Examining the Use of Online Social Networking to Improve Physical Activity Behaviors among Young Adult Cancer Survivors

eHealth interventions have the potential to reach young adult cancer survivors, who are increasingly turning to the Internet and social networking sites (SNS) for health information and support. The overall goal of this research project was to assess whether an existing SNS is an effective channel to deliver a physical activity (PA) intervention to young adult cancer survivors. Aim 1 examined distinct subgroups of young adults (n=1619, 18-39y) that vary in their likelihood of not meeting PA recommendations using signal detection analysis of data from the Health Information National Trends Survey 2007. Predictors of not meeting PA guidelines were general health, body mass index, perceived cancer risk, health-related Internet use, and trust in information sources. The purpose of Aim 2 was to evaluate the feasibility and efficacy of a 12-week, Internet-delivered intervention aimed at increasing moderate-intensity PA compared to a self-help comparison condition among young adult cancer survivors. Both interventions utilized Facebook as a means to promote social interaction. From baseline to 12 weeks, participants (n=86) in both groups increased self-reported weekly minutes of moderate-to-vigorous PA (intervention: 67.0 min/week, p=0.009 vs. comparison: 46.3 min/week, p=0.045), with no significant differences between groups. Intervention group participants had a significantly greater increase in mild PA (intervention: 163.6 min/week vs. comparison: 28.5 min/week; p=0.032 between groups) and reported significant weight loss over time (-2.1 kg, p=0.004), which was marginally significant between groups (p=0.083). Aim 3 examined the effects of the intervention on psychosocial factors (self-efficacy, social support, self-monitoring) and determined whether these factors mediated the relationship between the intervention and PA. The intervention group reported lower self-efficacy for sticking to exercise (mean change=-0.38; p=0.025 between groups) and social support from friends on SNS (mean change=-0.47; p=0.039 between groups) relative to the comparison group over time. Among all participants, social support from friends and self-monitoring were positively associated with changes in moderate-to-vigorous PA. The proposed psychosocial mediators did not explain the positive effect of the intervention on mild PA. Results of this dissertation project suggest that SNS intervention approaches may be an effective way to promote mild PA in young adult cancer survivors.Doctor of Philosoph

Engagement of young adult cancer survivors within a Facebook-based physical activity intervention

Few studies have examined how young adult cancer survivors use online social media. The objective of this study was to characterize Facebook engagement by young adult cancer survivors in the context of a physical activity (PA) intervention program. Young adult cancer survivors participated in one of two Facebook groups as part of a 12-week randomized trial of a PA intervention (FITNET) compared to a self-help comparison (SC) condition. A moderator actively prompted group discussions in the FITNET Facebook group, while social interaction was unprompted in the SC group. We examined factors related to engagement, differences in engagement by group format and types of Facebook posts, and the relationship between Facebook engagement and PA outcomes. There were no group differences in the number of Facebook comments posted over 12 weeks (FITNET, 153 vs. SC, 188 p = 0.85) or the proportion of participants that reported engaging within Facebook group discussions at least 1-2 days/week. The proportion of participants that made any posts decreased over time in both groups. SC participants were more likely than FITNET participants to agree that group discussions caused them to become physically active (p = 0.040) and that group members were supportive (p = 0.028). Participant-initiated posts elicited significantly more comments and likes than moderator-initiated posts. Responses posted on Facebook were significantly associated with light PA at 12 weeks (β = 11.77, t(85) = 1.996, p = 0.049) across groups. Engagement within Facebook groups was variable and may be associated with PA among young adult cancer survivors. Future research should explore how to promote sustained engagement in online social networks. ClinicalTrials.gov identifier: NCT01349153

Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: a randomized controlled pilot study

This study evaluated the feasibility and preliminary efficacy of two 6-month, self-regulation interventions that focused on daily self-weighing (DSW), and used objective monitoring and tailored feedback about weight (±activity), to prevent weight gain among African American breast cancer survivors

Nature-Based Solutions through Blue-Green Infrastructure as Measure of Adaptation, Resilience and Liveability to Climate Change: Case Study City Lab Saltillo, Mexico

