Effectiveness of a Smartphone-Based Self-Management App (BeHealth app) for Women with Breast Cancer: A Randomized Controlled Trial
Abstract
Background: Self-management and health behaviors are essential for improving the quality of life and preventing subsequent complications in patients with breast cancer. To investigate effects of a smartphone-application-based diet and exercise self-management program (BeHealth app) on self-efficacy, health behaviors, and selected cardiometabolic risk factors (body mass index, waist circumference, blood pressure, and fasting glucose) in women with breast cancer.
Methods: A randomized controlled trial was conducted with 49 participants (24 experimental, 25 control) in Seoul between Jan and Feb 2017, assigned using block randomization via Microsoft Excel. They received counseling and underwent a physical examination and blood testing at both trial’s commencement and at a follow-up 12 wk later. The experimental group was given the BeHealth app for setting health goals, keeping a self-diagnosis and health record, and using chat space and health information for 12 wk. Statistical analysis was conducted using SPSS with ANOVA to assess the BeHealth app's effects on self-efficacy, health behaviors, and selected cardiometabolic risk factors over time between and within groups.
Results: The experimental group showed significantly increased levels of vegetable intake(P=.017) and significantly reduced levels of fasting blood glucose(P=.037) compared to the control group, suggesting that the BeHealth app may be effective in reducing cardiovascular disease risk factors.
Conclusion: The BeHealth app could be further developed to have compatibility with medical data and use in hospitals so that it is more appealing to target breast cancer survivors and increase its effectiveness for decreasing cardiometabolic risk factors in breast cancer survivors.
2. Choi JE, Kim Z, Park CS, et al (2023). Breast cancer statistics in Korea, 2019. J Breast Cancer, 26(3):207-220.
3. Lee JA, Yu JH, Song YM (2016). Manage-ment of long-term breast cancer survi-vors in Korea. J Korean Med Assoc, 59(4):266-275.
4. Playdon M, Thomas G, Sanft T, et al (2013). Weight loss intervention for breast can-cer survivors: a systematic review. Curr Breast Cancer Rep, 5(3):222-246.
5. Austin D, Maier RH, Akhter N, et al (2024). Preventing cardiac damage in patients treated for breast cancer and lympho-ma: The PROACT clinical trial. JACC CardioOncol, 6(5):684-696.
6. Alexandre J, Cautela J, Ederhy S, et al (2020). Cardiovascular toxicity related to cancer treatment: A pragmatic approach to the American and European cardio‐oncology guidelines. J Am Heart Assoc, 9(18):e018403.
7. Emaus A, Veierød MB, Tretli S, et al (2010). Metabolic profile, physical activity, and mortality in breast cancer patients. Breast Cancer Res Treat, 121(3):651-660.
8. Healy LA, Ryan AM, Carroll P, et al (2010). Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Clin Oncol (R Coll Radiol), 22(4):281–288.
9. He M, Chen M, Ji Y et al (2024). Effective-ness of smartphone app-based interven-tions after surgery on quality of recovery among cancer patients: a systematic re-view and meta-analysis. Ann Med, 56(1). 2390167
10. Henry NL, Unger JM, Schott AF, et al (2018). Randomized, multicenter, place-bo-controlled clinical trial of duloxetine versus placebo for aromatase Inhibitor–Associated arthralgias in early-stage breast cancer: SWOG S1202. J Clin Oncol, 36(4):326–332.
11. Kim HJ, Kim HS (2020). Effects of a web-based expert support self- management program (WEST) for women with breast cancer: a randomized controlled trial. J Telemed Telecare, 26(7-8):433–442.
12. Schwarzer R, Renner B (2008). Health-specific self-efficacy scales. http://userpage.fu-berlin.de/~health/healself.pdf Ac-cessed 14 Mar 2015.
13. Oh EJ, Joh HK, Lee R, et al (2008). Rela-tions between the dietary habits and components of the metabolic syndrome in premenopausal women. Korean J Fam Med, 29:746–761.
14. Godin G (2011). The Godin-Shephard lei-sure-time physical activity questionnaire. The Health & Fitness Journal of Canada, 4:18–22.
15. McCarroll ML, Armbruster S, Pohle-Krauza RJ, et al (2015). Feasibility of a lifestyle intervention for overweight/obese en-dometrial and breast cancer survivors using an interactive mobile application. Gynecol Oncol, 137(3):508–515.
16. Guntzviller LM, King AJ, Jensen JD, et al (2017). Self-efficacy, health literacy, and nutrition and exercise behaviors in a low-income, Hispanic population. J Im-migr Minor Health, 19(2):489–493.
17. Anderson-Bill ES, Winet RA, Wojcik JR (2011). Social cognitive determinants of nutrition and physical activity among web-health users enrolling in an online intervention: the influence of social support, self-efficacy, outcome expecta-tions, and self-regulation. J Med Internet Res, 13(1):e28.
18. Petrella RJ, Stuckey MI, Shapiro S, et al (2014). Mobile health, exercise and met-abolic risk: a randomized controlled tri-al. BMC Public Health, 14:1082.
19. Akingbesote ND, Owusu D, Liu R, et al (2023). A review of the impact of energy balance on triple-negative breast cancer. J Natl Cancer Inst Monogr, 2023(61):104-124.
20. Arora S, Peters AL, Burner E, et al (2014). Trial to examine text message-based mHealth in emergency department pa-tients with diabetes (TExT-MED): a randomized controlled trial. Ann Emerg Med, 63(6):745–754.e6.
21. Zimbalist AS, Caan BJ, Chen WY, et al (2022). Metabolic abnormalities and sur-vival among patients with non-metastatic breast cancer. BMC Cancer, 22(1):1361.
22. Kim SK, Hwang HR, Lee Y, et al (2023). A systematic review of Korea’s medication management mobile application. Sage Open, 13(3):1-11.
| Files | ||
| Issue | Vol 54 No 11 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Breast cancer Diet Health behavior Mobile application Smartphone | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |



