Table 1.

Randomized controlled trials of mHealth interventions focused on a healthy diet and physical activity among cancer survivors (2016–2021).

Author, Year	Country	Sample Size	Study Population	Duration of Intervention	Intervention	Comparison Group	Primary Outcomes	Other Outcomes	Follow-Up Schedule: Overall Completion
Rees-Punia et al., 2021 [21]	US	85	Stage I or II breast, colon, endometrium, kidney, or bladder cancer survivors who reported less than 150 min MVPA/week and/or less than 2 days/week of strength training	12 weeks	Intervention (n = 45): access to the HEALED website including physical activity training recommendations, exercise videos, and a goal-setting tool; received monthly email reminders to return to the website	Waitlist control (n = 40)	Feasibility, acceptability, and usability	Physical activity and sedentary time	0 and 12 weeks: 92%
Pinto et al., 2021 [22]	US	20	Stage I–III >65-year-old breast (n = 15) or other (n = 5) cancer survivors who had completed treatment within 5 years	12 weeks	Intervention (n = 12): tailored step goal program with recommendation of listening to audiobooks during physical activity	Control (n = 8): tailored step goal program without audiobook recommendation	Difference in daily steps	Light-intensity physical activity, sedentary time, MVPA; intervention evaluation	0 and 12 weeks: 95%
Chan et al., 2020 [23]	US	202	Prostate cancer survivors	12 weeks	Level 2 (n = 51): level 1 plus personalized diet and exercise prescription delivered through website; Level 3 (n = 50): level 2 plus Fitbit Alta with physical activity reports, text messages (4 per week), and weekly survey for progress tracking; Level 4 (n = 52): level 3 plus 2 optional 30-min calls, one with an exercise trainer and one with a dietitian	Level 1 (n = 49): information about exercise and diet, resource directory, and guidelines delivered by website	Feasibility and acceptability; satisfaction; frequency of intervention use	Self-reported physical activity and diet; lifestyle behavior score	0, 3, and 6 months: 83% at 3 months and 77% at 6 months
Chow et al., 2020 [24]	US	41	Adults more than 5 years from initial cancer diagnosis who received hematopoietic cell transplantation or with any history of acute leukemia or lymphoma	16 weeks	Intervention (n = 24): 30-min telephone-based review session; Fitbit tracker and healthwatch360 app; coaching on goal-setting and feedback on their activity or diet by email or text message; private Facebook peer support group; iCanQuit app for smokers	Control (n = 17): 30-min telephone-based review session; Fitbit tracker and healthwatch360 app	Feasibility	Physical activity; HRQoL	0 and 16 weeks: 90%
Nguyen et al., 2020 [25]	Australia	83	Inactive, post-menopausal, stage I–III breast cancer survivors	12 weeks	Intervention (n = 43): wrist-worn Garmin vivofit2, behavioral feedback and goal setting in a single face-to-face session, and five telephone-delivered behavioral counseling sessions	Waitlist control (n = 40): abridged intervention with activity tracker at 12 weeks	Sleep quality		0, 12, and 24 weeks: 94% at 12 weeks and 86% at 24 weeks
Rastogi et al., 2020 [26] a Cadmus-Bertram et al., 2019 [27] a	US	50 dyads	Stage I–III breast (n = 45) or colorectal (n = 5) cancer survivors who had finished primary treatment and the survivors’ support partners	12 weeks	Intervention (n = 25 dyads): Fitbit tracker, educational handbook; survivors and partners were asked to assist each other; coaching email sent by staff at weeks 1, 2, 4, and 8	Control (n = 25 dyads): 2015 US Dietary Guidelines for Americans; standardized emails at 1, 2, 4, and 8 weeks with information on healthy eating and stress management	QoL and sleep; physical activity	Intervention feedback	0 and 12 weeks: 94%
Van Blarigan et al., 2020 [28]	US	50	Stage I–IV colorectal cancer survivors who were not actively undergoing chemotherapy and were considered disease-free or had a stable disease status	12 weeks	Intervention (n = 25): printed materials and personalized diet report; orientation session to website; website with dietary goal setting, food tracking, summary, progress, recipes, and meal planning; text messages (one per day)	Waitlist control (n = 25): print materials from weeks 1–12; had option to receive intervention from weeks 12–24 after completing 12-week assessment	Feasibility and acceptability	Self-reported diet; technician-assessed body measures	0, 3, and 6 months: 90% at 3 months and 84% at 6 months
Finlay et al., 2020 [29]	Australia	71	Stage I–III prostate cancer survivors who had completed primary treatment	4 weeks	Two intervention arms received the same computer-tailored physical activity self-monitoring and feedback modules; arms differed in the website architecture; Standard tunneled arm (n = 27) received a single weekly module that combined ‘once-off’ advice with a physical activity log; Free-choice arm (n = 27) received the ‘once-off’ tailored advice modules as standalone modules that could be accessed at any time and in any order.	Control (n = 17): access to homepage of website with static information	Differences in completion rates of the four physical activity logs between the two intervention arms	Website usage, physical activity, and user perceptions	0 and 4 weeks: 70%
