JMIR Cancer最新文献_第3页

Designing Positive Psychology Interventions for Social Media: Cross-Sectional Web-Based Experiment With Young Adults With Cancer. 为社交媒体设计积极心理学干预措施：以患癌症的年轻成年人为对象的跨部门网络实验。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-20 DOI: 10.2196/48627

Allison J Lazard, Rhyan N Vereen, Jieni Zhou, Hazel B Nichols, Marlyn Pulido, Catherine Swift, Nabarun Dasgupta, Barbara L Fredrickson

Background: Young adults (ages 18-39 years) with cancer face unique risks for negative psychosocial outcomes. These risks could be lessened with positive psychology interventions adapted for social media if intervention messages encourage intentions to do the activities and positive message reactions and if young adults with cancer perceive few downsides.Objective: This study aimed to assess whether social media messages from evidence-based positive psychology interventions encouraged intentions to do the intervention activities and intended positive message reactions, overall and among sociodemographic or cancer characteristic subgroups. We also aimed to identify perceived downsides of the activity that would negatively impact the interventions' feasibility.Methods: Young adults (ages 18-39 years, cancer diagnosis ages 15-39 years) were randomized to a between-persons web-based experiment. Participants viewed a social media message with social context cues (vs not) for 1 of 2 types of intervention (acts of kindness vs social connectedness). Participants reported intentions to do the activity, along with their perceived social presence in the message (how much they felt the sense of others) and forecasted positivity resonance (whether they would experience socially connected positive emotions when doing the activity), with 5-point items. Participants also reported their self-efficacy (how certain they can do the intervention activity) with a 0-100 item and potential downsides of the activity categorically.Results: More than 4 out of 5 young adults with cancer (N=396) reported they "somewhat" (coded as 3) to "extremely" (5) intended to do the intervention activity (336/396, 84.8%; mean ranged from 3.4-3.6, SD 0.9-1.0), perceived social presence in the messages (350/396, 88.4%; mean 3.8, SD 0.7), and forecasted positivity resonance (349/396, 88.1%; mean 3.8-3.9, SD 0.8). Participants reported having self-efficacy to complete the activity (mean 70.7% of possible 100%, SD 15.4%-17.2%). Most (320/396, 80.8%) did not think of the downsides of the interventions. Messages with social context cues (vs not) and both intervention types were rated similarly (all P>.05). Black young adults reported lower intentions, perceived social presence, and forecasted positivity resonance than White young adults (all P<.001). Participants in active treatment (vs completed) reported greater intentions to do the activities (P<.001).Conclusions: Positive psychology intervention messages adapted for social media were perceived as acceptable and feasible among young adults with cancer. The social media-based messages encouraged increasing one's social connectedness and performing acts of kindness. Young adults with cancer also predicted they would have feelings of positive social engagement (positivity resonance) when doing the interventions-the key ingredient

背景：患有癌症的年轻人（18-39岁）面临着独特的负面心理社会结局风险。如果干预信息鼓励进行活动的意图和积极的信息反应，并且患有癌症的年轻成年人几乎没有感觉到负面影响，那么针对社交媒体的积极心理学干预可以降低这些风险。目的：本研究旨在评估基于证据的积极心理学干预的社交媒体信息是否在总体上以及在社会人口学或癌症特征亚组中鼓励了进行干预活动的意愿和预期的积极信息反应。我们还旨在确定可能对干预措施的可行性产生负面影响的活动的负面影响。方法：年轻人（年龄在18-39岁，癌症诊断年龄在15-39岁）被随机分配到一个基于网络的人际实验中。参与者在两种干预（善意行为与社会联系）中的一种中观看了带有社会背景线索的社交媒体信息（与不带有社会背景线索的对照）。参与者报告了做这项活动的意图，以及他们在信息中感知到的社会存在感（他们感受到他人的感觉有多强烈）和预测的积极共鸣（他们在做这项活动时是否会体验到与社会相关的积极情绪）。参与者还用0-100分的项目分类地报告了他们的自我效能感（他们对干预活动的肯定程度）和活动的潜在缺点。结果：超过4 / 5的年轻癌症患者（N=396）报告他们“有点”（编码为3）到“非常”（编码为5）打算进行干预活动(336/396,84.8%；平均值为3.4-3.6，标准差为0.9-1.0)，信息中感知到的社会存在(350/396,88.4%；平均3.8，标准差0.7)，预测阳性共振(349/396,88.1%；平均值3.8-3.9，标准差0.8)。参与者报告在完成活动时具有自我效能感（平均为70.7%，标准差为15.4%-17.2%）。大多数（320/396,80.8%）没有想到干预措施的负面影响。具有社会背景线索的信息（与不具有）和两种干预类型的评价相似（P均为0.05）。与白人青年相比，黑人青年报告的意向、感知的社会存在和预测的积极共振较低(所有结论：适应社交媒体的积极心理干预信息在患有癌症的青年中被认为是可接受和可行的。基于社交媒体的信息鼓励增加一个人的社会联系和做善事。患有癌症的年轻人还预测，在进行干预时，他们会有积极的社会参与感（积极的共鸣），这是体验这些活动对健康有益的关键因素。这项研究为开发适合年龄的、高度可扩展的干预措施来改善年轻癌症患者的心理社会健康提供了有希望的证据。

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引用次数: 0

Prototype of an App Designed to Support Self-Management for Health Behaviors and Weight in Women Living With Breast Cancer: Qualitative User Experience Study. 旨在支持乳腺癌女性患者自我管理健康行为和体重的应用程序原型：定性用户体验研究。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-20 DOI: 10.2196/48170

Phillippa Lally, Christine N May, E Siobhan Mitchell, Meaghan McCallum, Andreas Michaelides, Abigail Fisher

Background: Accessible self-management interventions are required to support people living with breast cancer.

Objective: This was an industry-academic partnership study that aimed to collect qualitative user experience data of a prototype app with built-in peer and coach support designed to support the management of health behaviors and weight in women living with breast cancer.

Methods: Participants were aged ≥18 years, were diagnosed with breast cancer of any stage within the last 5 years, had completed active treatment, and were prescribed oral hormone therapy. Participants completed demographic surveys and were asked to use the app for 4 weeks. Following this, they took part in in-depth qualitative interviews about their experiences. These were analyzed using thematic analysis.

Results: Eight participants (mean age, 45 years; mean time since diagnosis, 32 months) were included. Of the 8 participants, 7 (88%) were white, 6 (75%) had a graduate degree or above, and 6 (75%) had stage I-III breast cancer. Four overarching themes were identified: (1) Support for providing an app earlier in the care pathway; (2) Desire for more weight-focused content tailored to the breast cancer experience; (3) Tracking of health behaviors that are generally popular; and (4) High value of in-app social support.

