Perspectives on Messaging-Based Interventions for Improving Sleep and Physical Activity among Breast Cancer Survivors: Insights from Focus Group and Individual Interviews (Preprint)

BACKGROUND Sleep disturbances and low physical activity are common among breast cancer (BC) survivors and are associated with increased morbidity and mortality. Given the increased access to technological devices and the growing popularity of conversational agents (CA), such as chatbots, in recent years, these tools have the potential to address both sleep disturbances and low physical activity in scalable and cost-effective manners. To understand and make effective use of these tools, it is important to explore the preferences and needs of BC survivors with sleep disturbances, including how a chatbot could interact on the topics of physical activity and sleep hygiene. OBJECTIVE The objectives of this study were to explore the perspectives and preferences of BC survivors regarding technology-based interventions, especially CA, to address sleep disturbances. METHODS Three focus groups (n=13) and three individual interviews (n=3) were conducted from May 2020 to March 2021 with 16 BC survivors (mean age = 59.3 years) currently experiencing sleep disturbance. The interview questions focused on their experiences with poor sleep and preferences for technology-based interventions. Thematic analysis was applied to the de-identified transcription of audio recordings. RESULTS Three themes were identified: (1) attitudes toward health interventions delivered via messages, (2) specific user needs, and (3) technology usage habits and preferences . Most participants reported a positive attitude toward the possibility of using technology to help improve their sleep and increase their physical activity, and endorsed a high level of acceptance toward some technologies, such as text messages and mobile applications, but not others, such as voice interactions. In terms of desired features, reminders and accountability features, such as meeting physical activity goals, were mentioned most frequently. In addition, incorporating bedtime and relaxation exercise reminders were thought to be helpful. Regarding time and frequency, a daily reminder and an hour before bedtime was found to be acceptable. CONCLUSIONS The insights will be used to guide the development of a tool for improving sleep and physical activity in BC survivors. Future research will focus on developing an intervention addressing these health behaviors and validating its acceptability.