Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study

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Abstract

Background

The majority of breast cancer survivors do not meet recommendations in terms of diet and physical activity. To address this problem, we developed a mobile health (mHealth) app for assessing and monitoring healthy lifestyles in breast cancer survivors, called the Energy Balance on Cancer (BENECA) mHealth system. The BENECA mHealth system is a novel and interactive mHealth app, which allows breast cancer survivors to engage themselves in their energy balance monitoring. BENECA was designed to facilitate adherence to healthy lifestyles in an easy and intuitive way.

Objective

The objective of the study was to assess the concurrent validity and test-retest reliability between the BENECA mHealth system and the gold standard assessment methods for diet and physical activity.

Methods

A reliability study was conducted with 20 breast cancer survivors. In the study, tri-axial accelerometers (ActiGraphGT3X+) were used as gold standard for 8 consecutive days, in addition to 2, 24-hour dietary recalls, 4 dietary records, and sociodemographic questionnaires. Two-way random effect intraclass correlation coefficients, a linear regression-analysis, and a Passing-Bablok regression were calculated.

Results

The reliability estimates were very high for all variables (alpha≥.90). The lowest reliability was found in fruit and vegetable intakes (alpha=.94). The reliability between the accelerometer and the dietary assessment instruments against the BENECA system was very high (intraclass correlation coefficient=.90). We found a mean match rate of 93.51% between instruments and a mean phantom rate of 3.35%. The Passing-Bablok regression analysis did not show considerable bias in fat percentage, portions of fruits and vegetables, or minutes of moderate to vigorous physical activity.

Conclusions

The BENECA mHealth app could be a new tool to measure energy balance in breast cancer survivors in a reliable and simple way. Our results support the use of this technology to not only to encourage changes in breast cancer survivors' lifestyles, but also to remotely monitor energy balance.

Trial Registration

ClinicalTrials.gov NCT02817724; https://clinicaltrials.gov/ct2/show/NCT02817724 (Archived by WebCite at http://www.webcitation.org/6xVY1buCc)

Related collections

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Author and article information

Contributors

Manuel Arroyo-Morales:

Department of Physical TherapyUniversity of GranadaAvenida de la Ilustración, 60Granada, 18016Spain34 958248765marroyo@ugr.es

ORCID: http://orcid.org/0000-0003-3552-8051

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: March 2018

Publication date (Electronic): 27 March 2018

Volume: 6

Issue: 3

Electronic Location Identifier: e67

Affiliations

[1] ¹ Department of Physical Therapy University of Granada Granada Spain

[2] ² Centro de Investigación Deporte y Salud University of Granada Granada Spain

[3] ³ Instituto de Investigación Biosanitaria ibs-Granada Complejo Hospitalario Universitario de Granada University of Granada Granada Spain

Author notes

Corresponding Author: Manuel Arroyo-Morales marroyo@ 123456ugr.es

Author information

Mario Lozano-Lozano http://orcid.org/0000-0001-5854-3567

Noelia Galiano-Castillo http://orcid.org/0000-0002-6825-4213

Lydia Martín-Martín http://orcid.org/0000-0003-4117-8262

Nicolás Pace-Bedetti http://orcid.org/0000-0002-7266-4127

Carolina Fernández-Lao http://orcid.org/0000-0002-9392-1532

Manuel Arroyo-Morales http://orcid.org/0000-0003-3552-8051

Irene Cantarero-Villanueva http://orcid.org/0000-0002-3834-1711

Article

Publisher ID: v6i3e67

DOI: 10.2196/mhealth.9669

PMC ID: 5893887

PubMed ID: 29588273

SO-VID: 308cb748-7650-4861-a662-7d9ae815d008

Copyright © ©Mario Lozano-Lozano, Noelia Galiano-Castillo, Lydia Martín-Martín, Nicolás Pace-Bedetti, Carolina Fernández-Lao, Manuel Arroyo-Morales, Irene Cantarero-Villanueva. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 27.03.2018.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 16 December 2017

Date revision requested : 17 January 2018

Date revision received : 25 January 2018

Date accepted : 26 January 2018

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