Table 3.
Adherence to and acceptance of mHealth behavioral interventions tested in randomized controlled trials among cancer survivors.
| Author, Year | Intervention Duration | Adherence to Intervention Components | Satisfaction/Acceptability | ||
|---|---|---|---|---|---|
| Website/Mobile Application Usage | Wearable Activity Tracker Wearing Time | Text Messages Response Rate | |||
| Finlay et al., 2020 [29] | 4 weeks | Mean number of physical activity logs completed: 2.6 (SD:3) for tunneled arm, 1.5 (SD: 1.4) for free-choice arm | N/A a | N/A a | The self-reported engagement and relevance scores were low to moderate across groups, with no significant between-group differences |
| Gell et al., 2019 [30] | 8 weeks | N/A a | Participants wore the Fitbit an average of 6 or more days per week (≥86%) throughout the 8-week intervention | N/A Text messages did not ask for reply |
In total, 91% of participants were satisfied or very satisfied with the Fitbit, while 93% and 90% of participants in the intervention group were satisfied with the health coaching component and the content of the text messages, respectively. The results showed that 91% of participants in the intervention group perceived the Fitbit as often or almost always motivating for physical activity, while 55% and 70% of participants in the intervention group reported text messages and the health coaching sessions as motivating to be physically active, respectively |
| Rees-Punia et al., 2021 [21] | 12 weeks | Median number of logins per person over 12-week intervention: 4 (IQR: 7); median total time logged in: 95 min (IQR: 193) | N/A a | N/A a | Mean score for system usability scale: 72 (range: 67–78); mean ratings for motivation and enjoyment of the website: 3.8/5 (range: 1–4) and 3.6/5 (range: 2–5), respectively |
| Pinto et al., 2021 [22] | 12 weeks | N/A a | 89% (n = 17) of participants wore Fitbit on >90% of the 84 study days | N/A a | Overall, 89% (n = 16) of the participants were very satisfied with their participation; 100% (n = 19) of the participants found the Fitbit to be helpful for physical activity |
| Chan et al., 2020 [23] | 12 weeks | Median number of days visiting the website for levels 1, 2, 3, and 4: 2 (IQR: 2), 9 (IQR: 8), 11 (IQR: 8), and 16 (IQR: 9), respectively, of 84 study days | Not reported | N/A Text messages did not allow for a response |
Most were satisfied or very satisfied with the intervention: 51% (n = 20), 64% (n = 27), 52% (n = 23), and 64% (n = 27) for levels 1, 2, 3, and 4, respectively |
| Nguyen et al., 2020 [25] | 12 weeks | N/A b | N/A b | N/A b | N/A b |
| Rastogi et al., 2020 * [26] Cadmus-Bertram et al., 2019 * [27] |
12 weeks | 44% of participants reported that they logged into the Fitbit website more than once per day, 13% logged in daily, 26% logged in 4–6 times per week, and 9% logged once per week or less | Not reported | N/A a | Overall, 74% (n = 18) of the survivors in the intervention group were “extremely satisfied with the intervention”; 91% (n = 22) and 62% (n = 15) of the survivors in the intervention group rated Fitbit and coaching emails, respectively, as “very important” or “extremely important” in helping them to increase their physical activity |
| Van Blarigan et al., 2020 [28] | 12 weeks | Median number of days participants visited the website: 13 (IQR: 32) out of 84 days | N/A a | The intervention arm responded to a median 15 (IQR: 11) of 21 text messages that asked for a reply | In total, 74% (n = 31) of the participants were satisfied or very satisfied with the text messages; 64% (n = 28) of the participants were satisfied or very satisfied with the overall intervention |
| Mohamad et al., 2019 [31] | 12 weeks | Median number of visits to the website: 5 (IQR: 12) for the intervention group, and 8 (IQR: 12) for the waitlist mini-intervention | Not reported | N/A a | Of the samples, 58% (n = 15) of the participants in the intervention group and 46% (n = 13) of the participants in the control group accessed the online resource during the 12-week intervention |
| Maxwell-Smith et al., 2019 [32] | 12 weeks | N/A b | Average valid wear days c of Fitbit: 86% (SD:29) of 84 study days | N/A a | N/A b |
| Dong et al., 2019 [33] | 12 weeks | N/A b | N/A b | N/A b | N/A b |
| Gomersall et al., 2019 [34] | 12 weeks | N/A a | N/A a | The average reply rate to the fortnightly MVPA goal checks was 78% (n = 14) among the 18 participants in the intervention group | The average satisfaction score for the intervention, among the 17 participants in the intervention group who completed the satisfaction survey, was 4.3 (SD: 0.8) out of 5 |