Conclusions: This early user experience work showed that women with breast cancer found an app with integrated social and psychological support appealing to receive support for behavior change and weight management or self-management. However, many features were recommended for further development. This work is the first step in an academic-industry collaboration that would ultimately aim to develop and empirically test a supportive app that could be integrated into the cancer care pathway.

背景：需要可获得的自我管理干预措施来支持乳腺癌患者。目的：这是一项行业-学术合作研究，旨在收集具有内置同伴和教练支持的原型应用程序的定性用户体验数据，旨在支持乳腺癌女性患者的健康行为和体重管理。方法：参与者年龄≥18岁，在过去5年内被诊断为乳腺癌的任何阶段，已完成积极治疗，并给予口服激素治疗。参与者完成了人口统计调查，并被要求使用该应用程序4周。在此之后，他们参加了关于他们经历的深度定性访谈。使用主题分析对这些进行了分析。结果：8名参与者(平均年龄45岁；平均诊断时间为32个月)。在8名参与者中，7名（88%）是白人，6名（75%）拥有研究生或以上学位，6名（75%）患有I-III期乳腺癌。确定了四个总体主题：(1)支持在护理途径的早期提供应用程序；(2)希望获得更多针对乳腺癌体验的以体重为重点的内容；(3)跟踪普遍流行的健康行为；(4)应用内社交支持价值高。结论：这项早期的用户体验研究表明，患有乳腺癌的女性发现，一款具有综合社会和心理支持的应用程序很有吸引力，可以获得行为改变、体重管理或自我管理方面的支持。然而，许多特性被推荐用于进一步开发。这项工作是学术与行业合作的第一步，最终目标是开发和实证测试一款可以整合到癌症治疗途径中的支持性应用程序。

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引用次数: 0

Demographics and Health Characteristics Associated With the Likelihood of Participating in Digitally Delivered Exercise Rehabilitation for Improving Heart Health Among Breast Cancer Survivors: Cross-Sectional Survey Study. 人口统计学和健康特征与参与数字交付运动康复改善乳腺癌幸存者心脏健康的可能性相关：横断面调查研究

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-16 DOI: 10.2196/51536

Tamara Jones, Lara Edbrooke, Jonathan C Rawstorn, Linda Denehy, Sandra Hayes, Ralph Maddison, Aaron L Sverdlov, Bogda Koczwara, Nicole Kiss, Camille E Short

Background: Strong evidence supports the benefits of exercise following both cardiovascular disease and cancer diagnoses. However, less than one-third of Australians who are referred to exercise rehabilitation complete a program following a cardiac diagnosis. Technological advances make it increasingly possible to embed real-time supervision, tailored exercise prescription, behavior change, and social support into home-based programs.Objective: This study aimed to explore demographic and health characteristics associated with the likelihood of breast cancer survivors uptaking a digitally delivered cardiac exercise rehabilitation program and to determine whether this differed according to intervention timing (ie, offered generally, before, during, or after treatment). Secondary aims were to explore the knowledge of cardiac-related treatment side-effects, exercise behavior, additional intervention interests (eg, diet, fatigue management), and service fee capabilities.Methods: This cross-sectional study involved a convenience sample of breast cancer survivors recruited via social media. A self-reported questionnaire was used to collect outcomes of interests, including the likelihood of uptaking a digitally delivered cardiac exercise rehabilitation program, and demographic and health characteristics. Descriptive statistics were used to summarize sample characteristics and outcomes. Ordered logistic regression models were used to examine associations between demographic and health characteristics and likelihood of intervention uptake generally, before, during, and after treatment, with odds ratios (ORs) <0.67 or >1.5 defined as clinically meaningful and statistical significance a priori set at P≤.05.Results: A high proportion (194/208, 93%) of the sample (mean age 57, SD 11 years; median BMI=26, IQR 23-31 kg/m2) met recommended physical activity levels at the time of the survey. Living in an outer regional area (compared with living in a major city) was associated with higher odds of uptake in each model (OR 3.86-8.57, 95% CI 1.04-68.47; P=.01-.04). Receiving more cardiotoxic treatments was also associated with higher odds of general uptake (OR 1.42, 95% CI 1.02-1.96; P=.04). There was some evidence that a higher BMI, more comorbid conditions, and lower education (compared with university education) were associated with lower odds of intervention uptake, but findings differed according to intervention timing. Respondents identified the need for better education about the cardiotoxic effects of breast cancer treatment, and the desire for multifaceted rehabilitation interventions that are free or low cost (median Aus $10, IQR 10-15 per session; Aus $1=US $0.69 at time of study).Conclusions: These findings can be used to better inform future research and the development of intervention techniques that are critical to improving the delivery

背景：强有力的证据支持心血管疾病和癌症诊断后锻炼的益处。然而，在接受运动康复治疗的澳大利亚人中，只有不到三分之一的人在心脏病诊断后完成了锻炼康复计划。技术进步使得实时监督、量身定制的运动处方、行为改变和社会支持越来越有可能嵌入到基于家庭的项目中。目的：本研究旨在探讨与乳腺癌幸存者接受数字化心脏运动康复计划可能性相关的人口统计学和健康特征，并确定这是否因干预时间（即一般、治疗前、治疗中或治疗后）而有所不同。次要目的是了解与心脏相关的治疗副作用、运动行为、额外的干预兴趣（如饮食、疲劳管理）和服务收费能力。方法：这项横断面研究包括通过社交媒体招募的乳腺癌幸存者的方便样本。一份自我报告的调查问卷用于收集感兴趣的结果，包括接受数字化心脏运动康复计划的可能性，以及人口统计学和健康特征。描述性统计用于总结样本特征和结果。使用有序逻辑回归模型来检查人口统计学和健康特征之间的关系以及通常在治疗前、治疗期间和治疗后接受干预的可能性，优势比（ORs）为1.5定义为有临床意义，P≤0.05为先验集，具有统计学意义。结果：高比例（194/208,93%）的样本(平均年龄57岁，SD 11岁；BMI中位数=26,IQR 23-31 kg/m2)在调查时达到了推荐的身体活动水平。在每个模型中，居住在外围地区（与居住在主要城市相比）与较高的摄取几率相关(OR 3.86-8.57, 95% CI 1.04-68.47；P = . 01 .04点)。接受更多的心脏毒性治疗也与更高的一般摄取几率相关(OR 1.42, 95% CI 1.02-1.96；P = .04点)。有证据表明，较高的BMI、更多的合并症和较低的教育程度（与大学教育相比）与较低的干预率相关，但根据干预时间的不同，结果有所不同。受访者指出，有必要对乳腺癌治疗的心脏毒性效应进行更好的教育，并希望采取免费或低成本的多方面康复干预措施(每次治疗中位数为10澳元，IQR 10-15；1澳元=学习时0.69美元)。结论：这些发现可用于更好地为未来的研究和干预技术的发展提供信息，这些技术对于改善有效、公平和可获取的数字服务模式的提供至关重要，特别是通过加强数字包容，解决慢性病人群经历的一般运动障碍，结合多学科护理和开发负担得起的提供模式。

