Feasibility and acceptability of a remote physical activity intervention coupled with short text messages in women with breast cancer and severe depressive or anxiety symptoms

Background. Physical activity (PA) interventions for women with breast cancer (BC) are extensively documented, but its adherence remains modest and patients with severe psychological distress are often excluded. Consequently, this study aimed to test the feasibility and acceptability of a remote PA intervention coupled with motivational text messages among women with BC experiencing severe depressive and/ or anxiety symptoms. Methods. A three-phase-single-case experimental study design was conducted among 18 women with BC reporting high levels of depressive and anxiety symptoms: A (pre-intervention; 2-week), B (intervention; 12-week), A’ (post-intervention; 2-week). Our intervention was based on the American College of Sport Medicine’s guidelines and behavior change techniques (BCTs) and included 2 to 3 supervised PA session per week, for at least 30 minutes, coupled with 4 to 7 weekly personalized text messages. Feasibility (satisfaction and drop-out rates), acceptability (participation rates, therapeutic alliance and qualitative data), fidelity (quality of BCTs delivered), and the effectiveness of PA level and physical fitness were assessed. Results. Participants expressed high satisfaction and reported an excellent working alliance with their kinesiologist. Notably, there were very high participation rates (90%) and a low dropout rate (11%). However, only 3 patients significantly increased their PA level between Phase A and A’. Conclusion. This study highlighted the importance to personalize and individualize remote PA interventions for women with BC, particularly those self-reporting severe depressive or anxiety symptoms. The combination of a remote PA intervention with daily text messages appears to be very suitable to increase their adherence.