Adapting a smartphone-based rehabilitation programme for older adults living with and beyond cancer: an intervention development study

Project Description

The number of people living with and beyond cancer is growing; many are over 65 years old who often have different and more complicated healthcare needs than younger people.

Being active is one of the best things people with, or who have had, cancer can do to help avoid future cancer. Research shows we could have fewer cancer cases, cancer-related deaths, and healthcare costs if people were more physically active. Regular physical activity, together with healthy eating, helps people maintain their daily activities and improves their energy levels and quality of life.

However, many older adults living with or beyond cancer are inactive with an unhealthy diet. Supervised activity programmes improve health short-term, but less so longer-term, and the pandemic has restricted available support. Recent studies have used technologies like smartphones and wearable devices to deliver unsupervised programmes, but these show smaller benefits.

More research into how lifestyle behaviours can help cancer recovery is urgently needed (a Top 10 Patient Priority (James Lind Alliance)) and remote delivery is being encouraged by the NHS. Our own research and patient and public involvement (PPI) work shows most older adults with cancer would like a personalised wellbeing programme. However, there are obstacles to overcome in such a programme, such as patients not knowing what is safe or having enough feedback from healthcare professionals.

We plan to work with 30 older adults living with and beyond cancer to learn about what is important to them, their daily activities, and their needs and preferences for a personalised smartphone-based wellbeing programme. We want to find out what support and education would encourage them to use such a programme. We will also talk to practitioners to learn their perspective. Insights and suggestions from study participant perspectives will be incorporated into a cancer-specific version of a smartphone-based programme shown to be effective in heart disease rehabilitation. We will then complete user testing with 10 older adults living with and beyond cancer.

We have met with our PPI group members to discuss the importance of our proposed work. They have contributed to the study design, been involved in writing and reviewing the lay summary, and will take part in co-producing the project. Members of the PPI group Involve Hull are working with us on a number of projects and are keen to continue our established working relationship.

At the end of this study, we will have developed a personalised smartphone-based programme for older adults living with and beyond cancer, and completed user testing to understand if it could help this population manage and improve their everyday wellbeing. The programme will then be ready to use in an early clinical trial to look for signs of patient benefit.