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引用次数: 0

Correlation Between Electronic Patient-Reported Outcomes and Biological Markers of Key Parameters in Acute Radiation Cystitis Among Patients With Prostate Cancer (RABBIO): Prospective Observational Study. 前列腺癌患者急性放射性膀胱炎（RABBIO）患者电子报告结果与关键参数生物学标志物的相关性：前瞻性观察研究。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-12 DOI: 10.2196/48225

Carole Helissey, Sophie Cavallero, Nathalie Guitard, Hélène Thery, Charles Parnot, Antoine Schernberg, Imen Aissa, Florent Raffin, Christine Le Coz, Stanislas Mondot, Christos Christopoulos, Karim Malek, Emmanuelle Malaurie, Pierre Blanchard, Cyrus Chargari, Sabine Francois

Background: Despite advances in radiation techniques, radiation cystitis (RC) remains a significant cause of morbidity from pelvic radiotherapy, which may affect patients' quality of life (QoL). The pathophysiology of RC is not well understood, which limits the development of effective treatments.

Objective: The Radiotoxicity Bladder Biomarkers study aims to investigate the correlation between blood and urinary biomarkers and the intensity of acute RC symptoms and QoL in patients undergoing localized prostate cancer radiotherapy.

Methods: This study included patients with low- or intermediate-risk localized prostate cancer who were eligible for localized radiotherapy. Blood and urinary biomarkers were analyzed before radiotherapy was initiated and at weeks 4 and 12 of radiation therapy. Patients completed questionnaires related to RC symptoms and QoL (International Prostate Symptom Score and Functional Assessment of Cancer Therapy-Prostate [FACT-P]) using a digital remote monitoring platform. The information was processed by means of an algorithm, which classified patients according to the severity of symptoms and adverse events reported. Levels of blood and urinary biomarkers were tested with the severity of acute RC symptoms and patient-reported QoL.

Results: A total of 401 adverse events questionnaires were collected over the duration of this study from 20 patients. The most frequently reported adverse events at week 4 were pollakiuria, constipation, and diarrhea. In comparison with baseline, the mean FACT-P score decreased at week 4. A significant increase in the proportion of M2 phenotype cells (CD206+, CD163+, CD204+) at W12 compared to W0 was observed. An increase in serum and urine levels of macrophage colony-stimulating factor (M-CSF), hepatocyte growth factor, and macrophagic inflammatory protein was observed at week 12 compared to baseline levels. Baseline serum and urine M-CSF concentrations showed a significant negative correlation with FACT-P scores at weeks 4 and 12 (r=-0.65, P=.04, and r=-0.76, P=.02, respectively).

Conclusions: The Radiotoxicity Bladder Biomarkers study is the first to explore the overexpression of inflammatory proteins in blood and urine of patients with symptoms of acute RC. These preliminary findings suggest that serum and urine levels of hepatocyte growth factor, M-CSF, and macrophagic inflammatory protein, as well as macrophage polarization, are mobilized after prostate radiotherapy. The elevated M-CSF levels in serum and urine at baseline were associated with the deterioration of QoL during radiotherapy. The results of this study may help to develop mitigation strategies to limit radiation damage to the bladder.

背景：尽管放射技术有所进步，但放射性膀胱炎（RC）仍然是骨盆放射治疗中发病率的重要原因，可能影响患者的生活质量（QoL）。RC的病理生理机制尚不清楚，这限制了有效治疗的发展。目的：放射毒性膀胱生物标志物研究旨在探讨血液和尿液生物标志物与局限性前列腺癌放疗患者急性RC症状强度和生活质量的相关性。方法：本研究纳入符合局部放疗条件的低或中危局限性前列腺癌患者。在放射治疗开始前、放射治疗第4周和第12周分析血液和尿液生物标志物。患者通过数字远程监测平台完成RC症状和QoL （International Prostate Symptom Score and Functional Assessment of Cancer Therapy-Prostate [FACT-P]）相关问卷。这些信息通过一种算法进行处理，该算法根据症状的严重程度和报告的不良事件对患者进行分类。血液和尿液生物标志物水平与急性RC症状的严重程度和患者报告的生活质量进行检测。结果：本研究共收集了20例患者的401份不良事件问卷。在第4周最常见的不良事件是大便、便秘和腹泻。与基线相比，平均FACT-P评分在第4周下降。与W0相比，W12时M2表型细胞（CD206+、CD163+、CD204+）的比例显著增加。与基线水平相比，在第12周观察到血清和尿液中巨噬细胞集落刺激因子（M-CSF）、肝细胞生长因子和巨噬炎性蛋白水平的增加。基线血清和尿液M-CSF浓度与第4周和第12周的FACT-P评分呈显著负相关（r=-0.65， P=）。04, r=-0.76， P=。02年,分别)。结论：放射性毒性膀胱生物标志物研究首次探讨了急性RC症状患者血液和尿液中炎症蛋白的过度表达。这些初步发现提示前列腺放疗后血清和尿液中肝细胞生长因子、M-CSF和巨噬炎性蛋白水平以及巨噬细胞极化被动员。基线时血清和尿液中M-CSF水平升高与放疗期间生活质量的恶化有关。这项研究的结果可能有助于制定缓解策略，以限制辐射对膀胱的损害。

