Work

Behaviorally Designed Gamification and Physical Activity Among Breast and Prostate Cancer Survivors

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND: Black and Hispanic cancer survivors exposed to cardiotoxic therapies are at higher risk for cardiovascular events than non-Hispanic White survivors, attributed to greater cardiovascular risk factors and lower physical activity. OBJECTIVES: This study sought to determine the effect of a remotely delivered and behaviorally designed gamification intervention vs attention control on physical activity in Black and Hispanic cancer survivors with cardiovascular risk factors. METHODS: Between May 2022 and February 2025, Black and Hispanic breast and prostate cancer survivors who had received cardiotoxic cancer therapy and had ≥1 cardiovascular risk factor were enrolled in a randomized clinical trial with a 24-week intervention and 12-week postintervention period. Participants received a wearable device to track daily steps, established a baseline, selected a step goal increase, and were assigned to attention control (n = 76) or gamification (n = 74). The primary outcome was change in mean daily steps from baseline through the intervention period. RESULTS: Mean participant age was 64 years; 81% women, 64% Black, and 35% Hispanic. Gamification arm participants had a greater change from baseline in mean daily steps than control participants during the intervention period (+759; 95% CI: 209-1,309; P = 0.007) and follow-up (+581; 95% CI: -47 to 1,208; P = 0.070), and a greater increase in weekly minutes of moderate-vigorous physical activity during intervention (+16; 95% CI: 4-29; P = 0.010) and follow-up (+11; 95% CI: 0-22; P = 0.048). CONCLUSIONS: Gamification increased physical activity compared with attention control in Black and Hispanic cancer survivors, and represents a scalable intervention to reduce cardiovascular risk in this high-risk population (RCT of Strategies to Augment Physical Activity in Black and Hispanic Breast and Prostate Cancer Survivors [ALLSTAR]; NCT05176756).

Source: JACC CardioOncology

DOI: 10.1016/j.jaccao.2025.10.001