Protocol: A cluster randomized controlled trial of a mobile application to support physical activity maintenance after an exercise oncology program

Objectives/purpose: Increasing physical activity (PA) among adults living with cancer is a public health priority, especially for those in remote/rural locations who have worse health outcomes and lower PA than urban populations. Mobile health technology may overcome barriers to PA participation and change PA behavior. However, few mobile health interventions have focused on sustaining PA long-term in remote/rural adults living with cancer. The present study will examine the effectiveness of a mobile health application to promote PA maintenance in remote/rural adults after completing an exercise oncology program. Methods: The 24-week prospective 2-arm pilot randomized controlled trial will be embedded within an exercise oncology program in in remote/rural Canada. Participants will be randomized by class cluster 1:1 to the intervention or EXCEL only control group. Both groups will participate in a supervised 12-week group-based exercise oncology program, followed by a 12-week PA maintenance period. The intervention group will use a mobile health application, Zamplo, to complete regular health check-ins and reflections via graphs for 24 weeks. Data will be collected at baseline, 4, 12, 24 weeks using surveys, activity tracking, and semi-structured interviews. Analyses will assess intervention effectiveness to promote PA maintenance and examine participant perspectives and use of Zamplo to support PA. Significance: The present study will generate new knowledge on the potential of an mHealth app to promote PA maintenance in remote/rural adults living with cancer. It will inform the integration of mobile health resources within online-delivered exercise oncology programs, leading to sustainable long-term health benefits for this population.