{"title":"Correlation Between Electronic Patient-Reported Outcomes and Biological Markers of Key Parameters in Acute Radiation Cystitis Among Patients With Prostate Cancer (RABBIO): Prospective Observational Study.","authors":"Carole Helissey, Sophie Cavallero, Nathalie Guitard, Hélène Thery, Charles Parnot, Antoine Schernberg, Imen Aissa, Florent Raffin, Christine Le Coz, Stanislas Mondot, Christos Christopoulos, Karim Malek, Emmanuelle Malaurie, Pierre Blanchard, Cyrus Chargari, Sabine Francois","doi":"10.2196/48225","DOIUrl":"10.2196/48225","url":null,"abstract":"Background: Despite advances in radiation techniques, radiation cystitis (RC) remains a significant cause of morbidity from pelvic radiotherapy, which may affect patients' quality of life (QoL). The pathophysiology of RC is not well understood, which limits the development of effective treatments.Objective: The Radiotoxicity Bladder Biomarkers study aims to investigate the correlation between blood and urinary biomarkers and the intensity of acute RC symptoms and QoL in patients undergoing localized prostate cancer radiotherapy.Methods: This study included patients with low- or intermediate-risk localized prostate cancer who were eligible for localized radiotherapy. Blood and urinary biomarkers were analyzed before radiotherapy was initiated and at weeks 4 and 12 of radiation therapy. Patients completed questionnaires related to RC symptoms and QoL (International Prostate Symptom Score and Functional Assessment of Cancer Therapy-Prostate [FACT-P]) using a digital remote monitoring platform. The information was processed by means of an algorithm, which classified patients according to the severity of symptoms and adverse events reported. Levels of blood and urinary biomarkers were tested with the severity of acute RC symptoms and patient-reported QoL.Results: A total of 401 adverse events questionnaires were collected over the duration of this study from 20 patients. The most frequently reported adverse events at week 4 were pollakiuria, constipation, and diarrhea. In comparison with baseline, the mean FACT-P score decreased at week 4. A significant increase in the proportion of M2 phenotype cells (CD206+, CD163+, CD204+) at W12 compared to W0 was observed. An increase in serum and urine levels of macrophage colony-stimulating factor (M-CSF), hepatocyte growth factor, and macrophagic inflammatory protein was observed at week 12 compared to baseline levels. Baseline serum and urine M-CSF concentrations showed a significant negative correlation with FACT-P scores at weeks 4 and 12 (r=-0.65, P=.04, and r=-0.76, P=.02, respectively).Conclusions: The Radiotoxicity Bladder Biomarkers study is the first to explore the overexpression of inflammatory proteins in blood and urine of patients with symptoms of acute RC. These preliminary findings suggest that serum and urine levels of hepatocyte growth factor, M-CSF, and macrophagic inflammatory protein, as well as macrophage polarization, are mobilized after prostate radiotherapy. The elevated M-CSF levels in serum and urine at baseline were associated with the deterioration of QoL during radiotherapy. The results of this study may help to develop mitigation strategies to limit radiation damage to the bladder.","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e48225"},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Engagement With Daily Symptom Reporting, Passive Smartphone Sensing, and Wearable Device Data Collection During Chemotherapy: Longitudinal Observational Study. 化疗期间参与每日症状报告、被动智能手机传感和可穿戴设备数据收集：纵向观察研究。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-10 DOI: 10.2196/57347

Sean McClaine, Jennifer Fedor, Christianna Bartel, Leeann Chen, Krina C Durica, Carissa A Low

Background: Chemotherapy can cause symptoms that impair quality of life and functioning. Remote monitoring of daily symptoms and activity during outpatient treatment may enable earlier detection and management of emerging toxicities but requires patients, including older and acutely ill patients, to engage with technology to report symptoms through smartphones and to charge and wear mobile devices.Objective: This study aimed to identify factors associated with participant engagement with collecting 3 data streams (ie, daily patient-reported symptom surveys, passive smartphone sensing, and a wearable Fitbit device [Google]) during chemotherapy.Methods: We enrolled 162 patients receiving outpatient chemotherapy into a 90-day prospective study. Patients were asked to install apps on their smartphones to rate daily symptoms and to collect passive sensor data and to wear a Fitbit device for the duration of the study. Participants completed baseline demographic and quality of life questionnaires, and clinical information was extracted from the electronic medical record. We fit a series of logistic generalized estimating equations to evaluate the association between demographic and clinical factors and daily engagement with each data stream.Results: Participants completed daily surveys on 61% (SD 27%) of days and collected sufficient smartphone data and wearable sensor data on 73% (SD 35%) and 70% (SD 33%) of enrolled days, respectively, on average. Relative to White participants, non-White patients demonstrated lower odds of engagement with both symptom surveys (odds ratio [OR] 0.49, 95% CI 0.29-0.81; P=.006) and wearable data collection (OR 0.35, 95% CI 0.17-0.73; P=.005). Patients with stage 4 cancer also exhibited lower odds of engagement with symptom reporting than those with earlier stage disease (OR 0.69, 95% CI 0.48-1.00; P=.048), and patients were less likely to complete symptom ratings on the weekend (OR 0.90, 95% CI 0.83-0.97; P=.008). Older patients (OR 1.03, 95% CI 1.01-1.06; P=.01) and those who reported better cognitive functioning at study entry (OR 1.18, 95% CI 1.03-1.34; P=.02) were more likely to engage with Fitbit data collection, and patients who reported higher levels of depressive symptoms were less likely to engage with smartphone data collection (OR 1.18, 95% CI 1.03-1.36; P=.02).Conclusions: Remote patient monitoring during chemotherapy has the potential to improve clinical management, but only if patients engage with these systems. Our results suggest significant associations between demographic and clinical factors and long-term engagement with smartphone and wearable device assessments during chemotherapy. Non-White participants, those with metastatic cancer, or those with existing cognitive impairment may benefit from additional resources to optimize engagement. Contrary to hypotheses, older adults were more l

背景：化疗可引起影响生活质量和功能的症状。对门诊治疗期间的日常症状和活动进行远程监测可能有助于更早地发现和管理新出现的毒性，但要求患者，包括老年人和急性患者，利用技术通过智能手机报告症状，并充电和佩戴移动设备。目的：本研究旨在通过收集化疗期间3个数据流（即每日患者报告的症状调查、被动智能手机传感和可穿戴Fitbit设备[谷歌]）来确定与参与者参与相关的因素。方法：我们招募了162名接受门诊化疗的患者进行为期90天的前瞻性研究。患者被要求在他们的智能手机上安装应用程序来评估日常症状，收集被动传感器数据，并在研究期间佩戴Fitbit设备。参与者完成基线人口统计和生活质量调查问卷，并从电子病历中提取临床信息。我们拟合了一系列逻辑广义估计方程来评估人口统计学和临床因素与每个数据流的日常参与之间的关联。结果：参与者在61% （SD 27%）的天数内完成了日常调查，在73% （SD 35%）和70% （SD 33%）的登记天数内分别收集了足够的智能手机数据和可穿戴传感器数据。与白人受试者相比，非白人患者参与两项症状调查的几率较低(比值比[OR] 0.49, 95% CI 0.29-0.81；P= 0.006)和可穿戴数据收集(OR 0.35, 95% CI 0.17-0.73；P = .005)。与早期癌症患者相比，4期癌症患者参与症状报告的几率也较低(OR 0.69, 95% CI 0.48-1.00；P= 0.048)，患者在周末完成症状评分的可能性较小(OR 0.90, 95% CI 0.83-0.97；P = .008)。老年患者(OR 1.03, 95% CI 1.01-1.06；P= 0.01)和在研究开始时报告认知功能较好的患者(OR 1.18, 95% CI 1.03-1.34；P=.02)更有可能参与Fitbit数据收集，报告抑郁症状水平较高的患者更不可能参与智能手机数据收集(OR 1.18, 95% CI 1.03-1.36；P = .02点)。结论：化疗期间的远程患者监测有可能改善临床管理，但前提是患者参与这些系统。我们的研究结果表明，在化疗期间，人口统计学和临床因素与长期参与智能手机和可穿戴设备评估之间存在显著关联。非白人参与者，那些有转移性癌症的人，或者那些有认知障碍的人可能会从额外的资源中受益，以优化参与。与假设相反，老年人比年轻人更有可能持续参与可穿戴设备评估。