The impacts of the current urbanization and climate change challenges are well documented, as well as, the role of cities and the urgent action that needs to take place at the local level, especially in small and middle-sized cities. As extreme climatic events unfold, there is a need to identify the potential and the strategies that can help municipalities steer urban planning on a more sustainable and resilient track to reach the global climate goals within the next decade. Now more than ever, Nature-based solutions (NbS) such as Blue-green infrastructure(BGI) are proving to be a feasible alternative for cities to adapt their urban environment in response to climate change, while simultaneously obtaining economic, environmental, and social co-benefits. Anticipating climate challenges in cities makes it vital to change today's traditional urban planning into initiatives that consider greener solutions like BGI. However, some implementation barriers such as the lack of stakeholders' involvement to navigate and co-create a more resilient and adaptive city environment, make difficult the transition. As part of the Morgenstadt Global Smart Cities Initiative (MGI), financed by the German Government through the International Climate Initiative (IKI), the city of Saltillo located in the Northeast region of Mexico is paving the path towards sustainable urban planning through the City Lab project. In the first phase, the City Lab consisted of an integrated urban analysis, stakeholder engagement, and the co-creation of a roadmap of solutions by experts and local actors to tackle the city’s urban challenges. The City Lab process allowed anchoring the identified measures in the planning documents of Saltillo, ensuring the implementation of the roadmap in the long term. Simultaneously, it opened up spaces for co-creation and community engagement valuable to understand the city´s local environment and identify its potential. In the second phase of the City Lab, the implementation of a pilot project based on BGI addressed the most pressing problems of the city such as pluvial floods, water scarcity, and depletion of aquifers. In this regard, the stakeholders were actively involved in analyzing, planning, formulating, developing, implementing, testing, evaluating, and maintaining the pilot project to cope with climate impacts and contribute to sustainable urban development in the short, medium and long term. In this paper, special attention will be given to the process of pilot project implementation, showing the efforts that the City Lab Saltillo is undertaking to implement BGI techniques such as rain gardens, infiltration basins, permeable pavement, and vegetation in a public and urban space as an adaptation measure in response to climate change. This effort is reshaping the city's discourse, shifting the role of urban planning, and highlighting climate action as a shared responsibility among the public, private, academic, and civil society

A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors

Over half of young adult cancer survivors do not meet physical activity (PA) guidelines. PA interventions can enhance health and quality of life among young adult cancer survivors. However, few exercise interventions have been designed and tested in this population. This study evaluated the feasibility and preliminary efficacy of a 12-week, Facebook-based intervention (FITNET) aimed at increasing moderate-to-vigorous intensity PA compared to a Facebook-based self-help comparison (SC) condition

Exploring Mediators of Physical Activity in Young Adult Cancer Survivors: Evidence from a Randomized Trial of a Facebook-Based Physical Activity Intervention

Purpose: This study examined the effects of a physical activity (PA) intervention for young adult cancer survivors on changes in self-efficacy, social support, and self-monitoring and determined whether changes in these social cognitive theory constructs mediated the relationship between the intervention and changes in PA

Evaluating the Dissemination of Body & Soul, an Evidence-based Fruit and Vegetable Intake Intervention: Challenges for Dissemination and Implementation Research

To evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve similar results to earlier efficacy and effectiveness trials

Physical Activity in Young Adults: A Signal Detection Analysis of Health Information National Trends Survey (HINTS) 2007 Data

Many young adults are insufficiently active to achieve the health benefits of regular physical activity (PA). We examined distinct subgroups of young adults (18–39y) that vary in their likelihood of not meeting PA recommendations using signal detection analysis of data from the Health Information National Trends Survey 2007. The sample was randomly split and signal detection analysis was conducted on the exploratory half to identify subgroups and interactions among sociodemographic and health communication variables that predicted engaging in <150 weekly minutes of moderate-intensity PA (low PA). Rates of low PA among subgroups were compared with similarly defined subgroups in the validation sample. Overall, 62% were not meeting PA recommendations. Among eight subgroups identified, low PA rates ranged from 31%-90%. Predictors of low PA were general health, BMI, perceived cancer risk, health-related Internet use, and trust in information sources. The least active subgroup (90% low PA) included young adults in poor to good health with a BMI≥30.8 (obese). The most active subgroup (31% low PA) comprised those in very good to excellent health, who used a website to help with diet, weight or PA, and had no to little trust in health information on television. Findings suggest potential intervention communication channels and can inform targeted PA interventions for young adults

Pilot weight control intervention among US veterans to promote diets high in fruits and vegetables

Obesity is a significant problem among US veterans. Diets high in fruits and vegetables (FV) can lower obesity risk. Health communication interventions are promising strategies for promoting healthy eating. We evaluated whether an enhanced intervention with tailored newsletters and motivational interviewing calls would be more effective than the Veterans Affairs (VA) weight management program, MOVE!, at increasing FV intake among overweight/obese veterans

Social Media Use for Cancer Support Among Young Adults with Cancer

Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18–39, with any diagnosis ages 15–39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%–60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health