Feasibility and acceptability of intensive longitudinal data collection of activity and patient-reported outcomes during chemotherapy for breast cancer

  • Payton Solk
  • Kara Gavin
  • Jason Fanning
  • Whitney Welch
  • Gillian Lloyd
  • Alison Cottrell
  • Anne Nielsen
  • Cesar A. Santa Maria
  • William Gradishar
  • Seema A. Khan
  • Swati Kulkarni
  • Juned Siddique
  • Siobhan M. PhillipsEmail author



Ecological momentary assessment (EMA) may help us better understand biopsychosocial determinants and outcomes of physical activity during chemotherapy, but may be burdensome for patients. The purpose of this study was to determine the feasibility and acceptability of using EMA to assess activity, symptoms, and motivation among early-stage breast cancer patients undergoing chemotherapy.


Women were instructed to wear an accelerometer 24/7 (hip during day and wrist overnight). Text message prompts were sent 4 times/day concerning patient-reported symptoms and motivational factors for 10 consecutive days (3 days pre-, day of, and 6 days post-chemotherapy dose). These measures occurred at the beginning, middle, and end of a full course of chemotherapy. At study conclusion, participants reported on perceived study acceptability, burden, and reactivity.


Of the 75 women who consented to participate, 63 (84%) completed all 3 assessment time points. Participants responded to 86% of total text prompts and had valid accelerometer data on 82% of study days. Compliance was similar across all time points. The majority (78%) rated their study experience as positive; 100% were confident in their ability to use study technology. Reactivity varied with 27% indicating answering symptom questions did not affect how they felt and 44% and 68% indicated answering questions and wearing the accelerometer, respectively, made them want to increase activity.


Findings indicate EMA methods are feasible for breast cancer patients undergoing chemotherapy. EMA may help us better understand the biopsychosocial processes underlying breast cancer patients’ activity in the context of daily life.


Physical activity Chemotherapy Breast cancer mHealth Patient-reported outcomes 



This research was supported by the Lynn Sage Cancer Research Foundation (Phillips) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Dr. Welch and Dr. Gavin are supported on National Cancer Institute Training Grant aware number T32CA193193 (PI Spring). Dr. Phillips is also supported by the National Cancer Institute (K07CA196840).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of and approved by the Northwestern University IRB (STU00201472) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Payton Solk
    • 1
  • Kara Gavin
    • 1
  • Jason Fanning
    • 2
  • Whitney Welch
    • 1
  • Gillian Lloyd
    • 3
  • Alison Cottrell
    • 1
  • Anne Nielsen
    • 1
  • Cesar A. Santa Maria
    • 4
  • William Gradishar
    • 5
  • Seema A. Khan
    • 5
  • Swati Kulkarni
    • 5
  • Juned Siddique
    • 1
  • Siobhan M. Phillips
    • 1
    Email author
  1. 1.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Department of Internal Medicine, Health and Exercise SciencesWake Forest UniversityWinston-SalemUSA
  3. 3.Department of PsychologyUniversity of Colorado at DenverDenverUSA
  4. 4.Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins UniversityBaltimoreUSA
  5. 5.Department of MedicineNorthwestern University Feinberg School of MedicineChicagoUSA

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