Narrative Visualization for Breast Cancer Survivors' Physical Activity

Not Applicable

Completed

Conditions: Breast Cancer

Interventions: Behavioral: Narrative visualization
Behavioral: Standard self-regulation

Registration Number: NCT03612596

Lead Sponsor: The University of Texas Medical Branch, Galveston

Brief Summary: This study tests the feasibility and acceptability of a physical activity intervention that combines use of a wearable activity monitor with a scrapbook. Half of the participants will receive this enhanced intervention, while the other half will receive a wearable activity monitor with a standard step log.

Detailed Description: Women breast cancer survivors could benefit from increased physical activity but are in need of greater motivation to be active. Interventions that use wearable activity monitors and mobile apps have shown promise in the short-term, but use drops off over time. Reports have suggested that users find the step data provided to be unclear and not very personally meaningful. The ultimate purpose of this line of research is to test whether enhanced motivational feedback, using scrapbooks, can increase motivation for activity. The scrapbooks will target integrated regulation, which is a type of motivation related to personal identity and values. Participants who receive this intervention will draw their step graph, add photographs and stickers an explanations to the graph, and answer reflection questions daily. Before testing the effects of this intervention on physical activity, the investigators must first ensure that the materials and procedures are feasible and acceptable. This small pilot study will allow the research team to iteratively test scrapbook materials and improve upon them for use in future studies. The investigators will compare an intervention using the enhanced materials to an intervention using only the wearable device, app, and a standard step log without scrapbook or reflection components. In addition to the primary outcome of feasibility (use of the scrapbook), the investigators will also explore the effects of the intervention on steps, motivational and values-related outcomes, and various aspects of feasibility and acceptability.

Recruitment & Eligibility

Status: COMPLETED

Sex: Female

Target Recruitment: 40

Inclusion Criteria

Age between 55 and 79 years
Female
Self-reported diagnosis of breast cancer
BMI between 18 and 40 kg/m2
Willingness to be randomized to any condition
Participant is able to walk for exercise
Able to read and understand English
Daily access to a smartphone or similar device compatible with Garmin app
PAR-Q+ indicates that physical activity would be safe (with note from physician required if any heart-related questions are endorsed)

Exclusion Criteria

Participant is active (150 minutes or more activity per week)
Major health interventions (surgery, radiation, chemo) within the past 6 months
Stroke, hip fracture, hip or knee replacement, or spinal surgery in the past 6 months
History of orthopedic complications that would prevent optimal participation
No active recurrence of cancer
Self-reported smoker
Reports psychological issues that would interfere with study completion (dementia, schizophrenia)
Reports hospitalization within the past year due to psychiatric problem(s)
Plans to be out of town for more than 2 weeks at a time during study period
Clinical judgement concerning safety
Currently participating in an organized commercial or research exercise program
Another member of the household is a participant or staff member on this trial
Current use of a wearable activity monitor

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Narrative visualization	Narrative visualization	Wearable activity monitor, app, and enhanced motivational scrapbook materials (instant camera, stickers, markers, enhanced content)
Standard self-regulation	Standard self-regulation	Wearable activity monitor, app, and standard workbook materials (markers, a workbook with a calendar log to keep track of steps over time)

Primary Outcome Measures

Name	Time	Method
Percentage of Daily Workbook Entries Completed	12 weeks	Percentage of daily workbook entries completed out of the total possible number, measured by photography of intervention materials at 12 week assessment and then assessment of each page.

Secondary Outcome Measures

Name	Time	Method
Physical Activity as Measured by Daily Steps During No-intervention Maintenance Period	Change from 12 to 24 weeks	Mean of steps per day taken from accelerometers worn for 7 days
Physical Activity as Measured by Steps Per Day During Intervention Period	Change from 0 to 12 weeks	Mean of daily steps taken from accelerometers worn for 7 days
Basic Psychological Needs: Competence	0 to 12 weeks	Self-reported fulfillment of basic psychological needs on a scale from 1 (least fulfilled) to 5 (most fulfilled) using the Basic Psychological Needs in Exercise Questionnaire. The three subscales are perceived autonomy, competence, and relatedness. Here, competence is reported. A higher score means greater perceived competence.
Self-reflection	Change from 0 to 12 weeks	Self-reported self-reflection on a scale from 1 (strongly disagree) to 5 (strongly agree) using the Self-Reflection and Insight Scale. Here, we report changes in the insight subscale, which has 8 items and a range of 5-40. For this scale, higher values indicate greater levels of insight.
Exercise Identity	Change from 0 to 12 weeks	Self-reported identity as an exerciser on a scale from 1 (strongly disagree) to 7 (strongly agree) as measured by the Exercise Identity Scale. The two subscales are exercise beliefs and exercise role identity. Here, exercise role identity is reported. A higher score means greater exercise role identity.
Intrinsic Regulation	Change from 0 to 12 weeks	Self-reported intrinsic regulation on a scale from 0 (least motivated) to 4 (most motivated) using the Behavioral Regulation in Exercise Questionnaire - 3. Reported here are results from the intrinsic regulation subscale. Higher results on the scale indicate greater intrinsic regulation.
Integrated Regulation	Change from 0 to 12 weeks	Self-reported integrated regulation on a scale from 0 (least motivated) to 4 (most motivated) using the Behavioral Regulation in Exercise Questionnaire - 3. Here, results from the integrated regulation subscale are reported. Higher numbers on the scale indicate greater integrated regulation.
Basic Psychological Needs: Autonomy	Change from 0 to 12 weeks	Self-reported fulfillment of basic psychological needs on a scale from 1 (least fulfilled) to 5 (most fulfilled) using the Basic Psychological Needs in Exercise Questionnaire. The three subscales are perceived autonomy, competence, and relatedness. Here, autonomy is reported. A higher score means greater perceived autonomy.
Basic Psychological Needs: Relatedness	0 to 12 weeks	Self-reported fulfillment of basic psychological needs on a scale from 1 (least fulfilled) to 5 (most fulfilled) using the Basic Psychological Needs in Exercise Questionnaire. The three subscales are perceived autonomy, competence, and relatedness. Here, relatedness is reported. A higher score means greater perceived relatedness.
Quality of Life (Physical, Social, Emotional, Functional, and Breast Cancer-specific)	Change from 0 to 12 weeks	Self-reported quality of life on a scale from 0 (not at all) to 4 (very much) using the Functional Assessment of Cancer Therapy - Breast measure. Reported here is the change in total score for the entire measure (with the total ranging from 0-123). Better quality of life is indicated by a lower score.
Importance of Valued Domains	Change from 0 to 12 weeks	Self-reported importance of family, intimate relationships, friends, work, health, and growth values domains on a scale from 0 (not at all important) to 5 (extremely important) using the Chronic Pain Values Inventory. Reported here is the change in total across all domains, which is an average of the individual items (range: 0-5). A higher score indicates stronger endorsement of importance of the valued domains.
Engaged Living	Change from 0 to 12 weeks	Self-reported perception of living in accordance with one's values on a scale from 1 (completely disagree) to 5 (completely agree) using the Engaged Living Scale. The two subscales are valued living and life fulfillment. Reported here is the change in total results for the scale (which ranges from 16-80). Higher scores on this scale indicate higher levels of engaged living.
Success in Living According to Valued Domains	Change from 0 to 12 weeks	Self-reported success in living according to values related to family, intimate relations, friends, work, health, and growth on a scale from 0 (not at all successful) to 5 (extremely successful) using the Chronic Pain Values Inventory. Reported here is the change in total across all domains, as an average across items (range: 0-5). A higher score indicates stronger endorsement of success in the valued domains.