Metastatic Breast Cancer, Metastatic Breast Cancer (MBC), Metastatic Breastcancer
Conditions
Keywords
exercise, wearables, coaching, EMR, Social Support, Metastatic Breast Cancer, MOST, physical activity
Brief summary
The purpose of this study is to examine which of four components of a digital health intervention using an App and Fitbit meaningfully contribute to increased physical activity in Metastatic Breast Cancer Patients. Participants will be asked to: * Wear a Fitbit and use an app, use 0 to 3 other components for 24 weeks and attend 6 or 12 coaching coaching calls in the first 12 weeks to increase daily steps. * Complete a questionnaire at baseline, week 12 and week 24 * Complete functional performance test (FPT) via Zoom at baseline, week 12 and week 24 * Wear a research activity monitor (Accelerometer) for 7 days at baseline, week 12 and week 24
Detailed description
Multiphase Optimization Strategy (MOST) methodology will be used to determine which intervention components or component combinations optimally increase daily steps in a 12-week intervention with a 12-week follow-up. MOST is a framework adapted from engineering that uses highly efficient factorial experiments to evaluate individual, and combined, effects of intervention components to determine which ones can be reduced, eliminated, or replaced to improve efficiency. Insufficiently active people with metastatic breast cancer (MBC) will receive a core intervention consisting of the FIt2ThriveMB app and Fitbit and be randomly assigned to four components, each with two-levels, under consideration for inclusion in the optimized intervention: 1) EHR-integration (on v. off); 2) coaching dose (weekly v. bi-weekly; 3) social+ (on v. off) and 4) goal-setting type (highly tailored v. static). The effects of increasing PA on symptom burden, other intensity activities (i.e. moderate to vigorous, light and sedentary), and functional performance and potential mediators and moderators of component effects will also be examined. Knowledge gained from this study will inform the development of more effective and scalable interventions to improve health and disease outcomes in this population.
Interventions
BEHAVIORALSocial+ (on v. off)
Participants assigned to this condition will receive the social feed app module and attend 7 synchronous, facilitated group sessions during the 12-week intervention. There will also be a social feed app module is intended to enhance communication and support among participants.
BEHAVIORALStatic Goal Setting
Participants will be provided with a daily step goal for the week. The goal will be progressive and tailored to each individual's progress to build efficacy and ensure safe progression until 10,000 steps/day is achieved (i.e. 4500 steps/day in week 1, 5500 steps/day in week 2, etc.).
BEHAVIORALBi-Weekly Coaching
Participants will receive 6 calls from study staff to provide feedback on PA progress and support to increase PA.
BEHAVIORALHighly Tailored Goal Setting
Participants will be prompted each morning to report the intensity of their symptom burden on a scale from 1 to 5. Based on symptom rating, prior day's step goal attainment and/or the number of steps achieved the previous day, participants will be provided with three to four goal options for that day.
BEHAVIORALCore Intervention
The core intervention includes educational materials, Fitbit and access to the Fit2ThriveMB Core App.
BEHAVIORALEHR Integration (On v. Off)
Participant Fitbit data will synchronize with the EHR. Participants will receive automated weekly messages via the patient portal. Clinicians can view patient Fitbit data and will receive Epic InBasket messages on the day of patient appointments with a summary of patients' PA progress and talking points to encourage patients.
BEHAVIORALWeekly Coaching
Participants will receive 12 calls from study staff to provide feedback on PA progress and support to increase PA.
Sponsors
Northwestern University
National Cancer Institute (NCI)
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female sex assigned at birth, age 18 years or older * Diagnosed with metastatic breast cancer or locally advanced disease not amenable to surgical resection. * Self-report engagement in \<150 min/week of moderate to vigorous physical activity * Ownership of an Android or iPhone with an up-to-date version of the operating system * Internet access to complete assessments * Fluency in spoken and written English * Willingness to obtain medical clearance to participate.
Exclusion criteria
* Untreated brain metastases * Breast cancer with metastases to only the axillary lymph nodes. * Self-reported absolute contraindications to exercise (i.e., non-ambulatory, acute myocardial infarction, severe cognitive or functional impairment) * Currently pregnant or plans to become pregnant * Plans to move out of the United States in next 12 months * Current enrollment in another dietary or physical activity trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Steps | Baseline, 12 and 24 weeks | The ActiGraph accelerometer will be used. Participants will wear the device during all waking hours for 7 consecutive days, except when bathing or swimming, on their non-dominant hip. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ActiGraph measured MVPA | Baseline, 12 and 24 weeks | Moderate to vigorous physical activity will be measured using the ActiGraph. Participants will wear the device during waking hours for 7 consecutive days, except when bathing or swimming, on their non-dominant hip. Freedson cut points will be used to determine this activity as 2,690-9,642 CPM. |
| ActiGraph measured light activity | Baseline, 12 and 24 weeks | Light intensity physical activity will be measured using the ActiGraph. I Participants will wear the device during waking hours for 7 consecutive days, except when bathing or swimming, on their non-dominant hip. Freedson cutpoints for light activity are defined as Light: 0 - 2,689 CPM. |
| ActiGraph measured sedentary behavior | Baseline, 12 and 24 weeks | Sedentary behavior will be measured using the ActiGraph. Participants will wear the device during waking hours for 7 consecutive days, except when bathing or swimming, on their non-dominant hip. Freedson cutpoints for sedentary behavior are defined as \<100 CPM. |
| Godin Leisure Time Exercise Questionnaire | Baseline, 12 and 24 weeks | Participants will be asked to indicate frequency of participation in strenuous (e.g., jogging), moderate (e.g., fast walking), and mild (e.g., easy walking) exercise over the past 7 days and average time spent in each activity. Activity frequencies will be multiplied by 9, 5, and 3 metabolic equivalents, respectively, and summed to create a total leisure time activity score. Weekly minutes of total, light, moderate, and vigorous activity will be calculated by multiplying the frequency and time of each activity. This value will be divided by 7 to obtain daily averages. |
| Short Physical Performance Battery (SPPB) Total Score | Baseline, 12 weeks, 24 weeks | The SPPB score is based on timed measures of gait speed, ability to rise from a chair, and standing balance. Gait speed will be measured using the better of two recorded times over a 4-meter course. Chair stand time will be measured as the time needed to rise five times from a seated position in a chair, with arms folded across the chest. For the balance test, participants will be asked to maintain their feet side-by-side, semi-tandem, and tandem positions for 10 seconds each. Each individual performance measure will be scored according to established cut points and aggregated for a total SPPB score. |
| PROMIS Physical Function | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure physical function with 4 items over the past 7 days. Items are combined using a t-score metric where higher score is better. |
| PROMIS Anxiety | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure Anxiety with 4 items over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
| PROMIS Depression | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure Depression with 4 items over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
| PROMIS Fatigue | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure Fatigue with 4 items over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
| PROMIS Ability to Participate in Social Roles and Activities | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure Ability to Participate in Social Roles and Activities with 4 items over the past 7 days. Items are combined using a t-score metric where the higher score is better. |
| PROMIS Sleep Disturbance | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure sleep disturbance with 4 items over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
| PROMIS Pain Interference | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure pain interference with 4 items over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
| PROMIS Pain Intensity | Baseline, 12 and 24 weeks | PROMIS-29 (Patient-Reported Outcomes Measurement Information System 29-item Profile) will be used to measure pain intensity with 1 item using a scale 1-10 over the past 7 days. Items are combined using a t-score metric where the lower score is better. |
Countries
United States
Contacts
CONTACTSiobhan Phillips, PhD
Outcome results
None listed