scholarly journals Use of Mental Health Apps by Breast Cancer Patients and Their Caregivers in the United States: Protocol for a Pilot Pre-Post Study (Preprint)

2018 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew S Gerber ◽  
Erin Kennedy ◽  
David R Brenin ◽  
...  

BACKGROUND Over one-third of cancer patients experience clinically significant mental distress, and distress in caregivers can exceed that of the cancer patients for whom they care. There is an urgent need to identify scalable and cost-efficient ways of delivering mental health interventions to cancer patients and their loved ones. OBJECTIVE The aim of this study is to describe the protocol to pilot a mobile app–based mental health intervention in breast cancer patients and caregivers. METHODS The IntelliCare mental health apps are grounded in evidence-based research in psychology. They have not been examined in cancer populations. This pilot study will adopt a within-subject, pre-post study design to inform a potential phase III randomized controlled trial. A target sample of 50 individuals (with roughly equal numbers of patients and caregivers) at least 18 years of age and fluent in English will be recruited at a US National Cancer Institute designated clinical cancer center. Consent will be obtained in writing and a mobile phone will be provided if needed. Self-report surveys assessing mental health outcomes will be administered at a baseline session and after a 7-week intervention. Before using the apps, participants will receive a 30-min coaching call to explain their purpose and function. A 10-min coaching call 3 weeks later will check on user progress and address questions or barriers to use. Self-report and semistructured interviews with participants at the end of the study period will focus on user experience and suggestions for improving the apps and coaching in future studies. RESULTS This study is ongoing, and recruitment will be completed by the end of 2018. CONCLUSIONS Results from this study will inform how scalable mobile phone-delivered programs can be used to support breast cancer patients and their loved ones. CLINICALTRIAL ClinicalTrials.gov NCT03488745; https://clinicaltrials.gov/ct2/show/NCT03488745 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11452

10.2196/11452 ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. e11452 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew S Gerber ◽  
Erin Kennedy ◽  
David R Brenin ◽  
...  

2019 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew Gerber ◽  
Erin M Kennedy ◽  
David Brenin ◽  
...  

BACKGROUND Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. METHODS This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. RESULTS The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. CONCLUSIONS There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. INTERNATIONAL REGISTERED REPORT RR2-10.2196/11452


JMIR Cancer ◽  
10.2196/16476 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e16476 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew Gerber ◽  
Erin M Kennedy ◽  
David Brenin ◽  
...  

Background Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. Objective The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. Methods This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. Results The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. Conclusions There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. International Registered Report Identifier (IRRID) RR2-10.2196/11452


2021 ◽  
Author(s):  
Anna N Baglione ◽  
Lihua Cai ◽  
Aram Bahrini ◽  
Isabella Posey ◽  
Mehdi Boukhechba ◽  
...  

BACKGROUND Health interventions delivered via smart devices are increasingly being used to address mental health challenges associated with cancer treatment. Engagement with mobile interventions has been associated with treatment success, yet the relationship between mood and engagement among cancer patients remains poorly understood. One reason is the lack of a data-driven process for analyzing mood and app engagement data for cancer patients. OBJECTIVE The purpose of this study is to provide a step-by-step process for using app engagement metrics to predict continuously assessed mood outcomes in breast cancer patients. We describe the steps of data preprocessing, feature extraction, and data modeling and prediction. We then apply this process as a case study to data collected from breast cancer patients who engaged with a mobile mental health app intervention (IntelliCare) over 7-weeks. We compare engagement patterns over time (e.g., frequency, days of use) between high- and low-anxious and high- and low-depressed participants. We then use a Linear Mixed Model to identify significant effects and evaluate the performance of Random Forest and XGBoost classifiers in predicting weekly state mood from baseline affect and engagement features. METHODS We describe the steps of data preprocessing, feature extraction, and data modeling and prediction. We then apply this process as a case study to data collected from breast cancer patients who engaged with a mobile mental health app intervention (IntelliCare) over 7-weeks. We compare engagement patterns over time (e.g., frequency, days of use) between high- and low-anxious and high- and low-depressed participants. We then use a Linear Mixed Model to identify significant effects and evaluate the performance of Random Forest and XGBoost classifiers in predicting weekly state mood from baseline affect and engagement features. RESULTS We observed differences in engagement patterns between high- and low-anxious and depressed participants. Linear Mixed Model results varied by the featureset; these results revealed weak effects for several features of engagement, including duration-based metrics and frequency. Accuracy of predicting state mood varied according to classifier and featureset. The XGBoost classifier achieved the highest accuracy for state anxiety prediction when self-report scores and engagement features were used for only the most highly-used apps. The Random Forest classifier achieved the highest accuracy for state depression prediction when self-report scores and engagement features were used from all apps. CONCLUSIONS The results from the case study support the feasibility and potential of our analytic process for understanding the relationship between app engagement and mood outcomes in breast cancer patients. The ability to leverage both self-report and engagement features to predict state mood during an intervention could be used to enhance decision-making for researchers and clinicians, as well as assist in developing more personalized interventions for breast cancer patients.


2002 ◽  
Vol 20 (20) ◽  
pp. 4150-4159 ◽  
Author(s):  
Alfredo Berruti ◽  
Raffaella Bitossi ◽  
Gabriella Gorzegno ◽  
Alberto Bottini ◽  
Palmiro Alquati ◽  
...  

PURPOSE: To investigate the value of the addition of either cisplatin (CDDP) or lonidamine (LND) to epirubicin (EPI) in the first-line treatment of advanced breast cancer. PATIENTS AND METHODS: Three hundred seventy-one metastatic breast cancer patients with no prior systemic chemotherapy for advanced disease were randomized to receive either EPI alone (60 mg/m2 on days 1 and 2 every 21 days), EPI and CDDP (30 mg/m2 on days 1 and 2 every 21 days), EPI and LND (450 mg orally daily, given continuously), or EPI, CDDP, and LND. Time to progression, response rates, side effects, and survival were compared according to the 2 × 2 factorial design of this study. RESULTS: The groups were well balanced with respect to prognostic factors. Time to progression did not differ in the comparison between CDDP arms and non-CDDP arms (median, 10.9 months v 9.4 months, respectively; P = .10) or between that of LND arms and non-LND arms (median, 10.8 months v 9.9 months, respectively; P = .47), nor did overall survival. The response rate did not significantly differ in the comparison between LND arms and non-LND arms (62.9% v 54.0%, P = .08). No difference in treatment activity was observed between CDDP arms and non-CDDP arms. Toxicity was significantly higher in the CDDP arms, leading to CDDP dose adjustment in 40% of cases. The most frequent side effects were of a hematologic and gastrointestinal nature. The addition of LND produced more myalgias and fatigue. CONCLUSION: Neither CDDP nor LND was able to significantly improve the time to progression obtained by EPI. CDDP, however, significantly worsened the drug’s tolerability.


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