尽管有利于癌症患者的身体活动（PA），但大多数人仍活动不足。运动肿瘤学干预可以改善PA水平。由于持续存在的心理和环境PA障碍，个体在干预后难以维持PA水平。健康技术（eHealth）可能可以解决一些PA障碍，并提供有效且可扩展的肿瘤学PA干预措施，但其改变PA水平的效果存在差异。在农村癌症患者中利用eHealth支持PA维持尚未得到充分研究，而这些患者可能需要更大的PA支持，因为他们的PA水平较低且健康状况更差。本研究旨在考察一个基于应用程序的自我监测干预措施在辅助农村癌症患者在接受网络辅助运动肿瘤计划后维持PA方面的效果。本随机对照试验嵌入在“运动用于癌症促进健康”（EXCEL）效果实施研究中。接受同意后，参与者按EXCEL类别簇进行1:1随机分组，分为干预组（24周的应用程序自我监测PA）和等待名单对照组（24周后获得应用程序访问权）。两组完成了为期12周的网络辅助运动肿瘤计划，然后进行了为期12周的自我引导式PA维持期。使用卡方检验和双尾t检验比较基线人口统计学、eHealth素养和患者报告结果。通过干预期间对应用程序使用情况进行测量。主要结果-自我报告的中等至剧烈PA（MVPA）分钟-与次要结果-客观MVPA分钟和步数以及应用程序可用性评级-在基线、12周和24周收集。采用线性混合建模评估干预措施对自我报告MVPA维持的影响，并通过描述性研究探索次要结果。在359个有资格参与EXCEL的人员中，有205人（57.1%）同意参加，199人（55.4%；干预组：106/199，53.3%；对照组：93/199，46.7%）开始参加研究，183人（51%；干预组：100/183，54.6%；对照组：83/183，45.4%）和141人（39.3%；干预组：69/141，48.9%；对照组：72/141，51.1%）分别完成了为期12周和24周的测量。平均年龄为57.3（SD 11.5）岁。大多数参与者为女性（174/199，87.4%），白人（163/199，81.9%）和被诊断为乳腺癌（108/199，54.3%）。干预组和等待名单对照组的基线自我报告每周MVPA分钟分别为60.0（IQR 0-180）和40.0（IQR 0-135），差异无统计学意义（P=.74）。使用应用程序的中位数使用持续时间为10.3（IQR 1.3-23.9）周，每周进行9.6（IQR 4.4-17.8）次自我监测。两组在12周时的每周MVPA分钟增加显著（P<.001），并在24周时保持增加（P<.001），与基线相比没有组间差异（P=.87）。干预组在PA维持期间有7周步数显著高于对照组（P=.048 to .001）。基于应用程序的自我监测干预措施并没有改善MVPA的维持，但可能在PA维持期间有助于增加步数。还需进一步研究以实现eHealth在运动肿瘤学中的全部潜力。ClinicalTrials.gov NCT04790578；https://clinicaltrials.gov/study/NCT04790578.原始发表于JMIR Cancer（https://cancer.jmir.org），2023年9月7日。

Despite the benefits of physical activity (PA) for individuals with cancer, most remain insufficiently active. Exercise oncology interventions can improve PA levels. Individuals struggle to maintain PA levels after interventions because of persistent psychological and environmental PA barriers. Health technology (eHealth) may address some PA barriers and deliver effective, scalable PA interventions in oncology, yet its effectiveness for changing PA levels remains mixed. Using eHealth to support PA maintenance among rural populations with cancer, who may need greater PA support given lower PA levels and worse health outcomes, remains under-studied.This study examined the effectiveness of an app-based self-monitoring intervention in supporting PA maintenance among rural populations with cancer after a supervised web-based exercise oncology program.This 2-arm, cluster randomized controlled trial was embedded within the Exercise for Cancer to Enhance Living Well (EXCEL) effectiveness-implementation study. Upon consent, participants were randomized 1:1 by EXCEL class clusters to the intervention (24 weeks of app-based PA self-monitoring) or waitlist control (app access after 24 weeks). Both groups completed a 12-week supervised web-based exercise oncology program followed by a 12-week self-directed PA maintenance period. Baseline demographics, eHealth literacy, and patient-reported outcomes were compared using chi-square and 2-tailed t tests. App use was measured throughout the intervention. The primary outcome-self-reported moderate-to-vigorous PA (MVPA) minutes-and secondary outcomes-objective MVPA minutes and steps and app usability ratings-were collected at baseline, 12 weeks, and 24 weeks. Intervention effects on self-report MVPA maintenance were assessed via linear mixed modeling, with secondary outcomes explored descriptively.Of the 359 eligible EXCEL participants, 205 (57.1%) consented, 199 (55.4%; intervention: 106/199, 53.3%; control: 93/199, 46.7%) started the study, and 183 (51%; intervention: 100/183, 54.6%; control: 83/183, 45.4%) and 141 (39.3%; intervention: 69/141, 48.9%; control: 72/141, 51.1%) completed 12- and 24-week measures, respectively. Mean age was 57.3 (SD 11.5) years. Most participants were female (174/199, 87.4%), White (163/199, 81.9%), and diagnosed with breast cancer (108/199, 54.3%). Median baseline self-report weekly MVPA minutes were 60.0 (IQR 0-180) and 40.0 (IQR 0-135) for the intervention and waitlist control groups, respectively (P=.74). Median app use duration was 10.3 (IQR 1.3-23.9) weeks, with 9.6 (IQR 4.4-17.8) self-monitoring entries/week. Both groups increased their weekly MVPA minutes significantly at 12 weeks (P<.001) and maintained the increases at 24 weeks (P<.001), relative to baseline, with no between-group differences (P=.87). The intervention group had significantly higher step counts for 7 of the 12 weeks during the PA maintenance period (P=.048 to <.001).The app-based self-monitoring intervention did not improve MVPA maintenance but may have contributed to increased step counts during the PA maintenance period. More work is needed to realize the full potential of eHealth in exercise oncology.ClinicalTrials.gov NCT04790578; https://clinicaltrials.gov/study/NCT04790578.RR2-10.1016/j.cct.2021.106474.©Manuel Ester, Chad W Wagoner, Julianna Dreger, Guanmin Chen, Meghan H McDonough, Margaret L McNeely, S Nicole Culos-Reed. Originally published in JMIR Cancer (https://cancer.jmir.org), 07.09.2023.