Supporting breast cancer survivors via text messages: reach, acceptability, and utility of EMPOWER-SMS

Anna C Singleton; Rebecca Raeside; Stephanie R Partridge; Justin Tat-Ko; Stephanie Che Mun Sum; Karice K Hyun; Molly Hayes; Clara K Chow; Aravinda Thiagalingam; Katherine Maka; Kerry A Sherman; Elisabeth Elder; Julie Redfern

doi:10.1007/s11764-021-01106-7

Supporting breast cancer survivors via text messages: reach, acceptability, and utility of EMPOWER-SMS

J Cancer Surviv. 2022 Dec;16(6):1165-1175. doi: 10.1007/s11764-021-01106-7. Epub 2021 Sep 9.

Authors

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

3}, Justin Tat-Ko², Stephanie Che Mun Sum², Karice K Hyun^{2

4}, Molly Hayes², Clara K Chow^{5

6

7

8}, Aravinda Thiagalingam^{5

9}, Katherine Maka^{10

11}, Kerry A Sherman⁹, Elisabeth Elder¹⁰, Julie Redfern^{2

6

7}

Affiliations

¹ Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Level 6 Block K Westmead Hospital, Westmead, Sydney, Australia. anna.singleton@sydney.edu.au.
² Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Level 6 Block K Westmead Hospital, Westmead, Sydney, Australia.
³ Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia.
⁴ Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia.
⁵ Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁶ Department of Cardiology, Westmead Hospital, Sydney, Australia.
⁷ George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁸ Research Education Network, Western Sydney Local Health District, Sydney, Australia.
⁹ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
¹⁰ Department of Physiotherapy, Westmead Hospital, PO Box 533, Sydney, Australia.
¹¹ Westmead Breast Cancer Institute, Westmead Hospital, PO Box 143, Westmead, Sydney, Australia.

Abstract

Purpose: This study aims to evaluate the reach, usefulness, acceptability, and factors influencing engagement with a lifestyle-focused text message intervention to support women's mental and physical health after breast cancer treatment.

Methods: This study uses a mixed-methods process evaluation nested in the EMPOWER-SMS randomised controlled trial (n = 160; intervention n = 80, wait-list control n = 80). Data sources included screening logs, text message delivery software analytics, intervention feedback survey, and focus groups (n = 16), which were summarised thematically based on the framework approach.

Results: A total of 387 women met the inclusion criteria (mean_age ± SD = 59.3 ± 11.6 years). Participants who declined (n = 227) were significantly older than those who enrolled (n = 160; 62.2 ± 11.1 vs 55.1 ± 11.1 years, respectively, p < 0.001). Most intervention participants (64/80; 80%) completed the end-of-study survey, reporting the messages were easy to understand (64/64; 100%), useful (58/64; 91%), and motivating (43/64; 67%). The focus groups (n = 16) revealed five factors influencing engagement: (i) feelings of support/continued care, (ii) convenience/flexibility of message delivery, (iii) weblinks, (iv) information from a credible source, and (v) options to save or share messages.

Conclusion: A lifestyle-focused text message program was acceptable and useful for women after breast cancer treatment. However, text messaging may be a barrier for women aged over 68 years. Suggestions for program improvements included delivering the program to patients with other cancers, during all stages of treatment, and including more weblinks in text messages. Implications for Cancer Survivors Text message programs offer a low-cost way to deliver post-treatment health support to breast cancer survivors in a non-invasive way. Text messages can improve patient-health professional communication and were found to be acceptable and useful.

Keywords: Breast cancer survivor; Mobile health; Process evaluation; Supportive care; Text messaging; mHealth.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Breast Neoplasms* / therapy
Cancer Survivors*
Female
Focus Groups
Humans
Life Style
Text Messaging*