Usability, Acceptability, and Safety Analysis of a Computer-Tailored Web-Based Exercise Intervention (ExerciseGuide) for Individuals With Metastatic Prostate Cancer: Multi-Methods Laboratory-Based Study

Holly El Evans; Cynthia C Forbes; Daniel A Galvão; Corneel Vandelanotte; Robert U Newton; Gary Wittert; Suzanne Chambers; Andrew D Vincent; Ganessan Kichenadasse; Danielle Girard; Nicholas Brook; Camille E Short

doi:10.2196/28370

Usability, Acceptability, and Safety Analysis of a Computer-Tailored Web-Based Exercise Intervention (ExerciseGuide) for Individuals With Metastatic Prostate Cancer: Multi-Methods Laboratory-Based Study

JMIR Cancer. 2021 Jul 28;7(3):e28370. doi: 10.2196/28370.

Authors

Affiliations

¹ Freemasons Centre for Male Health & Wellbeing, School of Medicine, University of Adelaide, Adelaide, Australia.
² Wolfson Palliative Care Research Centre, Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, United Kingdom.
³ Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.
⁴ Physical Activity Research Group, Appleton Institute, Central Queensland University, North Rockhampton, Australia.
⁵ School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
⁶ Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
⁷ College of Medicine and Public Health, Flinders Centre for Innovation in Cancer, Bedford Park, Australia.
⁸ Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
⁹ Department of Surgery, School of Medicine, University of Adelaide, Adelaide, Australia.
¹⁰ Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
¹¹ Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia.

^# Contributed equally.

PMID: 34318759
PMCID: PMC8367181
DOI: 10.2196/28370

Abstract

Background: Digital health interventions such as tailored websites are emerging as valuable tools to provide individualized exercise and behavioral change information for individuals diagnosed with cancer.

Objective: The aim of this study is to investigate and iteratively refine the acceptability and usability of a web-based exercise intervention (ExerciseGuide) for men with metastatic prostate cancer and determine how well individuals can replicate the video-based exercise prescription.

Methods: A laboratory-based multi-methods design was used, incorporating questionnaires, think-aloud tests, interviews, and movement screening among 11 men aged 63 to 82 years with metastatic prostate cancer. Overall, 9 participants were undergoing androgen deprivation therapy, and 2 were completing chemotherapy. Data were collected in two waves, with changes made for quality improvement after participant 5.

Results: The intervention's usability score was deemed moderate overall but improved after modifications (from 60, SD 2.9 to 69.6, SD 2.2 out of 100). Overall, the participants found the intervention acceptable, with scores improving from wave 1 (24.2, SD 1.1 out of 30) to wave 2 (26.3, SD 2.1 out of 30). The personalized multimodal exercise prescription and computer-tailored education were seen as valuable. After wave 1, website navigation videos were added, medical terminology was simplified, and a telehealth component was included after expert real-time telehealth support was requested. Wave 2 changes included the added variety for aerobic exercise modes, reduced computer-tailoring question loads, and improved consistency of style and grammar. Finally, the participants could replicate the resistance exercise videos to a satisfactory level as judged by the movement screen; however, additional technique cueing within the videos is recommended to address safety concerns.

Conclusions: The acceptability and usability of ExerciseGuide were deemed satisfactory. Various problems were identified and resolved. Notably, the participants requested the inclusion of personalized expert support through telehealth. The resistance training algorithms were shown to provide appropriate content safely, and the users could replicate the exercise technique unaided to a satisfactory level. This study has optimized the ExerciseGuide intervention for further investigation in this population.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001978257; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001978257.

Keywords: acceptability; behavioral change; computer-tailoring; eHealth; exercise; metastatic prostate cancer; usability.

©Holly EL Evans, Cynthia C Forbes, Daniel A Galvão, Corneel Vandelanotte, Robert U Newton, Gary Wittert, Suzanne Chambers, Andrew D Vincent, Ganessan Kichenadasse, Danielle Girard, Nicholas Brook, Camille E Short. Originally published in JMIR Cancer (https://cancer.jmir.org), 28.07.2021.