Skip to main content

Advertisement

SpringerLink
Log in

SurvivorCHESS to increase physical activity in colon cancer survivors: can we get them moving?

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

This randomized controlled trial evaluated the impact of SurvivorCHESS, an eHealth intervention, on physical activity in colon cancer survivors and to explore the impact of SurvivorCHESS on quality of life and distress.

Methods

This was a two-arm single-blinded multi-site randomized controlled trial comparing a control group to an intervention group receiving a smartphone with the SurvivorCHESS program.

Results

Participants using SurvivorCHESS (n = 144) increased their moderate to vigorous physical activities from 19.4 min at baseline to 50 min compared to the control group (n = 140) increasing from 15.5 to 40.3 min at 6 months (p = .083) but was not sustained 3 months after the study ended. No significant differences were found between groups over time for quality of life or distress items. Reports of physical symptoms were greater than other categories for distress items. Patients who had a higher body mass index and number of comorbid conditions were less likely to increase their physical activity. Self-determination theory including autonomous motivation and relatedness was not associated with the outcomes.

Conclusions

Physical activity did increase over time in both groups and was not significantly different with the use of the eHealth intervention, SurvivorCHESS, compared to the control group. The amount of SurvivorCHESS use was not associated with physical activity.

Implications for cancer survivors

Increasing physical activity in colon cancer survivors has the potential to improve quality of life and reduce recurrences. Using smartphone-tracking devices may be useful in helping to change this health behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Notes

  1. University of Wisconsin Hospital and Clinics, WI; The University of Texas M.D. Anderson Cancer Center, TX; University of North Carolina at Chapel Hill, NC; Hartford Hospital’s Helene and Harry Gray Cancer Center, CT; Marshfield Clinic, WI; Gundersen Lutheran, WI; and Columbia St. Mary’s, WI

  2. https://www.cancer.gov/publications/patient-education/facing-forward

  3. http://www.canceradvocacy.org/resources/cancer-survival-toolbox/

References

  1. Ballard-Barbash R, Potosky AL, Harlan LC, Nayfield SG, Kessler LG. Factors associated with surgical and radiation therapy for early stage breast cancer in older women. J Natl Cancer Inst. 1996;88(11):716–26.

    Article  CAS  PubMed  Google Scholar 

  2. Arem H, Pfeiffer RM, Engels EA, Alfano CM, Hollenbeck A, Park Y, et al. Pre- and postdiagnosis physical activity, television viewing, and mortality among patients with colorectal cancer in the National Institutes of Health-AARP diet and health study. J Clin Oncol. 2014.

  3. Lemanne D, Cassileth B, Gubili J. The role of physical activity in cancer prevention, treatment, recovery, and survivorship. Oncology (Williston Park). 2013;27(6):580–5.

    Google Scholar 

  4. Winzer BM, Whiteman DC, Reeves MM, Paratz JD. Physical activity and cancer prevention: a systematic review of clinical trials. Cancer Causes Control. 2011;22(6):811.

    Article  PubMed  Google Scholar 

  5. Gunnell AS, Joyce S, Tomlin S, Taaffe DR, Cormie P, Newton RU, et al. Physical activity and survival among long-term cancer survivor and non-cancer cohorts. Front Public Health. 2017;5:19.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344:e70.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wu W, Guo F, Ye J, Li Y, Shi D, Fang D, et al. Pre- and post-diagnosis physical activity is associated with survival benefits of colorectal cancer patients: a systematic review and meta-analysis. Oncotarget. 2016;7(32):52095–103.

    PubMed  PubMed Central  Google Scholar 

  8. Anzuini F, Battistella A, Izzotti A. Physical activity and cancer prevention: a review of current evidence and biological mechanisms. J Prev Med Hyg. 2011;52(4):174–80.

    CAS  PubMed  Google Scholar 

  9. Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM. Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104(11):815–40.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Meneses-Echavez JF, Gonzalez-Jimenez E, Ramirez-Velez R. Supervised exercise reduces cancer-related fatigue: a systematic review. J Physiother. 2014;12.

  11. 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):243–74.