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引用次数: 0

Identifying Factors Associated With Heightened Anxiety During Breast Cancer Diagnosis Through the Analysis of Social Media Data on Reddit: Mixed Methods Study. 通过分析Reddit上的社交媒体数据来识别乳腺癌诊断过程中与高度焦虑相关的因素：混合方法研究

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-05 DOI: 10.2196/52551

Joni Pierce, Mike Conway, Kathryn Grace, Jude Mikal

Background: More than 85% of patients report heightened levels of anxiety following breast cancer diagnosis. Anxiety may become amplified during the early stages of breast cancer diagnosis when ambiguity is high. High levels of anxiety can negatively impact patients by reducing their ability to function physically, make decisions, and adhere to treatment plans, with all these elements combined serving to diminish the quality of life.Objective: This study aimed to use individual social media posts about breast cancer experiences from Reddit (r/breastcancer) to understand the factors associated with breast cancer-related anxiety as individuals move from suspecting to confirming cancer diagnosis.Methods: We used a mixed method approach by combining natural language processing-based computational methods with descriptive analysis. Our team coded the entire corpus of 2170 unique posts from the r/breastcancer subreddit with respect to key variables, including whether the post was related to prediagnosis, diagnosis, or postdiagnosis concerns. We then used Linguistic Inquiry and Word Count (LIWC) to rank-order the codified posts as low, neutral, or high anxiety. High-anxiety posts were then retained for deep descriptive analysis to identify key themes relative to diagnostic progression.Results: After several iterations of data analysis and classification through both descriptive and computational methods, we identified a total of 448 high-anxiety posts across the 3 diagnostic categories. Our analyses revealed that individuals experience higher anxiety before a confirmed cancer diagnosis. Analysis of the high-anxiety posts revealed that the factors associated with anxiety differed depending on an individual's stage in the diagnostic process. Prediagnosis anxiety was associated with physical symptoms, cancer-related risk factors, communication, and interpreting medical information. During the diagnosis period, high anxiety was associated with physical symptoms, cancer-related risk factors, communication, and difficulty navigating the health care system. Following diagnosis, high-anxiety posts generally discussed topics related to treatment options, physical symptoms, emotional distress, family, and financial issues.Conclusions: This study has practical, theoretical, and methodological implications for cancer research. Content analysis reveals several possible drivers of anxiety at each stage (prediagnosis, during diagnosis, and postdiagnosis) and provides key insights into how clinicians can help to alleviate anxiety at all stages of diagnosis. Findings provide insights into cancer-related anxiety as a process beginning before engagement with the health care system: when an individual first notices possible cancer symptoms. Uncertainty around physical symptoms and risk factors suggests the need for increased education and improved access to t

背景：超过85%的患者报告在乳腺癌诊断后焦虑水平升高。在乳腺癌诊断的早期阶段，当模糊性很高时，焦虑可能会被放大。高度焦虑会降低患者的身体机能、决策能力和坚持治疗计划的能力，从而对患者产生负面影响，所有这些因素结合起来会降低生活质量。目的：本研究旨在利用Reddit （r/breastcancer）上关于乳腺癌经历的个人社交媒体帖子，了解个体从怀疑到确诊乳腺癌的过程中与乳腺癌相关焦虑相关的因素。方法：采用基于自然语言处理的计算方法与描述性分析相结合的混合方法。我们的团队根据关键变量对reddit r/breastcancer子版块的2170个帖子的整个语料库进行编码，包括帖子是否与诊断前、诊断后或诊断后的问题有关。然后，我们使用语言调查和字数统计（LIWC）对编纂后的帖子进行排名，分为低焦虑、中性焦虑和高焦虑。然后保留高焦虑职位进行深入的描述性分析，以确定与诊断进展相关的关键主题。结果：通过描述和计算方法对数据进行多次迭代分析和分类后，我们在3个诊断类别中共确定了448个高焦虑帖子。我们的分析显示，在确诊癌症之前，个体会经历更高的焦虑。对高焦虑帖子的分析显示，与焦虑相关的因素因个体在诊断过程中的阶段而异。诊断前焦虑与身体症状、癌症相关危险因素、沟通和解读医疗信息有关。在诊断期间，高度焦虑与身体症状、癌症相关风险因素、沟通和医疗保健系统导航困难有关。诊断后，高焦虑帖子通常讨论与治疗方案、身体症状、情绪困扰、家庭和经济问题相关的话题。结论：本研究对癌症研究具有实践、理论和方法学意义。内容分析揭示了每个阶段（诊断前、诊断期间和诊断后）焦虑的几个可能驱动因素，并为临床医生如何帮助减轻诊断所有阶段的焦虑提供了关键见解。研究结果提供了对癌症相关焦虑的见解，认为它是在与医疗系统接触之前开始的一个过程：当一个人第一次注意到可能的癌症症状时。身体症状和风险因素的不确定性表明，需要加强教育，并有更多机会接触训练有素的医务人员，以便在诊断过程中帮助患者解决问题和关切。在理解技术报告、日程安排和以患者为中心的临床医生行为方面的帮助，可以确定改善患者和提供者之间沟通的机会。

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引用次数: 0

Delivering a Group-Based Quality of Life Intervention to Young Adult Cancer Survivors via a Web Platform: Feasibility Trial. 通过网络平台为年轻成年癌症幸存者提供基于群体的生活质量干预：可行性试验。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-04 DOI: 10.2196/58014

Rina S Fox, Tara K Torres, Terry A Badger, Emmanuel Katsanis, DerShung Yang, Stacy D Sanford, David E Victorson, Betina Yanez, Frank J Penedo, Michael H Antoni, Laura B Oswald

Background: Young adult (YA) cancer survivors frequently report unmet health information and peer support needs, as well as poor health-related quality of life (HRQOL). YAs also have expressed a desire that behavioral interventions be convenient. In response to this, our team has developed a 10-week, group-based, supportive care intervention titled TOGETHER to improve YA cancer survivors' HRQOL. TOGETHER is delivered via videoconference and has shown initial feasibility, acceptability, and promise for improving HRQOL among YA survivors.

Objective: In an effort to increase convenience, the goal of this 2-part study was to design and test a website to host the TOGETHER intervention for YA cancer survivors aged 18-39 years at the time of participation and aged 15-39 years at the time of initial cancer diagnosis.

Methods: In part 1, we leveraged an existing web-based platform and adapted it to meet the needs of TOGETHER. We conducted 3 iterative waves of usability testing with 3 YAs per wave to refine the website. In part 2, we conducted a single-group feasibility trial of TOGETHER using the website. Primary outcomes were feasibility (ie, recruitment, retention, and attendance) and acceptability (ie, satisfaction).

