Randomized Controlled Trial

. 2023 Dec;17(6):1533-1545.

doi: 10.1007/s11764-022-01209-9. Epub 2022 Apr 23.

Supporting women's health outcomes after breast cancer treatment comparing a text message intervention to usual care: the EMPOWER-SMS randomised clinical trial

Anna C Singleton¹, Rebecca Raeside², Stephanie R Partridge^{2

3}, Karice K Hyun^{2

4}, Justin Tat-Ko², Stephanie Che Mun Sum², Molly Hayes², Clara K Chow^{5

6

7

8}, Aravinda Thiagalingam^{5

6

7}, Katherine Maka^{9

10}, Kerry A Sherman¹¹, Elisabeth Elder¹⁰, Julie Redfern^{2

7

8}

Affiliations

¹ Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. anna.singleton@sydney.edu.au.
² Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
³ Prevention Research Collaboration, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
⁴ Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
⁵ Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁶ Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
⁷ George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
⁸ Research Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.
⁹ Department of Physiotherapy, Westmead Hospital, Sydney, NSW, Australia.
¹⁰ Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia.
¹¹ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.

PMID: 35460441
PMCID: PMC9034445
DOI: 10.1007/s11764-022-01209-9

Randomized Controlled Trial

Supporting women's health outcomes after breast cancer treatment comparing a text message intervention to usual care: the EMPOWER-SMS randomised clinical trial

Anna C Singleton et al. J Cancer Surviv. 2023 Dec.

. 2023 Dec;17(6):1533-1545.

doi: 10.1007/s11764-022-01209-9. Epub 2022 Apr 23.

Authors

Affiliations

¹ Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. anna.singleton@sydney.edu.au.
² Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
³ Prevention Research Collaboration, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
⁴ Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
⁵ Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁶ Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
⁷ George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
⁸ Research Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.
⁹ Department of Physiotherapy, Westmead Hospital, Sydney, NSW, Australia.
¹⁰ Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia.
¹¹ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.

PMID: 35460441
PMCID: PMC9034445
DOI: 10.1007/s11764-022-01209-9

Abstract

Purpose: The aim of this study is to evaluate the efficacy, feasibility and acceptability of a co-designed lifestyle-focused text message intervention (EMPOWER-SMS) for breast cancer survivors' self-efficacy, quality of life (QOL), mental (anxiety, depression, stress) and physical (endocrine therapy medication adherence, physical activity, BMI) health.

Methods: Single-blind randomised controlled trial (1:1) comparing EMPOWER-SMS to usual care at 6-months (intention-to-treat).

Setting: public Breast Cancer Institute (Sydney, Australia).

Eligibility criteria: adult (> 18 years) females, < 18-months post-active breast cancer treatment (stage I-III), owned a mobile phone, written informed consent.

Primary outcome: Self-Efficacy for Managing Chronic Disease Scale at 6 months. Process data: message delivery analytics, cost, and post-intervention survey.

Results: Participants (N = 160; mean age ± SD 55.1 ± 11.1 years) were recruited 29th-March-2019 to 7th-May-2020 and randomised (n = 80 EMPOWER-SMS: n = 80 control). Baseline mean self-efficacy was high (I: 7.1 [95%CI 6.6, 7.5], C: 7.4 [7, 7.8]). Six-month follow-up: no significant differences between groups for self-efficacy (I: 7.6 [7.3, 7.9], C: 7.6 [7.3, 7.9], adjusted mean difference 0 (95%CI 0.4, 0.4), QOL, mental health, physical activity, or BMI. Significantly less EMPOWER-SMS participants missed ≥ 1 endocrine therapy medication doses compared to control (I: 3/42[7.1%], C: 8/47[17.0%], Adjusted RR 0.13 [95%CI 0.02, 0.91]). Text messages were delivered successfully (7925/8061, 98.3%), costing $13.62USD/participant. Participants strongly/agreed EMPOWER-SMS was easy-to-understand (64/64; 100%), useful (58/64; 90.6%), motivating for lifestyle change (43/64; 67.2%) and medication adherence (22/46; 47.8%).

Conclusion: EMPOWER-SMS was feasible, inexpensive, acceptable for delivering health information to breast cancer survivors between medical appointments, with minor improvements in medication adherence.

Implications for cancer survivors: Text messages offer a feasible strategy for continuity-of-care between medical appointments.

Keywords: Breast cancer; Cancer survivorship; Mobile health; Randomised controlled trial; Telemedicine; Text messaging.

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Conflict of interest statement

The authors declare no competing interests.

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References

1. Ji P, et al. The burden and trends of breast cancer from 1990 to 2017 at the global, regional, and national levels: results From the Global Burden of Disease Study 2017. Front Oncol. 2020, 10(650). - PMC - PubMed
1. Mols F, et al. Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer. 2005;41(17):2613–2619. doi: 10.1016/j.ejca.2005.05.017. - DOI - PubMed
1. Strecher VJ, et al. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986;13(1):73–92. doi: 10.1177/109019818601300108. - DOI - PubMed
1. de Jongh T, et al. Mobile phone messaging for facilitating self-management of long-term illnesses. Cochrane Database Syst Rev. 2012;12:Cd007459. - PMC - PubMed
1. Grembowski D, et al. Self-efficacy and health behavior among older adults. J Health Soc Behav. 1993;34(2):89–104. doi: 10.2307/2137237. - DOI - PubMed

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Supporting women's health outcomes after breast cancer treatment comparing a text message intervention to usual care: the EMPOWER-SMS randomised clinical trial

Affiliations

Supporting women's health outcomes after breast cancer treatment comparing a text message intervention to usual care: the EMPOWER-SMS randomised clinical trial

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical