TY - JOUR
T1 - Optimization of mHealth behavioral interventions for patients with chronic lymphocytic leukemia
T2 - the HEALTH4CLL study
AU - Lee, Che Young
AU - Gordon, Max J.
AU - Markofski, Melissa M.
AU - LaVoy, Emily C.
AU - Peterson, Susan K
AU - Li, Liang
AU - Fares, Sara
AU - Baum, Miranda
AU - Pace, Margaret
AU - Walsh, Danielle
AU - Ferrajoli, Alessandra
AU - Basen-Engquist, Karen
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024
Y1 - 2024
N2 - Purpose: This pilot study of a diet and physical activity intervention (HEALTH4CLL) was conducted to reduce fatigue and improve physical function (PF) in patients with chronic lymphocytic leukemia (CLL). Methods: The HEALTH4CLL study used a randomized factorial design based on the multiphase optimization strategy (MOST). Patients received diet, exercise, and body weight management instructional materials plus a Fitbit and were randomized to undergo one of 16 combinations of 4 evidence-based mHealth intervention strategies over 16 weeks. Patients’ fatigue, PF, health-related quality of life, behavior changes, and program satisfaction and retention were assessed. Paired t-tests were used to examine changes in outcomes from baseline to follow-up among patients. Factorial analysis of variance examined effective intervention components and their combinations regarding improvement in fatigue and PF scores. Results: Among 31 patients, we observed significant improvements in fatigue (+ 11.8; t = 4.08, p = 0.001) and PF (+ 2.6; t = 2.75, p = 0.01) scores. The combination of resistance and aerobic exercise with daily self-monitoring was associated with improved fatigue scores (β = 3.857, SE = 1.617, p = 0.027). Analysis of the individual components of the MOST design demonstrated greater improvement in the PF score with resistance plus aerobic exercise than with aerobic exercise alone (β = 2.257, SE = 1.071, p = 0.048). Conclusions: Combined aerobic and resistance exercise and daily self-monitoring improved PF and reduced fatigue in patients with CLL. Implications for Cancer Survivors: This pilot study supported the feasibility of a low-touch mHealth intervention for survivors of CLL and provided preliminary evidence that exercising, particularly resistance exercise, can improve their symptoms and quality of life.
AB - Purpose: This pilot study of a diet and physical activity intervention (HEALTH4CLL) was conducted to reduce fatigue and improve physical function (PF) in patients with chronic lymphocytic leukemia (CLL). Methods: The HEALTH4CLL study used a randomized factorial design based on the multiphase optimization strategy (MOST). Patients received diet, exercise, and body weight management instructional materials plus a Fitbit and were randomized to undergo one of 16 combinations of 4 evidence-based mHealth intervention strategies over 16 weeks. Patients’ fatigue, PF, health-related quality of life, behavior changes, and program satisfaction and retention were assessed. Paired t-tests were used to examine changes in outcomes from baseline to follow-up among patients. Factorial analysis of variance examined effective intervention components and their combinations regarding improvement in fatigue and PF scores. Results: Among 31 patients, we observed significant improvements in fatigue (+ 11.8; t = 4.08, p = 0.001) and PF (+ 2.6; t = 2.75, p = 0.01) scores. The combination of resistance and aerobic exercise with daily self-monitoring was associated with improved fatigue scores (β = 3.857, SE = 1.617, p = 0.027). Analysis of the individual components of the MOST design demonstrated greater improvement in the PF score with resistance plus aerobic exercise than with aerobic exercise alone (β = 2.257, SE = 1.071, p = 0.048). Conclusions: Combined aerobic and resistance exercise and daily self-monitoring improved PF and reduced fatigue in patients with CLL. Implications for Cancer Survivors: This pilot study supported the feasibility of a low-touch mHealth intervention for survivors of CLL and provided preliminary evidence that exercising, particularly resistance exercise, can improve their symptoms and quality of life.
KW - Cancer
KW - Exercise
KW - Non-Hodgkin lymphoma
KW - Nutrition
KW - Physical activity
KW - Skeletal muscle function
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U2 - 10.1007/s11764-024-01555-w
DO - 10.1007/s11764-024-01555-w
M3 - Article
C2 - 38472612
AN - SCOPUS:85187419416
SN - 1932-2259
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
ER -