Results: Usability testing participants (n=9) indicated that the TOGETHER website was easy to use (mean 5.9, SD 1.3) and easy to learn (mean 6.5, SD 0.9; possible ranges 1-7). Qualitative feedback identified needed revisions to the aesthetics (eg, images), content (eg, session titles), function (eg, clarity of functionality), and structure (eg, expandable sections), which were implemented. In the feasibility trial, participants (n=7) were an average of 25 (SD 4.7) years old and mostly non-Hispanic White (n=4, 57%). Recruitment (58%) and retention (71%) rates and average session attendance (mean 7.1 , SD 4.2) supported feasibility. Participant agreement with positive statements about TOGETHER and average satisfaction ratings (mean 5.06, SD 1.64; possible range: 1-7) demonstrated acceptability.

Conclusions: Results supported the usability, feasibility, and acceptability of the TOGETHER program and website. By providing the content digitally, the program effectively addresses YAs' expressed preference for convenience. Future studies are needed to increase TOGETHER's efficiency and explore its efficacy for improving targeted outcomes.

背景：年轻成人（YA）癌症幸存者经常报告未满足的健康信息和同伴支持需求，以及较差的健康相关生活质量（HRQOL）。yes也表达了一种愿望，即行为干预要方便。为此，我们的团队开发了一项为期10周、以小组为基础的支持性护理干预，名为“TOGETHER”，以改善YA癌症幸存者的HRQOL。TOGETHER通过视频会议提供，并已显示出改善YA幸存者HRQOL的初步可行性，可接受性和承诺。目的：为了增加便利性，这个两部分研究的目标是设计和测试一个网站，为参与时年龄在18-39岁和最初癌症诊断时年龄在15-39岁的YA癌症幸存者提供TOGETHER干预。方法：在第1部分中，我们利用现有的基于web的平台并对其进行调整以满足TOGETHER的需求。我们进行了3波可用性测试，每波3个ya来完善网站。在第二部分中，我们进行了TOGETHER使用网站的单组可行性试验。主要结果是可行性（即招聘、留任和出勤率）和可接受性（即满意度）。结果：可用性测试参与者（n=9）表示TOGETHER网站易于使用（平均5.9,SD 1.3）和易学习(平均6.5,SD 0.9；可能范围1-7)。定性反馈确定了需要修改的美学（如图像）、内容（如会话标题）、功能（如功能的清晰度）和结构（如可扩展部分）。在可行性试验中，参与者（n=7）平均为25岁（SD 4.7），主要是非西班牙裔白人（n=4, 57%）。招募率（58%）和保留率（71%）以及平均会议出席率（平均值7.1，标准差4.2）支持可行性。参与者对“在一起”的正面评价的认同度和平均满意度(平均5.06，标准差1.64；可能范围：1-7)证明可接受性。结论：结果支持TOGETHER项目和网站的可用性、可行性和可接受性。通过提供数字内容，该计划有效地解决了青少年对便利的偏好。未来的研究需要提高TOGETHER的效率，并探索其改善目标结果的功效。

{"title":"Delivering a Group-Based Quality of Life Intervention to Young Adult Cancer Survivors via a Web Platform: Feasibility Trial.","authors":"Rina S Fox, Tara K Torres, Terry A Badger, Emmanuel Katsanis, DerShung Yang, Stacy D Sanford, David E Victorson, Betina Yanez, Frank J Penedo, Michael H Antoni, Laura B Oswald","doi":"10.2196/58014","DOIUrl":"10.2196/58014","url":null,"abstract":"Background: Young adult (YA) cancer survivors frequently report unmet health information and peer support needs, as well as poor health-related quality of life (HRQOL). YAs also have expressed a desire that behavioral interventions be convenient. In response to this, our team has developed a 10-week, group-based, supportive care intervention titled TOGETHER to improve YA cancer survivors' HRQOL. TOGETHER is delivered via videoconference and has shown initial feasibility, acceptability, and promise for improving HRQOL among YA survivors.Objective: In an effort to increase convenience, the goal of this 2-part study was to design and test a website to host the TOGETHER intervention for YA cancer survivors aged 18-39 years at the time of participation and aged 15-39 years at the time of initial cancer diagnosis.Methods: In part 1, we leveraged an existing web-based platform and adapted it to meet the needs of TOGETHER. We conducted 3 iterative waves of usability testing with 3 YAs per wave to refine the website. In part 2, we conducted a single-group feasibility trial of TOGETHER using the website. Primary outcomes were feasibility (ie, recruitment, retention, and attendance) and acceptability (ie, satisfaction).Results: Usability testing participants (n=9) indicated that the TOGETHER website was easy to use (mean 5.9, SD 1.3) and easy to learn (mean 6.5, SD 0.9; possible ranges 1-7). Qualitative feedback identified needed revisions to the aesthetics (eg, images), content (eg, session titles), function (eg, clarity of functionality), and structure (eg, expandable sections), which were implemented. In the feasibility trial, participants (n=7) were an average of 25 (SD 4.7) years old and mostly non-Hispanic White (n=4, 57%). Recruitment (58%) and retention (71%) rates and average session attendance (mean 7.1 , SD 4.2) supported feasibility. Participant agreement with positive statements about TOGETHER and average satisfaction ratings (mean 5.06, SD 1.64; possible range: 1-7) demonstrated acceptability.Conclusions: Results supported the usability, feasibility, and acceptability of the TOGETHER program and website. By providing the content digitally, the program effectively addresses YAs' expressed preference for convenience. Future studies are needed to increase TOGETHER's efficiency and explore its efficacy for improving targeted outcomes.","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e58014"},"PeriodicalIF":3.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining Racial Disparities in Colorectal Cancer Screening and the Role of Online Medical Record Use: Findings From a Cross-Sectional Study of a National Survey. 检查结直肠癌筛查中的种族差异和在线医疗记录使用的作用：来自全国调查的横断面研究的结果

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-04 DOI: 10.2196/53229

Aldenise P Ewing, Fode Tounkara, Daniel Marshall, Abhishek V Henry, Mahmoud Abdel-Rasoul, Skylar McElwain, Justice Clark, Jennifer L Hefner, Portia J Zaire, Timiya S Nolan, Willi L Tarver, Chyke A Doubeni