Gell et al., 2019 [30]	US	66	Stage I–III breast (n = 38) or other cancer (n = 28) survivors who had completed a supervised oncology rehabilitation program with no concurrent radiation or chemotherapy	8 weeks	Intervention (n = 34): Fitbit tracker, health coach session about physical activity at week 1, follow-up calls from health coach at weeks 2, 4, 8, and 25; 25 text messages over 8 weeks	Control (n = 32): Fitbit tracker only	Physical activity measured by accelerometer	Participants’ satisfaction with the Fitbit, health coach session, and text messages	0 and 8 weeks: 89%
Mohamad et al., 2019 [31]	UK	62	Overweight or obese prostate cancer survivors who were not currently enrolled in a weight management program and had no distant metastases	12 weeks	Intervention (n = 31): one group meeting, a supporting letter from their urologist, three telephone dietitian consultations at 4-week intervals; a pedometer; access to web-based diet and physical activity resources	Waitlist control (n = 31): delayed intervention group session and option to receive Fitbit and access to website after 12 weeks	Difference between groups in change in body weight at 12 weeks and 12 months	HRQoL; feasibility and acceptability	0, 3, 6, and 12 months: 87% at 3 months, 82% at 6 months, and 44% at 12 months
Maxwell-Smith et al., 2019 [32]	Australia	68	Stage I or II colorectal (n = 53) or endometrial (n = 15) cancer survivors at cardiovascular disease risk who had completed active cancer treatment within 5 years	12 weeks	Intervention (n = 34): Fitbit tracker; two group sessions about physical activity with a behavioral change specialist at weeks 1 and 4; 20-min phone call at week 8 for support and feedback	Control (n = 34): printed materials on physical activity guidelines	Minutes per week of MVPA; cardiovascular risk markers (blood pressure, BMI)		0 and 12 weeks: 94%
Dong et al., 2019 [33]	China	60	Stage I –III post-operative breast cancer survivors with no metastasis, mental health problem, or dementia who had finished adjuvant radiotherapy/chemotherapy within 4 months to 2 years	12 weeks	Intervention (n = 30): face-to-face televideo muscle training (three/week) and endurance training (four/week); mobile app to record step counts; daily prompt with information on postoperative breast cancer rehab and physical exercise rehab from social media app	Control (n = 30): traditional treatment and rehab	HRQoL	Muscle strength; cardiorespiratory capacity	0 and 12 weeks: 83%
Gomersall et al., 2019 [34]	Australia	36	Colorectal (n = 25), prostate (n = 10) or breast (n = 1) cancer survivors with no cardiopulmonary or metabolic disorders at least 1 month post-surgery	Standard clinic, 4 weeks; text message-enhanced clinic, 12 weeks	Text message-enhanced clinic (n = 18): standard clinic plus tailored text messages for 12 weeks. Frequency of text messages varied with a minimum of six per fortnight. The purpose of the messages was to reduce sedentary time and increase MVPA	Face-to-face standard clinic (n = 18): participated in four 1-h clinical exercise rehab program with AEP sessions; home exercise information	Feasibility and acceptability; daily time spent sitting	Sitting, standing, stepping at a light or moderate-to-vigorous intensity, sedentary behavior	0 and 12 weeks: 86%
Kenfield et al., 2019 [35]	US	76	Stage T1–T3a nonmetastatic prostate cancer survivors who had completed treatment more than 3 months before enrollment	12 weeks	Intervention (n = 37): Fitbit, personalized recommendation report based on eight healthy behaviors; access to website and Fitbit community group; one email every 2 weeks and four to five text messages /week on four areas: get active, eat well, stop smoking, find support	Standard of care control (n = 39)	Feasibility and acceptability	Change in the prostate score of 8 and individual behaviors; objective change in MVPA and daily steps; body size; HRQoL; maintenance or adoption of behaviors after 1 year	0, 3, and 12 months: 84% at 3 months and 64% at 12 months
McNeil et al., 2019 [36] b McNeil et al., 2021 [37] b	Canada	45	Stage I–IIIc breast cancer survivors who had completed adjuvant treatment, except for hormonal therapy	12 weeks	Instruction of lower-intensity physical activity (n = 15) or higher-intensity physical activity (n = 15); completed diary with responses to questions and goal-setting every 3 weeks; active follow-up discussion by phone or email with exercise physiologist	Control (n = 15): instruction to maintain baseline physical activity levels	Total physical activity, MVPA and light-intensity physical activity, and sedentary and sleeping times	Health-related fitness (body size, body scan, fitness); adherence to the prescribed physical activity interventions; total absolute physical activity time; ≥40% heart rate reserve	0, 3, and 6 months: 96% at 3 months and 91% at 6 months
Van Blarigan et al., 2019 [38]	US	42	Stage I–III colorectal cancer survivors, who were disease-free at enrollment	12 weeks	Intervention (n = 21): printed materials on physical activity after cancer, Fitbit flex with website providing physical activity feedback, daily automated text messages (one per day)	Control (n = 21): printed educational materials about physical activity after cancer	Feasibility and acceptability	Changes in moderate physical activity, MVPA, vigorous physical activity, and daily steps between baseline and 12 weeks	0 and 12 weeks: 93%