    Article  PubMed  Google Scholar 

  12. Cell phone and smartphone ownership demographics [Internet]. Washington, DC: Pew Research Center; 2014 [cited 9/2/16]. Available from: http://www.pewinternet.org/data-trend/mobile/cell-phone-and-smartphone-ownership-demographics/.

  13. Mobile health 2012 [Internet]. Pew Research Internet Project [cited 12/26/14]. Available from: http://pewinternet.org/Reports/2012/Mobile-Health.aspx.

  14. Whitehead L, Seaton P. The effectiveness of self-management mobile phone and tablet apps in long-term condition management: a systematic review. J Med Internet Res. 2016;18(5):e97.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res. 2016;18(11):e287.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fanning J, Mullen SP, McAuley E. Increasing physical activity with mobile devices: a meta-analysis. J Med Internet Res. 2012;14(6):e161.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gustafson DH, McTavish FM, Chih MY, Atwood AK, Johnson RA, Boyle MG, et al. A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA Psychiatry. 2014;71(5):566–72.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gustafson DH, Boyle MG, Shaw BR, Isham A, McTavish F, Richards S, et al. An e-health solution for people with alcohol problems. Alcohol Res Health. 2011;33(4):327–37.

    PubMed  PubMed Central  Google Scholar 

  19. Gustafson DH, DuBenske LL, Namkoong K, Hawkins R, Chih MY, Atwood AK, et al. An eHealth system supporting palliative care for patients with non-small cell lung cancer: a randomized trial. Cancer. 2013;119(9):1744–51.

    Article  PubMed  PubMed Central  Google Scholar 

  20. DuBenske LL, Wen KY, Gustafson DH, Guarnaccia CA, Cleary JF, Dinauer SK, et al. Caregivers’ differing needs across key experiences of the advanced cancer disease trajectory. Palliat Support Care. 2008;6(3):265–72.

    Article  PubMed  Google Scholar 

  21. DuBenske LL, Gustafson DH, Namkoong K, Hawkins RP, Atwood AK, Brown RL, et al. CHESS improves cancer caregivers’ burden and mood: results of an eHealth RCT. Health Psychol. 2014;33(10):1261–72.

    Article  PubMed  Google Scholar 

  22. Gustafson DH, Bosworth K, Hawkins RP, Boberg EW, Bricker E. CHESS: a computer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises. Proc Annu Symp Comput Appl Med Care. 1992:161–5.

  23. Chih MY, DuBenske LL, Hawkins RP, Brown RL, Dinauer SK, Cleary JF, et al. Communicating advanced cancer patients’ symptoms via the internet: a pooled analysis of two randomized trials examining caregiver preparedness, physical burden, and negative mood. Palliat Med. 2013;27(6):533–43.

    Article  PubMed  Google Scholar 

  24. Deci E, Ryan R. Handbook of self-determination research. Rochester, NY: University of Rochester Press; 2002.

    Google Scholar 

  25. Gustafson D, Wise M, Bhattacharya A, Pulvermacher A, Shanovich K, Phillips B, et al. The effects of combining web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial. J Med Internet Res. 2012;14(4):e101.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141–6.

    CAS  PubMed  Google Scholar 

  27. Gionet NJ, Godin G. Self-reported exercise behavior of employees: a validity study. J Occup Med. 1989;31(12):969–73.

    Article  CAS  PubMed  Google Scholar 

  28. Jacobs DR Jr, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc. 1993;25(1):81–91.

    Article  PubMed  Google Scholar 

  29. Amireault S, Godin G. The Godin-Shephard leisure-time physical activity questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories. Percept Mot Skills. 2015;120(2):604–22.

    Article  PubMed  Google Scholar 

  30. Amireault S, Godin G, Lacombe J, Sabiston CM. The use of the Godin-Shephard leisure-time physical activity questionnaire in oncology research: a systematic review. BMC Med Res Methodol. 2015;15:60. 015-0045-7

    Article  PubMed  PubMed Central  Google Scholar 

  31. Godin G. The Godin-Shephard leisure-time exercise questionnaire. Health Fi J Can. 2011;4(1):18–22.

    Google Scholar 

  32. NCCN distress management [Internet]. National Comprehensive Cancer Network; 2016 [cited 4/2/17]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf.

