Promoting Physical Activity in Young Adult Cancer Survivors Using mHealth and Adaptive Tailored Feedback Strategies

There are over half a million young adult cancer survivors in the United States. Young adult
cancer survivors are an underserved and vulnerable subgroup of survivors that experience
increased risk over time for obesity and chronic diseases such as diabetes and cardiovascular
disease. Increasing physical activity is a promising behavioral intervention that has
positive effects on physical function, body composition, cardiovascular fitness,
health-related quality of life, and depression, and may prevent cancer recurrence, new
cancers and improve survival. To date, few interventions have been designed specifically to
promote physical activity in young adult cancer survivors, nor used novel technologies for
delivery; none have been successful in promoting long-term adherence to physical activity.
This is a randomized controlled trial to test the efficacy of a theory-based, mobile physical
activity intervention with adaptive goal-setting and tailored feedback that is aimed at
increasing PA among young adult cancer survivors. Young adult cancer survivors (n=280),
diagnosed between ages 18-39, will be recruited and randomized into one of two conditions: 1)
activity tracker + Facebook group (Self-help) or 2) activity tracker + Facebook group +
adaptive goal-setting and tailored feedback (Intervention). Young adult cancer survivors will
receive a 6-month intervention followed by an additional 6 months of tapered contacts.
Assessments of objectively-measured physical activity and other outcomes will be conducted at
baseline, 3, 6, and 12 months.

Inclusion Criteria:

- Currently age 18-39

- Diagnosed with invasive malignancy between the ages of 18-39 years

- Diagnosed with invasive malignancy in the last 10 years with no evidence of
progressive disease or second primary cancers

- Completed active cancer directed therapy (cytotoxic chemotherapy, radiation therapy
and/or definitive surgical intervention), except may be receiving "maintenance"
therapy to prevent recurrences

- Have the ability to read, write and speak English

- No pre-existing medical condition(s) that preclude adherence to an unsupervised
exercise program, including cardiovascular disease, congestive heart failure,
pulmonary conditions, renal disease, and severe orthopedic conditions

- Not adhering to the American College of Sports Medicine recommendation of at least 150
moderate-to-vigorous physical activity minutes/week

- Have access to the Internet on at least a weekly basis

- Possession and usage of an Internet e-mail address or willingness to sign up for a
free email account (e.g., gmail)

- Have mobile phone with text messaging plan

- Willing to be randomized to either arm

- Successful completion of accelerometer-assessed activity (i.e., at least 10 hours/day
on 4 of 7 days) and return of the accelerometer in a pre-paid envelope at baseline

Exclusion Criteria:

- History of heart attack or stroke within past 6 months

- Untreated hypertension, hyperlipidemia, or diabetes, unless permission is provided by
their health care provider

- Health problems which preclude ability to walk for physical activity

- Report a diagnosis of psychiatric diseases (schizophrenia, bipolar disorder,
depression leading to hospitalization in the past year), drug or alcohol dependency.

- Report a past diagnosis of or treatment for a DSM-IV-TR eating disorder (anorexia
nervosa or bulimia nervosa)

- Current participation in another physical activity or weight control program

- Currently using prescription weight loss medications

- Currently pregnant, pregnant within the past 6 months, or planning to become pregnant
within the next 6 months

- Currently exercising > 150 minutes/week of moderate-to-vigorous intensity physical
activity