# Feasibility and Acceptability of a Mobile App to Improve Quality of Life of Long-Term Breast Cancer Survivors: Single-Arm Pre-Post Intervention Pilot Study

## TL;DR

A mobile app called CUMACA-M was tested for improving quality of life in long-term breast cancer survivors, showing good usability but no significant improvements in quality of life or self-efficacy.

## Contribution

This is the first study to evaluate the feasibility and acceptability of a mobile app for long-term breast cancer survivors.

## Key findings

- The app had excellent usability with a 100% retention rate among participants.
- No significant improvements in overall quality of life or self-efficacy were observed.
- A reduction in spiritual well-being was noted, but it was statistically significant.

## Abstract

Long-term breast cancer survivors often continue to experience physical and psychological sequelae, despite being cancer-free; these challenges can negatively impact their quality of life and self-efficacy. Mobile health interventions constitute a promising strategy for providing personalized support. However, the feasibility and acceptability of these tools in long-term breast cancer survivors have not yet been sufficiently explored.

This study aimed to evaluate the feasibility and acceptability of the CUMACA-M, a digital health app designed to improve the quality of life and self-efficacy in long-term breast cancer survivors.

A single-arm feasibility pilot study was conducted with pre- and post-intervention evaluations. Participants were recruited from the Navarra Breast Cancer Association (Saray), a nonprofit organization supporting individuals with breast cancer in Navarra, Spain. The inclusion criteria included being female, being aged ≥18 years, having been diagnosed with breast cancer, and being disease-free for at least 5 years after primary treatment. The participants used the CUMACA-M app for 3 months. Feasibility was assessed through recruitment and completion rates, whereas acceptability was measured using the System Usability Scale and open-ended qualitative questions. Changes in quality of life and self-efficacy were analyzed with the Quality of Life-Cancer Survivors (QOL-CS) scale and the Self-Efficacy to Manage Chronic Disease Scale. Paired t tests were performed for pre-post comparisons.

A total of 23 women (mean age =52.8, SD 6.1 years) participated, with a 100% retention rate. The System Usability Scale score (mean 80.8, SD 15.2) indicated excellent usability. The health advice module received the highest level of satisfaction, whereas the nutrition and physical activity modules received suggestions for improvement. With respect to the clinical outcomes, no statistically significant differences were found between the pre- and post-intervention scores on the QOL-CS (total score: pre=5.96, SD 1.08; post=5.72, SD 1.20; P=.07) or the Self-Efficacy to Manage Chronic Disease Scale (total score: pre=6.57, SD 1.90; post=6.26, SD 1.82; P=.40). However, a reduction was observed in the QOL-CS spiritual well-being subscale (pre=5.35, SD 1.13; post=4.93, SD 1.22; P=.05).

As a pioneering digital intervention for long-term breast cancer survivors, CUMACA-M appears to be a potentially viable and acceptable intervention for this population, as suggested by the high level of usability and absence of dropouts. However, the findings should be interpreted with caution because of the limited sample size and the short follow-up period. The lack of significant changes in quality of life or self-efficacy may be influenced by these constraints. Future studies with larger, more diverse samples and longer follow-up periods are needed to more robustly assess the long-term impact of this intervention.