Acceptability of online exercise-based interventions after breast cancer surgery: Systematic review and narrative synthesis

Purpose:
eHealth and mHealth approaches are increasingly used to support cancer survivors. This review aimed to examine adherence, acceptability and satisfaction with internet-based self-management programmes for post-surgical cancer rehabilitation and to identify common components of such interventions.
Methods:
Between 1st of November 2018 and 15th of February 2020, nine electronic databases were searched for relevant quantitative and qualitative studies evaluating internet-based cancer rehabilitation interventions. Studies were required to include an exercise or physical activity based self-management intervention and a measure of adherence, acceptability or user satisfaction with the programme. Two independent reviewers performed all data extraction and quality assessment procedures. Data were synthesised using a narrative approach.
Results:
696 potential papers were identified and screened. Eleven met the inclusion criteria. Interventions had wide variations in levels of adherence, but the majority were reported as being acceptable to users. Increased acceptability and user satisfaction were associated with interventions which were seen as time and cost-efficient, requiring acquisition of minimal or no new skills, which used coherent language, or which provided tailored information. The majority contained behaviour change components such as goal setting.
Conclusions:
Despite high levels of heterogeneity between studies, internet-based approaches may be an acceptable method for delivery of self-management interventions in post-surgical cancer rehabilitation.
Implications for Cancer Survivors:
There is a need for further studies exploring factors associated with increased user engagement and usage of digital interventions in cancer rehabilitation settings. These findings should be used to help develop interventions prior to testing their effectiveness in adequately powered randomised controlled trials.