Developing and adapting a mobile health exercise intervention for older patients with myeloid neoplasms: A qualitative study

Kah Poh Loh; Chandrika Sanapala; Grace Di Giovanni; Heidi D Klepin; Michelle Janelsins; Rebecca Schnall; Eva Culakova; Paula Vertino; Martha Susiarjo; Jason H Mendler; Jane L Liesveld; Po-Ju Lin; Richard F Dunne; Ian Kleckner; Karen Mustian; Supriya G Mohile

doi:10.1016/j.jgo.2021.02.023

Developing and adapting a mobile health exercise intervention for older patients with myeloid neoplasms: A qualitative study

J Geriatr Oncol. 2021 Jul;12(6):909-914. doi: 10.1016/j.jgo.2021.02.023. Epub 2021 Mar 4.

Authors

Kah Poh Loh¹, Chandrika Sanapala², Grace Di Giovanni³, Heidi D Klepin⁴, Michelle Janelsins⁵, Rebecca Schnall⁶, Eva Culakova⁷, Paula Vertino⁸, Martha Susiarjo⁹, Jason H Mendler¹⁰, Jane L Liesveld¹¹, Po-Ju Lin¹², Richard F Dunne¹³, Ian Kleckner¹⁴, Karen Mustian¹⁵, Supriya G Mohile¹⁶

Affiliations

¹ James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: kahpoh_loh@urmc.rochester.ed.
² James P. Wilmot Cancer Institute, Rochester, NY, USA. Electronic address: chandrika_sanapala@urmc.rochester.edu.
³ James P. Wilmot Cancer Institute, Rochester, NY, USA. Electronic address: grace_digiovanni@urmc.rochester.edu.
⁴ Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston-Salem, NC, USA. Electronic address: hklepin@wakehealth.edu.
⁵ James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: michelle_janelsins@urmc.rochester.edu.
⁶ School of Nursing, Columbia University, New York, NY, USA. Electronic address: rb897@columbia.edu.
⁷ James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: eva_culakova@urmc.rochester.edu.
⁸ James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: paula_vertino@urmc.rochester.edu.
⁹ Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: martha_susiarjo@urmc.rochester.edu.
¹⁰ James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: jason_mendler@urmc.rochester.edu.
¹¹ James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: jane_liesveld@urmc.rochester.edu.
¹² James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: po-ju_lin@urmc.rochester.edu.
¹³ James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: richard_dunne@Urmc.rochester.edu.
¹⁴ James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: ian_kleckner@urmc.rochester.edu.
¹⁵ James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: karen_mustian@urmc.rochester.edu.
¹⁶ James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: supriya_mohile@urmc.rochester.edu.

Abstract

Introduction: Older patients with myeloid neoplasms (MN) receiving outpatient chemotherapy are at risk of experiencing treatment-related toxicities such as functional decline. A mobile health (mHealth) exercise intervention may ameliorate these toxicities. This qualitative study aimed to inform the design of a mHealth exercise intervention for this population.

Methods: This was a qualitative study of thirteen patients aged ≥60 years receiving hypomethylating agents for MN. EXCAP©® is a home-based walking and progressive resistance exercise program. We combined EXCAP©® with a mobile app; the combination (GO-EXCAP Mobile App) has not been previously tested. A brief verbal description about the intervention was provided to the participants but they did not perform it. Participants were interviewed and inductive thematic analysis was used to analyze the data.

Results: Mean age was 71.6 (SD 8.5). Three themes were identified: 1) Perceptions of the intervention feasibility, 2) Ways to leverage the app to deliver the exercise intervention, and 3) Personalized exercise goals. Walking and resistance exercises were perceived to be feasible. Patients were comfortable initiating the intervention in cycle 2 of chemotherapy, with exercise increments occurring from week 2-4 of the cycle. Ways to leverage the app to deliver EXCAP©® include 1) Video feature for exercise demonstration and interactions, and 2) Exercise data and symptom surveys to be communicated to the exercise physiologist and primary oncology team. Preservation of existing function and activity was an important goal to participants.

Conclusions: Our findings provide insights about the preferences of older adults with MN for a mHealth exercise intervention.

Keywords: Exercise intervention; Geriatric hematology; Mobile health; Myeloid neoplasms.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Exercise Therapy
Humans
Mobile Applications*
Neoplasms* / therapy
Qualitative Research
Telemedicine*

Abstract

Publication types

MeSH terms

Grants and funding