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Early detection via routine CRC screening can significantly lower risks for CRC-specific morbidity and mortality. Public health initiatives between 2000 and 2015 nearly doubled CRC screening rates for some US adults. However, screening rates remain lowest for adults aged 45-49 years (20%), patients of safety net health care facilities (42%), adults without insurance (44%), and other subgroups compared with national averages (72%). Given the evolving landscape of digital health care and trends in web-based health information-seeking behaviors, leveraging online medical record (OMR) systems may be an underutilized resource to promote CRC screening utilization. Recognizing trends in OMR usage and patient demographics may enhance digital inclusion-a key social determinant of health-and support equitable web-based interventions aimed at boosting CRC screening across diverse populations.Objective: This study examined the association of accessing an OMR with CRC screening utilization and corresponding sociodemographic characteristics of US adults.Methods: In 2023, we conducted a secondary data analysis using a pooled, weighted sample from Health Information National Trends Survey (HINTS) 5 cycles, 2, 3, and 4 (2018-2020), a nationally representative survey assessing how US adults access and use health-related information. We analyzed the association between sociodemographic characteristics, medical conditions, OMR access, and CRC screening behaviors via logistic regression.Results: The sample included adults aged 45-75 years (N=5143). The mean age was 59 (SD 8) years for those who reported CRC screening and 52 (SD 6) years for those never screened. Nearly 70% (4029/5143) of participants reported CRC screening and 52% (2707/5143) reported OMR access in the past year. Adjusted odds of CRC screening were higher among non-Hispanic African American or Black adults than among non-Hispanic White adults (odds ratio [OR] 1.76, 95% CI 1.22-2.53), adults who accessed an OMR (OR 1.89, 95% CI 1.45-2.46), older individuals (OR 1.18, 95% CI 1.16-1.21), the insured (OR 3.69, 95% CI 2.34-5.82), and those with a professional or graduate degree versus those with a high school diploma or less (OR 2.65, 95% CI 1.28-5.47). Individuals aged 65-75 years were significantly more likely (P<.001) to be screened (1687/1831, 91%) than those aged 45-49 years (190/610, 29%).Conclusions: Promoting OMR access, especially among the most disadvantaged Americans, may assist in reaching national screening goals. Emphasis should be placed on the mutability of OMR use compared with most other statistically significant associations with CRC screening behaviors. OMR access provides an intervenable means of promoting CRC education and screening, especially among those faci

背景：结直肠癌（CRC）是美国癌症相关死亡的第二大原因。通过常规CRC筛查早期发现可显著降低CRC特异性发病率和死亡率的风险。2000年至2015年间的公共卫生倡议使一些美国成年人的CRC筛查率几乎翻了一番。然而，与全国平均水平（72%）相比，45-49岁的成年人（20%）、安全网卫生保健设施的患者（42%）、没有保险的成年人（44%）和其他亚组的筛查率仍然最低。鉴于数字医疗保健的不断发展和基于网络的健康信息寻求行为的趋势，利用在线医疗记录（OMR）系统可能是一种未充分利用的资源，以促进结直肠癌筛查的利用。认识到OMR使用趋势和患者人口统计数据可以增强数字包容（健康的关键社会决定因素），并支持公平的基于网络的干预措施，旨在促进不同人群的结直肠癌筛查。目的：本研究考察了美国成年人获得OMR与CRC筛查利用和相应的社会人口学特征的关系。方法：在2023年，我们使用来自健康信息国家趋势调查（HINTS） 5个周期、2、3和4个周期（2018-2020）的合并加权样本进行了二次数据分析，这是一项具有全国代表性的调查，评估了美国成年人如何获取和使用健康相关信息。我们通过逻辑回归分析了社会人口学特征、医疗条件、OMR获取和CRC筛查行为之间的关系。结果：样本包括45-75岁的成年人（N=5143）。报告CRC筛查者的平均年龄为59岁（SD 8），未筛查者的平均年龄为52岁（SD 6）。在过去一年中，近70%（4029/5143）的参与者报告了CRC筛查，52%（2707/5143）的参与者报告了OMR获取。非西班牙裔非裔美国人或黑人成年人CRC筛查的调整后几率高于非西班牙裔白人成年人（比值比[or] 1.76, 95% CI 1.22-2.53）、获得OMR的成年人（比值比[or] 1.89, 95% CI 1.45-2.46）、老年人（比值比[or] 1.18, 95% CI 1.16-1.21）、被保险人（比值比[or] 3.69, 95% CI 2.34-5.82）、具有专业或研究生学位的人高于具有高中或以下文凭的人（比值比]2.65,95% CI 1.28-5.47）。结论：促进OMR的获取，特别是在最弱势的美国人中，可能有助于实现国家筛查目标。与大多数其他与结直肠癌筛查行为有统计学意义的关联相比，重点应放在使用OMR的易变性上。获得OMR提供了一种可干预的手段，促进结直肠癌的教育和筛查，特别是在那些面临癌症诊断和护理结构性障碍的人群中。未来的研究应侧重于量身定制和可获得的干预措施，以扩大OMR的可及性，特别是针对年轻人群。

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引用次数: 0

Relationship Between Perceived COVID-19 Risk and Change in Perceived Breast Cancer Risk: Prospective Observational Study. 感知COVID-19风险与感知乳腺癌风险变化的关系：前瞻性观察性研究

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-12-02 DOI: 10.2196/47856

Ryan Baxter-King, Arash Naeim, Tina Q Huang, Karen Sepucha, Annette Stanton, Aaron Rudkin, Rita Ryu, Leah Sabacan, Lynn Vavreck, Laura Esserman, Allison Stover Fiscalini, Neil S Wenger

Background: Whether COVID-19 is associated with a change in risk perception about other health conditions is unknown. Because COVID-19 occurred during a breast cancer study, we evaluated the effect of COVID-19 risk perception on women's breast cancer risk perception.Objective: This study aims to evaluate the relationship between perceived risk of COVID-19 and change in perceived breast cancer risk. We hypothesized that women who perceived greater COVID-19 risk would evidence increased perceived breast cancer risk and this risk would relate to increased anxiety and missed cancer screening.Methods: Women aged 40-74 years with no breast cancer history were enrolled in a US breast cancer prevention trial in outpatient settings. They had provided breast cancer risk perception and general anxiety before COVID-19. We performed a prospective observational study of the relationship between the perceived risk of COVID-19 and the change in perceived breast cancer risk compared to before the pandemic. Each woman was surveyed up to 4 times about COVID-19 and breast cancer risk perception, general anxiety, and missed medical care early in COVID-19 (May to December 2020).Results: Among 13,002 women who completed a survey, compared to before COVID-19, anxiety was higher during COVID-19 (mean T score 53.5 vs 49.7 before COVID-19; difference 3.8, 95% CI 3.6-4.0; P<.001) and directly related to perceived COVID-19 risk. In survey wave 1, anxiety increased by 2.3 T score points for women with very low perceived COVID-19 risk and 5.2 points for those with moderately or very high perceived COVID-19 risk. Despite no overall difference in breast cancer risk perception (mean 32.5% vs 32.5% before COVID-19; difference 0.24, 95% CI -0.47 to 0.52; P=.93), there was a direct relationship between change in perceived breast cancer risk with COVID-19 risk perception, ranging in survey wave 4 from a 2.4% decrease in breast cancer risk perception for those with very low COVID-19 risk perception to a 3.4% increase for women with moderately to very high COVID-19 risk perception. This was not explained by the change in anxiety or missed cancer screening. After adjustment for age, race, education, and survey wave, compared to women with very low perceived COVID-19 risk, perceived breast cancer risk increased by 1.54% (95% CI 0.75%-2.33%; P<.001), 4.28% (95% CI 3.30%-5.25%; P<.001), and 3.67% (95% CI 1.94%-5.40%; P<.001) for women with moderately low, neither high nor low, and moderately or very high perceived COVID-19 risk, respectively.Conclusions: Low perceived COVID-19 risk was associated with reduced perceived breast cancer risk, and higher levels of perceived COVID-19 risk were associated with increased perceived breast cancer risk. This natural experiment suggests that a threat such as COVID-19 may have implications beyond the pandemic. Preventive health behaviors

