Studies have shown that most breast cancer survivors who do not die of their cancer may die from other conditions, such as heart disease, that could be managed through lifestyle changes or screening.
In 2006, the National Academy of Medicine recommended that every cancer patient receive an individualized survivorship care plan after treatment ends that includes guidelines for monitoring and maintaining their health. While some experts question whether this strategy is effective, others are concerned about reaching the most vulnerable survivors, such as those who live in rural areas.
Researchers from the University of Washington School of Public Health say, ‘There’s an app for that.’
Researchers developed and successfully pilot-tested a mobile application, most commonly referred to as an app, called SmartSurvivor, which incorporated components of a survivorship care plan into a mobile interface. The app met survivorship care objectives and the needs of both breast cancer survivors and their health care providers.
To design the app, researchers worked with a graphic designer to mock up a paper prototype and build out the steps to navigate through survivorship care plan components. Researchers then used a rapid prototyping tool to generate a downloadable mobile app and HTML website which created a functional prototype with the look and feel of the actual app. For testing, the final prototype was uploaded on a smartphone and the HTML version was loaded onto a laptop on a website.
Breast cancer survivors, primary care providers and an oncologist were recruited to test the mobile app. Survivors ranged between two months and five years post-treatment and lived in an urban area. All primary care providers had prior experience working in rural settings in which they saw breast cancer patients for ongoing care.
Using a feasibility and usability approach, survivors and providers were asked about the app features, utility, resources and overall ease of use. They were also asked to talk aloud about their interactive experience while navigating through the screens. Additionally, providers were asked to comment on how the app might integrate with their care delivery strategies.
“It was poignant to hear a patient say that if she had a tool like this, she could show her doctor something concrete, such as a graph showing day-to-day change in fatigue, rather than just say she was really tired,” said Ms. Debra Revere, a research scientist and clinical instructor in the department of health services, who designed and led the usability sessions.
Overall, both survivors and providers were positive about the value of using SmartSurvivor to support survivorship care objectives. They also thought it would be easy to use and viewed the app as a way to make care planning more accessible and useful.
“Providers were excited about having a tool like this to help them make decisions, particularly for rural patients who would have to drive 250 miles to see a specialist,” Ms. Revere added. “We could see that developing this app could be truly useful and make a difference in survivorship care.”
Six primary themes emerged from the analysis, published Sept. 26 in the Journal of Medical Internet Research—Cancer, including the following findings:
“Those living in rural areas experience unique challenges in their survivorship care,” the researchers wrote. “Although mobile health technologies have the potential to mitigate some of those challenges, the unique needs of rural survivors identified in this study, such as health literacy levels, need to be addressed in building an mHealth app for this population.”
The study team is led by Dr. Janet Baseman, associate chair and associate professor in the department of epidemiology, and includes Dr. Laura-Mae Baldwin, professor of family medicine at Washington.
“We believe that this pilot study establishes the foundation for future work on SmartSurvivor that will include a larger sample of rural survivors and providers to explore efficacy,” the researchers wrote. A proposal is in process to conduct a randomized trial to explore the utility of SmartSurvivor further.