Comparing the Effectiveness of a Wearable Activity Tracker in Addition to Counseling and Counseling Only to Reinforce Leisure-Time Physical Activity among Breast Cancer Patients: A Randomized Controlled Trial

SIMPLE SUMMARY: Many interventions have been introduced to promote PA among patients with breast cancer. While patients have become active and their PA levels have improved during interventions, they discontinued their PA and became inactive once the study ended. Recently, interventions that use new technologies, such as wearable activity trackers (WATs) or smartphones, have become popular and replaced traditional face-to-face interventions emphasizing its efficiency. However, the use of wearable devices would not be sufficient for intervening in PA among patients with breast cancer, as each patient has different physical conditions, baseline PA levels, and clinical characteristics requiring individual counseling. Therefore, we conducted a randomized controlled trial to evaluate whether WAT in addition to counseling would reinforce leisure-time PA (LTPA) among patients with breast cancer under radiation therapy (RT) in comparison with counseling only. We found that the counseling with WAT application group had increased LTPAs immediately after the intervention and they were more likely to maintain long-term LTPAs (6 months after the intervention). We also found that patients who did not perform regular PAs before cancer diagnosis had significantly increased step counts (steps/day) compared with those who did perform regular PAs before cancer diagnosis. ABSTRACT: This randomized controlled trial aimed to compare the effectiveness of a wearable activity tracker (WAT) in addition to counseling (WAT+counseling) and counseling only for reinforcing leisure-time physical activity (LTPA) among breast cancer patients during radiotherapy (RT). A total of 152 breast cancer patients who were planning to undergo radiation therapy (RT) after surgery participated in the study. The WAT+counseling group (n = 76) underwent physical activity (PA) self-monitoring using a WAT and participated in counseling. The counseling-only group (n = 76) received telephone counseling once a week during RT and did not receive WAT. The WAT+counseling group had increased relative change in self-reported LTPA (102.8) compared with the counseling-only group (57.8) immediately after RT compared to baseline. Although the relative changes of self-reported LTPA of the WAT+counseling group were higher at three and six months after the end of RT compared to in the counseling-only group, the results were not significant. The mean average daily step count of the WAT+counseling group was 9351.7, which increased to 11,592.2 during RT and 12,240.1 after RT. In the subgroup analysis, patients who did not perform regular PA before cancer diagnosis had significantly increased step counts. This study shows the feasibility of WAT with counseling to reinforce PA among breast cancer patients.