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).
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Research-Tested Mobile Apps for Breast Cancer Care: Systematic Review
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- Authors
- Lozano-Lozano, M., Galiano-Castillo, N., Martín-Martín, L., Pace-Bedetti, N., Fernández-Lao, C., Arroyo-Morales, M., & Cantarero-Villanueva, I.
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2018-03-27
- Volume
- 6
- Issue
- 3
- Pages
- e67
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5893887
- OpenAlex
- W2795198366
- Cited by
- 37
- References
- 45
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2022: 13 · 2021: 6 · 2020: 2 · 2019: 6 · 2018: 1
- FWCI
- 5.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministerio de Economía y Competitividad (PI14/)
- Universidad de Granada
- Instituto de Salud Carlos III (PI14/, 2013-2016, PI14/01627)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- breast cancer survivors, energy balance, mobile health apps, test-retest reliability, concurrent validity, physical activity monitoring, accelerometer, dietary assessment, healthy lifestyle adherence, remote patient monitoring, fruit and vegetable intake
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