Walking Juntos: Developing a Culturally-Tailored Mobile Health and Social Media Physical Activity Intervention Among Latinx Adolescent and Young Adult Childhood Cancer Survivors (Preprint)
Year: 2026
Type: preprint
Abstract: BACKGROUND Hispanic/Latinx childhood cancer survivors are at increased risk of cardiometabolic dysfunction which could be mitigated by physical activity (PA). Although 57% of Hispanic/Latinx adolescent and young adult (AYA) survivors are physically inactive after completion of cancer therapy, culturally tailored PA interventions for this population do not currently exist. OBJECTIVE This study employed an iterative qualitative approach to culturally tailor the StepByStep Study (U01CA246665) into a bilingual, PA intervention for Latinx AYA survivors, in preparation for future testing in a randomized controlled trial. The StepByStep intervention combines a wearable Fitbit PA tracker with personalized goal setting via text message and a private Instagram (IG) group for peer support. METHODS Twenty Latinx AYA survivors were recruited from 10 United States sites representing diverse country of origin heritage to participate in 3 iterative rounds (R1, R2, and R3) of intervention refinement. In R1, participants reviewed recruitment materials and 10 days of IG content, participated in qualitative interviews, and informed initial changes. After incorporating features suggested in R1, R2 tested revised materials and IG content over 7 days to mirror the pace of postings during the intervention. In R3, we evaluated 2 new features suggested in prior rounds: optional video calls and motivational quotes integrated into goal setting. RESULTS Twenty participants (mean age 17.3 years, range 15-20 years; 55% female; 11 preferred English and 9 preferred Spanish) were enrolled. Qualitative data were collected in R1 (n=19), R2 (n=16), and R3 (n=13). All participants completed the baseline demographic survey, received study materials, and joined a private IG group. Feedback informed substantial cultural tailoring of recruitment materials and intervention components as follows: a redesigned study logo and flyer to enhance relatability and inclusivity, bilingual welcome materials, and the integration of motivational quotes into weekly goal setting. The Fitbit was well received and adopted for both intervention and evaluation purposes. IG content was revised to reflect participant preferences, including user-submitted posts, music, and a moderated group chat to foster connection. A participant-chosen PA partner was added based on feedback emphasizing family and social support. CONCLUSIONS Bilingual, iterative participant feedback resulted in a culturally tailored remote mobile health intervention to increase PA in AYA Latinx survivors of childhood cancer. The tailored intervention, “Walking Juntos”, will be investigated in a pilot RCT. CLINICALTRIAL Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT06410209; COG Identifier: ALTE2321.
Authors: Carolina Nieto, Margaret Milton, Nina Kadan-Lottick, Wilhelmenia L. Ross, Yaiomy Santiago-Rivera, Hayleigh Armstrong, Rachel Ceballos, Eric J. Chow, Kirsten K. Ness, Jacqueline Casillas, Rozalyn L. Rodwin, Smita Dandekar, Rusha Bandhari, Wendy M. Leisenring, Willem Collier, Jason A. Mendoza
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7163208046