背景：COVID-19是否与对其他健康状况风险认知的改变有关尚不清楚。由于COVID-19发生在乳腺癌研究期间，我们评估了COVID-19风险认知对女性乳腺癌风险认知的影响。目的：探讨新冠肺炎感知风险与乳腺癌感知风险变化的关系。我们假设，认为COVID-19风险更高的女性患乳腺癌的风险会增加，这种风险与焦虑增加和错过癌症筛查有关。方法：年龄40-74岁、无乳腺癌病史的女性被纳入美国乳腺癌预防门诊试验。他们在COVID-19之前提供了乳腺癌风险认知和普遍焦虑。与大流行前相比，我们对COVID-19感知风险与乳腺癌感知风险变化之间的关系进行了一项前瞻性观察研究。每位女性在2019冠状病毒病早期（2020年5月至12月）接受了多达4次关于COVID-19和乳腺癌风险认知、一般焦虑和错过医疗服务的调查。结果：在完成调查的13002名女性中，与COVID-19前相比，COVID-19期间的焦虑程度更高(平均T评分53.5比COVID-19前的49.7；差异3.8,95% CI 3.6-4.0；结论：低感知风险与乳腺癌感知风险降低相关，高感知风险与乳腺癌感知风险增加相关。这一自然实验表明，COVID-19等威胁的影响可能超出大流行的范围。随着COVID-19成为流行病，可能需要关注与感知风险相关的预防性健康行为。

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引用次数: 0

Experiences of a Digital Behavior Change Intervention to Prevent Weight Gain and Promote Risk-Reducing Health Behaviors for Women Aged 18 to 35 Years at Increased Risk of Breast Cancer: Qualitative Interview Study. 对 18 至 35 岁乳腺癌风险增加的女性进行数字行为改变干预以防止体重增加并促进降低风险的健康行为的体验：定性访谈研究。

IF 3.3 Q2 ONCOLOGY

JMIR Cancer

Pub Date : 2024-11-25 DOI: 10.2196/57964

Rhiannon E Hawkes, Mary Pegington, Alan Davies, Julia Mueller, Anthony Howell, D Gareth Evans, Sacha J Howell, David P French, Michelle Harvie

Background: Breast cancer is the most common form of cancer in women. Adult weight gain and modifiable health behaviors, including smoking, alcohol intake, and lack of physical activity, are well-known risk factors. Most weight gain in women occurs between the ages of 18 and 35 years. Digital interventions have the potential to address logistical challenges that arise in reaching women in this age range. We designed a digital intervention targeting weight gain prevention and other modifiable health behaviors for young women at increased risk of breast cancer. Women aged 18 to 35 years were recruited to this single-arm intervention study over 2 months to test the acceptability and usability of the intervention, which comprised a group welcome event held via videoconferencing, app, and private Facebook group.

Objective: This nested qualitative substudy explored women's views and experiences of being part of the digital health intervention to inform future intervention development for a feasibility study.

Methods: A total of 20 women aged 23 to 35 years who were at increased risk of breast cancer were interviewed via telephone within 1 month after completing the intervention, between February 2023 and March 2023. The women were asked about their experiences of the digital intervention and the extent to which it may have influenced their health behaviors. Data were analyzed thematically and organized using the framework approach.

Results: The interviews lasted for a median of 37 (IQR 30-46) minutes. Overall, the women perceived the digital health intervention comprising education, tracking, and support to be acceptable for weight gain prevention. In total, 4 themes were generated. A "missed opportunity" in breast cancer prevention services encompasses the lack of services that currently exist for young women at increased risk of breast cancer. The pros and cons of being part of a community encompasses the divergent views that the women had regarding engaging with other women at increased risk. The importance of an interactive app focuses on features that the women would want from the app to promote engagement with the intervention. The different wants and needs of different age groups highlights that an intervention such as this one would need to be customizable to suit the needs of women at different life stages.

Conclusions: There is an unmet need in prevention services for young women aged 18 to 35 years at increased risk of breast cancer. The women perceived the app to be an acceptable intervention for weight gain prevention but emphasized that the intervention would need to be customizable to meet the needs of different age groups within the group of women aged 18 to 35 years. The digital intervention could be a scalable behavior change strategy for UK family history clinics.

背景：乳腺癌是女性最常见的癌症。成年人体重增加和可改变的健康行为（包括吸烟、饮酒和缺乏体育锻炼）是众所周知的风险因素。大多数女性的体重增加发生在 18 至 35 岁之间。数字干预措施有可能解决这一年龄段女性在接受干预时遇到的后勤挑战。我们设计了一种针对预防体重增加和其他可改变健康行为的数字化干预措施，以帮助乳腺癌风险较高的年轻女性。我们招募了 18 至 35 岁的女性参与这项为期 2 个月的单臂干预研究，以测试干预措施的可接受性和可用性，干预措施包括通过视频会议、应用程序和私人 Facebook 群组举行的集体欢迎活动：这项嵌套定性子研究探讨了女性对参与数字健康干预的看法和体验，为未来的可行性研究提供干预发展信息：在 2023 年 2 月至 2023 年 3 月期间，共对 20 名 23 至 35 岁的乳腺癌高危女性进行了电话采访。这些女性被问及她们对数字干预的体验以及数字干预对其健康行为的影响程度。采用框架法对数据进行了专题分析和整理：访谈持续时间中位数为 37 分钟（IQR 30-46 分钟）。总体而言，女性认为由教育、跟踪和支持组成的数字健康干预在预防体重增加方面是可以接受的。共产生了 4 个主题。乳腺癌预防服务中 "错失的机会 "包括目前缺乏针对乳腺癌高危年轻女性的服务。成为社区一员的利与弊 "包含了妇女们对与其他高危妇女接触的不同看法。互动应用程序的重要性侧重于妇女希望应用程序具有的功能，以促进她们参与干预。不同年龄段的妇女有不同的愿望和需求，这突出表明，像这样的干预措施必须是可定制的，以满足妇女在不同人生阶段的需求：结论：18 至 35 岁的年轻女性罹患乳腺癌的风险较高，她们对预防服务的需求尚未得到满足。妇女们认为该应用程序是一种可接受的预防体重增加的干预措施，但强调该干预措施需要定制，以满足 18 至 35 岁妇女群体中不同年龄段的需求。数字化干预措施可以成为英国家族史诊所的一种可扩展的行为改变策略。

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