Ferrante et al., 2018 [39]	US	35	Stage 0–III breast cancer survivors who identified as African American and had a BMI ≥ 25	6 months	Intervention (n = 18): had access to SparkPeople website; received handout with goal information on weight loss, calorie intake, and physical activity; a wrist-worn physical activity tracker (Fitbit); 30-min training on using the website	Waitlist control group (n = 17) received handout with goal information on weight loss, calorie intake, and physical activity; a wrist-worn physical activity tracker (Fitbit)	Adherence and acceptability	Weight change; QoL	0, 6, and 12 months: 97% at 6 months and 89% at 12 months
Ormel et al., 2018 [40]	Netherlands	32	Testicular (n = 27), breast (n = 4) or osteosarcoma (n = 1) cancer survivors	12 weeks	Intervention (n = 16): Information about benefits of regular physical activity; instructed to self-monitor physical activity with RunKeeper and activate training reminder in the app	Usual care control (n = 16)	Change in physical activity between baseline, 6 weeks, and 12 weeks	App usability and patients’ experience	0, 6, and 12 weeks: 100% at 6 and 12 weeks
Golsteijn et al., 2018 [41]	Netherlands	478	Prostate (n = 292) or colorectal (n = 186) cancer survivors receiving adjuvant treatment (at least 6 months post-surgery) or who had successfully completed primary treatment up to 1 year ago	12 weeks	Intervention (n = 249): Computer-tailored physical activity advice at three time points and pedometer; access to interactive content on the website	Waitlist control group (n = 229)	Change in physical activity	HRQoL; fatigue; distress	0, 3, and 6 months: 89% at 3 months and 87% at 6 months
Mayer et al., 2017 [42]	US	284	Post-cancer treatment, inactive stage I–III colon cancer survivors	6 months	Intervention (n = 144): received all materials provided to the controls; smartphones with the SurvivrosCHESS application that included core skill building, support services, and information services and tools; a coach was available in the later study period to initiate a discussion group and send tailored private message to inactive users	Control (n = 140): received National Cancer Institute’s “Facing Forward: Life after Cancer Treatment” Booklet, the National Coalition for Cancer Survivorship’s Cancer Survival Toolbox, and a pedometer	Change in MVPA at 6 months	Distress; QoL	0 and 6 months: 80% at 6 months
Valle et al., 2017 [43]	US	35	Stage I–IIIA African American/Black breast cancer survivors with a BMI of 20–45 who had completed cancer treatment	6 months	Intervention group (n = 13): individual face-to-face session with information about weight; received a Bluetooth- and WIFI-enabled wireless scale that connected to a mobile app and website and were instructed to weigh themselves daily; received 24 weekly emails that delivered behavioral lessons and tailored feedback on their weight; Intervention+ group (n = 11): received the intervention above plus an activity tracker and tailored feedback on their physical activity, a website/app, and a behavior lesson twice per week without tailored feedback	Control group (n = 11) had an initial group session and received a wireless scale with a companion app	Proportion of participants who completed the 3- and 6-month assessments	Anthropometric and clinical measures (weight, waist circumference, body composition, etc.); adherence to self-monitoring; adherence to weight-management strategies; diet and physical activity; acceptability and satisfaction	0, 3, and 6 months: 94% at 3 months and 97% at 6 months
Short et al., 2017 [44]	Australia	492	Stage I–IV breast cancer survivors who had finished active cancer treatment and were not already meeting national physical activity guidelines	12 weeks	Group A (n = 167): three tailored modules with information and interactive feedback on physical activity, one per month; Group B (n = 168): three modules with information and interactive feedback on physical activity in the first three weeks of the 12-week intervention period, one per week; Group C (n = 157): single module with information on physical activity but no interactive feedback in the first week of the 12-week intervention period; All participants had access to an action planning tool and information on resistance training		Engagement with website	Website acceptability and self-reported physical activity	0, 3, and 6 months: 32% at 3 months and 11% at 6 months
Gnagnarella et al., 2016 [45]	Italy	125	Breast (n = 77), gastrointestinal (n = 20), gynecologic (n = 8), lung (n = 6), or other (n = 14) cancer patients not receiving enteral nutrition, parental nutrition or palliative care and not reporting significant weight loss in the last 6 months	6 months	Intervention (n = 61): access to an interactive nutritional online information website with social media features	Control (n = 64): PDF version of the website content by email	Change in nutritional knowledge	HRQoL and psychological distress inventory	0 and 24 weeks: 54%

Abbreviations: BMI, body mass index; MVPA, moderate-to-vigorous physical activity; HRQoL, health-related quality of life; QoL, quality of life; RD, registered dietitian; AEP, accredited exercise physiologist. ^a [26,27] described the same study. ^b [36,37] described the same study.