Mobile Technology Development and Dissemination at CTxCARES Deborah Vollmer Dahlke, MPAff Yan Hong, PhD October 16, 2012 This presentation was supported by Cooperative Agreement Number 1U48 DP from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Apps for Persuasive Mobile Health Behavior Change Applying Theories of Reasoned Action and Planned Behavior in Health Communication Communication/Dissemination of research findings for physical activity, diet and nutrition, and survivorship planning for cancer survivors Use of PROS in App assessment (Diet, PA, Smoking, Alcohol, QOL) Apps offer tailored interventional communication with resource locators, assessments, kudos, and tips Apps taking advantage of technology convergence of web, mobile, and social media

iPhone & Mobile-Enabled Website (

AYA App Collaborators CTXCARES – CDC funded project at TX A&M School for Rural Public Health ACCESS AYA – Seton’s Cancer Prevention & Research Institute of Texas grant CureSearch for Children’s Cancer Children’s Oncology Group

Icon Screen: App Functions Intro & Help Screening & Late Effects Tips & Tools Survivorship plan Community (Facebook)

Screenings & Children’s Oncology Group Late Effects AYA survivor screening guidelines Children’s Oncology Group “Health Links”

AYA Health & Well Being Assessment

Tips and Kudos Mobile persuasion uses tips & kudos to sand reinforce health behavior changes –Cancer Screenings –Diet –Physical Activity –Well being

Easy to use survey templates for Survivorship Plans

Adoption and Use of AYA APP AYA User Adoption Trends

Lessons Learned & Next Steps Apps take care and feeding… iPhone app card works for communication/dissemination about app (print media still works) Re-launch of AYA at Critical Mass AYA Meeting 11’12 Planned Research Study to assess adoption, use and HRQOL related to app and survivorship plans Expansion of mobile web site for English/Spanish Adult Survivorship App and survivorship plans

What is ? ICANFIT is a mobile- enabled web application designed for older cancer survivors promotes physical activity and access to community resources

ICANFIT Features One of the first mobile application for older cancer survivors (OCS) Addresses known cancer risk factors (lack of physical activity) using best practices for behavior change:  Locates places and programs for physical activity (PA) based on zip code or address.  Allows users to set personal goals and track progress.  Offers engagement in social networks to promote PA  Locator allows users to seek, map and rate senior-friendly resources

ICANFIT Research Formative phase: Cancer survivors and cancer care providers provide input for ICANFIT design CTxCARES research team incorporate best practices for behavior change—e.g., goal setting and tracking Development phase: Design the application based on formative data. Test phase: two-hundred cancer survivors age 50+ will test and provide feedback

Formative Phase: July July 2012 Mixed method approach: –Group discussions with community leaders –Interviews with cancer care providers, surgeons, oncologists, family physicians, health educators, and counselors (n=14) –Individual Interviews with older cancer survivors (n=11) –Survey of older cancer survivors with mean age of 62 (n=92)

Formative Phase: Findings Most of the Older Cancer Survivors (OCS) were comfortable with accessing the internet. Internet is a major source of information, especially health-related information. Most OCS were willing to participate in an online cancer survivorship and health promotion program. Care providers identified lack of motivation among OCS as the major barrier to regular physical activity. OCS identified both personal (e.g., too tired, not necessary) and environmental factors (no appropriate places close by) as barriers.

Formative Phase: Findings OCS personal and structural barriers to regular physical activity:  Lack of awareness of benefits of physical activity  Limited access to information on local physical activity resources  Inadequate social support  Lack of knowledge and support to adhere to regular physical activity plan

Formative Phase: Conclusions and Next Steps Growing population of OCS creates strong need for cost effective health promotion programs. Online access is common in older adults and mobile use is accelerating. Currently testing whether ICANFIT behavior change features will reduce OCS’ barriers to regular physical activity and ultimately improve health and quality of life. Based on pilot data, ICANFIT will be tested in a in a larger implementation and dissemination study.