date: 01-04-2021
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 2/2021
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-020-00931-6

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