  33. Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F, et al. Screening for psychologic distress in ambulatory cancer patients. Cancer. 2005;103(7):1494–502.

    Article  PubMed  Google Scholar 

  34. Mitchell AJ. Pooled results from 38 analyses of the accuracy of distress thermometer and other ultra-short methods of detecting cancer-related mood disorders. J Clin Oncol. 2007;25(29):4670–81.

    Article  PubMed  Google Scholar 

  35. Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D. Reliability and validity of the functional assessment of cancer therapy-colorectal (FACT-C) quality of life instrument. Qual Life Res. 1999;8(3):181–95.

    Article  CAS  PubMed  Google Scholar 

  36. Gustafson DH, Hawkins R, McTavish F, Pingree S, Chen WC, Volrathongchai K, et al. Internet-based interactive support for cancer patients: are integrated systems better? Aust J Commun. 2008;58(2):238–57.

    Article  Google Scholar 

  37. Cohen J, Cohen P. Applied multiple regression/correlation analysis for the behavioral sciences. Hillsdale: Erlbaum; 1983.

    Google Scholar 

  38. Gustafson DH, Hawkins R, Pingree S, McTavish F, Arora NK, Mendenhall J, et al. Effect of computer support on younger women with breast cancer. J Gen Intern Med. 2001;16(7):435–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Japuntich SJ, Zehner ME, Smith SS, Jorenby DE, Valdez JA, Fiore MC, et al. Smoking cessation via the internet: a randomized clinical trial of an internet intervention as adjuvant treatment in a smoking cessation intervention. Nicotine Tob Res. 2006;8(Suppl 1):S59–67.

    Article  PubMed  Google Scholar 

  40. Saver BG, Gustafson D, Taylor TR, Hawkins RP, Woods NF, Dinauer S, et al. A tale of two studies: the importance of setting, subjects and context in two randomized, controlled trials of a web-based decision support for perimenopausal and postmenopausal health decisions. Patient Educ Couns. 2007;66(2):211–22.

    Article  PubMed  Google Scholar 

  41. Gustafson DH, Hawkins R, Boberg E, Pingree S, Serlin RE, Graziano F, et al. Impact of a patient-centered, computer-based health information/support system. Am J Prev Med. 1999;16(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  42. Vollmer Dahlke D, Fair K, Hong YA, Beaudoin CE, Pulczinski J, Ory MG. Apps seeking theories: results of a study on the use of health behavior change theories in cancer survivorship mobile apps. JMIR Mhealth Uhealth. 2015;3(1):e31.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Kuijpers W, Groen WG, Aaronson NK, van Harten WH. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. J Med Internet Res. 2013;15(2):e37.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Morey MC, Blair CK, Sloane R, Cohen HJ, Snyder DC, Demark-Wahnefried W. Group trajectory analysis helps to identify older cancer survivors who benefit from distance-based lifestyle interventions. Cancer. 2015;121(24):4433–40.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Kenzik KM, Morey MC, Cohen HJ, Sloane R, Demark-Wahnefried W. Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors. J Geriatr Oncol. 2015;6(6):424–32.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Demark-Wahnefried W, Clipp EC, Morey MC, Pieper CF, Sloane R, Snyder DC, et al. Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from project LEAD. J Clin Oncol. 2006;24(21):3465–73.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Demark-Wahnefried W, Morey MC, Sloane R, Snyder DC, Miller PE, Hartman TJ, et al. Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol. 2012;30(19):2354–61.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Courneya KS, Vardy JL, O'Callaghan CJ, Friedenreich CM, Campbell KL, Prapavessis H, et al. Effects of a structured exercise program on physical activity and fitness in colon cancer survivors: one year feasibility results from the CHALLENGE trial. Cancer Epidemiol Biomark Prev. 2016;25(6):969–77.