| Kenfield et al., 2019 [35] | 12 weeks | Participants visited the website on a median of 3 days (IQR: 3) over the 12-week period | The intervention arm participants wore their Fitbit for a median of 82 (98% of the study days, IQR: 11) days in the 12-week period | The intervention arm responded to a median of 71% (IQR: 32%) of the 60 text messages that asked for a reply | Overall, 61% of the participants in the intervention arm rated the quality of the website as high or very high, 87% rated the Fitbits as good to excellent, and 69% rated the text messaging as good to excellent. Satisfaction (“satisfied” or “very satisfied”) for participants in the intervention arm was 60% for the website, 91% for Fitbits, and 73% for text messaging |
| McNeil et al., 2019 [36] McNeil et al., 2021 [37] |
12 weeks | N/A a | Not reported | N/A a | Participants in the lower-intensity physical activity group enjoyed the intervention more than participants in the higher-intensity PA group (p = 0.05) |
| Van Blarigan et al., 2019 [38] | 12 weeks | N/A a | Participants in the intervention arm wore their Fitbits a median of 74 out of 84 days (88% of the study days, IQR 60) | Intervention arm participants responded to a median of 34 out of the 46 (74%; IQR: 25) text messages that asked for a reply | Overall, 88% (n = 14) of participants in the intervention arm were satisfied or very satisfied with their experience with the text messages and the Fitbit, reported that the text messages motivated them to exercise, and said that they would continue to wear the Fitbit after the study ended |
| Golsteijn et al., 2018 [41] | 12 weeks | N/A b | N/A b | N/A a | N/A b |
| Ormel et al., 2018 [40] | 12 weeks | Not reported | N/A a | N/A a | Among the 14 intervention participants who completed the qualitative semi-structured interview, 12 were enthusiastic about the RunKeeper app; 8 reported that they became more active due to the RunKeeper app and were planning to continue use of the app |
| Short et al., 2017 [44] | 12 weeks |
The average time spent on the study website was 57 min (SD: 72, range: 0–556) over the 12-week intervention
The average number of visits to the website was 4.8 times (SD: 8.5, range: 1–146) over the 12-week intervention |
N/A a | N/A a | Website acceptability among study completers was fair, with a mean score of 22.2 (SD: 5.98) out of a possible 36 |
| Chow et al., 2020 [24] | 16 weeks | 92% of intervention participants interacted with the study’s mHealth apps | 75% of the intervention participants met the goal d for regular fitness tracker use | N/A Text messages did not ask for reply |
Among the 11 approached, 10 intervention participants expressed satisfaction with their experience |
| Ferrante et al., 2018 [39] | 6 months | Mean number of days logged onto the website per week: 2.7 (95% CI: 2.2, 3.2) | Adherence with Fitbit was high; participants in both groups wore the Fitbit an average of 5 or more days per week (84%) throughout the 6-month intervention | N/A a
Text messages did not ask for reply |
Mean score for usefulness of the Fitbit: 4/4 (95% CI: 3.9–4.0) |
| Mayer et al., 2017 [42] | 6 months | Among the participants in the intervention group, the median number of application uses was 15.7 (range: 1–27) throughout the possible 24 weeks of use | Not reported | N/A a | N/A b |
| Valle et al., 2017 [43] | 6 months | Not reported | Among participants in the intervention group with a wearable activity tracker, the median total wear days was 162 (96.4%) out of the 168 study days | N/A a | For participants in the intervention groups with and without a wearable activity tracker, respectively, the median acceptability scores for the smart scale were 4 (IQR: 1) and 2.5 (IQR: 2) out of 4; for the email feedback, they were 3 (IQR: 1.2) and 3 (IQR: 1) out of 4. For participants in the intervention group with a wearable activity tracker, the median acceptability score for the activity tracker was 4 (IQR: 1) out of 4 |
| Gnagnarella et al., 2016 [45] | 6 months | N/A b | N/A a | N/A a | N/A b |
Abbreviations: IQR, interquartile range; SD, standard deviation; 95% CI, 95% confidence interval; MVPA, moderate-to-vigorous physical activity. * [26,27] are two articles describing the same study. a Tool was not used in the study. b Feasibility or acceptability is not the main outcome of interest in this study. c A step count of ≥1000 steps per day was defined as a valid wear-day. d ≥75% of the study days that the fitness tracker record ≥ 500 steps.