@Article{info:doi/10.2196/cancer.7495,
author="Paxton, Raheem J
and Hajek, Richard
and Newcomb, Patricia
and Dobhal, Megha
and Borra, Sujana
and Taylor, Wendell C
and Parra-Medina, Deborah
and Chang, Shine
and Courneya, Kerry S
and Block, Gladys
and Block, Torin
and Jones, Lovell A",
title="A Lifestyle Intervention via Email in Minority Breast Cancer Survivors: Randomized Parallel-Group Feasibility Study",
journal="JMIR Cancer",
year="2017",
month="Sep",
day="21",
volume="3",
number="2",
pages="e13",
keywords="breast neoplasm; African Americans; diet; feasibility study; physical activity; posture; program evaluation; Internet; computer tailoring; email",
abstract="Background: Our data have indicated that minority breast cancer survivors are receptive to participating in lifestyle interventions delivered via email or the Web, yet few Web-based studies exist in this population. Objective: The aim of this study was to examine the feasibility and preliminary results of an email-delivered diet and activity intervention program, ``A Lifestyle Intervention Via Email (ALIVE),'' delivered to a sample of racial and ethnic minority breast cancer survivors. Methods: Survivors (mean age: 52 years, 83{\%} [59/71] African American) were recruited and randomized to receive either the ALIVE program's 3-month physical activity track or its 3-month dietary track. The fully automated system provided tools for self-monitoring and goal setting, tailored content, and automated phone calls. Descriptive statistics and mixed-effects models were computed to examine the outcomes of the study. Results: Upon completion, 44 of 71 survivors completed the study. Our ``intention-to-treat'' analysis revealed that participants in the physical activity track made greater improvements in moderate to vigorous activity than those in the dietary track (+97 vs. +49 min/week, P<.001). Similarly, reductions in total sedentary time among those in the physical activity track (−304 vs. −59 min/week, P<.001) was nearly 5 times greater than that for participants in the dietary track. Our completers case analysis indicated that participants in the dietary track made improvements in the intake of fiber (+4.4 g/day), fruits and vegetables (+1.0 cup equivalents/day), and reductions in saturated fat (−2.3 g/day) and trans fat (−0.3 g/day) (all P<.05). However, these improvements in dietary intake were not significantly different from the changes observed by participants in the physical activity track (all P>.05). Process evaluation data indicated that most survivors would recommend ALIVE to other cancer survivors (97{\%}), were satisfied with ALIVE (82{\%}), and felt that ALIVE was effective (73{\%}). However, survivors expressed concerns about the functionality of the interactive emails. Conclusions: ALIVE appears to be feasible for racial and ethnic minority cancer survivors and showed promising results for larger implementation. Although survivors favored the educational content, a mobile phone app and interactive emails that work on multiple email domains may help to boost adherence rates and to improve satisfaction with the Web-based platform. Trial Registration: ClinicalTrials.gov NCT02722850; https://clinicaltrials.gov/ct2/show/NCT02722850 (Archived by WebCite at http://www.webcitation.org/6tHN9VsPh) ",
issn="2369-1999",
doi="10.2196/cancer.7495",
url="http://cancer.jmir.org/2017/2/e13/",
url="https://doi.org/10.2196/cancer.7495",
url="http://www.ncbi.nlm.nih.gov/pubmed/28935620"
}