    Article  Google Scholar 

  49. Van Vulpen JK, Velthuis MJ, Steins Bisschop CN, Travier N, Van Den Buijs BJ, Backx FJ, et al. Effects of an exercise program in colon cancer patients undergoing chemotherapy. Med Sci Sports Exerc. 2016;48(5):767–75.

    Article  PubMed  Google Scholar 

  50. Mobile fact sheet [Internet]. Pew Research Center Internet & Technology; 2017 [updated January 12, 2017; cited 8/5/17]. Available from: http://www.pewinternet.org/fact-sheet/mobile/.

  51. Ernsting C, Dombrowski SU, Oedekoven M, O’Sullivan JL, Kanzler M, Kuhlmey A, et al. Using smartphones and health apps to change and manage health behaviors: a population-based survey. J Med Internet Res. 2017;19(4):e101.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Krebs P, Shtaynberger J, McCabe M, Iocolano M, Williams K, Shuk E, et al. An eHealth intervention to increase physical activity and healthy eating in older adult cancer survivors: summative evaluation results. JMIR Cancer. 2017;3(1):e4.

    Article  PubMed  PubMed Central  Google Scholar 

  53. SEER stat fact sheets: colon and rectum cancer [Internet]. Bethesda, MD: National Cancer Institute [cited 12/26/14]. Available from: http://seer.cancer.gov/statfacts/html/colorect.html.

  54. Van Blarigan EL, Meyerhardt JA. Role of physical activity and diet after colorectal cancer diagnosis. J Clin Oncol. 2015;33(16):1825–34.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Winkels RM, Heine-Broring RC, van Zutphen M, van Harten-Gerritsen S, Kok DE, van Duijnhoven FJ, et al. The COLON study: colorectal cancer: longitudinal, observational study on nutritional and lifestyle factors that may influence colorectal tumour recurrence, survival and quality of life. BMC Cancer. 2014;14:374. 2407-14-374

    Article  PubMed  PubMed Central  Google Scholar 

  56. Winkels RM, van Lee L, Beijer S, Bours MJ, van Duijnhoven FJ, Geelen A, et al. Adherence to the World Cancer Research Fund/American Institute for Cancer Research lifestyle recommendations in colorectal cancer survivors: results of the PROFILES registry. Cancer Med. 2016;14.

  57. Nyrop KA, Deal AM, Williams GR, Guerard EJ, Pergolotti M, Muss HB. Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer. Cancer. 2016;122(3):470–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank all participants and staff involved in this study. We would also like to thank Ming-Yuan Chih, PhD, University of Kentucky, College of Health Sciences, for his assistance with additional statistical analyses. This paper is based on a presentation at the NCI Centers of Excellence in Cancer Communication Research (CECCR) 2013 Grantee Meeting, Ann Arbor, MI.

Funding

This study was supported by a grant from the National Cancer Institute (P50 CA095817).

Author information

Authors and Affiliations

  1. UNC Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Deborah K. Mayer

  2. Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA

    Gina Landucci, Lola Awoyinka, Fiona McTavish & David H. Gustafson

  3. T-Mobile Workforce Analysis and Insights, Bellevue, WA, USA

    Amy K. Atwood

  4. Department of Behavior Science, M.D. Anderson Cancer Center, Houston, Texas, USA

    Cindy L. Carmack

  5. UAB Comprehensive Cancer Center, University of Alabama, Birmingham, AL, USA

    Wendy Demark-Wahnefried

Authors
  1. Deborah K. Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gina Landucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lola Awoyinka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amy K. Atwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cindy L. Carmack
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wendy Demark-Wahnefried
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fiona McTavish
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David H. Gustafson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deborah K. Mayer.

Ethics declarations

This study was approved by the relevant institutional review boards at all the centers. Participants provided written informed consent before starting the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution.

Conflict of interest

Deborah K. Mayer, Stock Holder for CareVive. The other authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mayer, D.K., Landucci, G., Awoyinka, L. et al. SurvivorCHESS to increase physical activity in colon cancer survivors: can we get them moving?. J Cancer Surviv 12, 82–94 (2018). https://doi.org/10.1007/s11764-017-0647-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-017-0647-7

Keywords

Search

Navigation