Introduction to focused issue on mHealth and social media interventions for cancer

Rapid advances in mHealth and social media technologies are contributing to a burgeoning number of novel clinical and public health interventions for preventing, controlling, diagnosing, and treating cancer (1,2). Exciting innovations in mHealth and social media applications are occurring across the cancer spectrum, from primary prevention to screening, early diagnosis, treatment, survivorship, and end-of-life care. Additional innovations in technologies are enhancing research data collection and patient recruitment and treatment adherence in oncology trials (2,3). The articles included in this focused issue of the journal highlight many of these important developments and future directions.

As noted by O’Leary et al. (3), mHealth and social media interventions are useful for improving the efficiency and reach of cancer screening interventions through the provision of educational messages and reminders about the importance of routine screening. Cellphone text messaging and smartphone apps for cancer screening, smoking cessation; weight management through caloric restriction, healthy diet and nutrition, and physical activity, and helping app users to avoid carcinogenic exposures at home and in the workplace are all relevant to cancer prevention (4-11). Coughlin et al. (12) discuss the potential for research-tested smartphone apps to provide a low-cost, effective strategy for preventing breast cancer in women. Of particular interest are apps that are suitable for people with varying levels of health literacy and eHealth literacy (12,13). Culturally tailored smartphone apps for preventing cancer among specific cultural, racial, and ethnic groups (for example, African Americans and sexual minorities) are also important, as discussed by Coughlin et al. (12) and Bowen et al. (14). These papers provide encouragement for the use of mHealth applications to solve health disparities, not widen them. The paper by Quintiliani et al. (15) highlights the potential for using mHealth strategies for health promotion among very poor and marginal populations, such as public housing residents. Social media interventions have also employed Facebook to provide cancer-related health messages, as discussed by O’Leary et al. (3). Research-tested apps are also needed for people who have a positive family history of cancer. The article by Theiss et al. (16) in this focused issue of the journal highlights the U.S. Centers for Disease Control and Prevention’s (CDC) Bring Your Brave campaign, which uses targeted, measurable social media to raise awareness of breast cancer among high-risk women younger than 45 years. In low- and middle-income countries, mHealth modalities have been used as adjuncts for the early detection of cervical cancer (17).

Two of the articles included in this focused issue highlight the utility and future promise of mHealth modalities to assist patients who are currently receiving oncology care (3,18). The examples provided by O’Leary et al. (3) include wearable technology to assist patients suffering from chemotherapy-induced peripheral neuropathy and telemonitoring solutions for pediatric cancer patients that improve the quality of life of these patients (19,20). Telemedicine is an important adjunct to oncology care where patients face barriers to receiving diagnostic and treatment services due to rural residence or geographic distances. Fu et al. (18) provide an important case study of an innovative mHealth self-care intervention for patient management of lymphedema following breast cancer treatment. The patient-centered, web- and mobile-based educational and behavioral mHealth intervention provides safe and effective electronic assessment and self-care strategies for lymphedema symptom management. In addition to applications for cancer prevention, early detection, and treatment, there is an emerging literature on mHealth and social media interventions for cancer survivors and for patients who are receiving end-of-life care (21-24). For example, recent studies have tested mHealth interventions for uterine cancer survivors (an accelerometer to measure physical activity) and African American breast cancer survivors (a web-based app to promote adherence with dietary and physical activity guidelines) (23,24). The study by Smith et al. (24) is particularly interesting because community-based participatory research principles were followed in development the intervention.

There is an ongoing need for the evaluation of cancer-related mHealth and social media interventions to ensure they are safe and effective. An increasing number of guidelines have been proposed for successful smartphone app development (1). In the U.S. and other countries, government agencies have begun to regulate mHealth interventions such as those used in oncology care (25,26). The U.S. Food and Drug Administration (FDA) released guidance for mobile medical apps that distinguish between mobile medical apps that are subject to FDA regulation and unregulated apps such as those useful for health education in the general population (25). The FDA regulates mHealth devices such as apps that convert a smartphone or tablet computer into a medical device for clinical testing or displaying diagnostic images from X-rays or magnetic resonance imaging. Health Insurance Portability and Accountability Act (HIPAA) regulations may also apply such as when an app developed for covered entities and their business associates (e.g., health plans, hospitals, physicians) will include protected health information (1,27). Apps that store medical information or that send personal information over the Internet should be encrypted in accordance with privacy regulations and security best practices (1).

The articles included in this focused issue of the journal highlight the innovativeness, creativity, and flexibility that are hallmarks of recent developments in cancer-related mHealth and social media interventions. These ongoing technological advances are likely to contribute importantly to alleviating the burden of cancer, improving quality of life, empowering patients, and improving patient-provider communication.

Acknowledgements

None.

Footnote

Conflicts of Interest: The author has no conflicts of interest to declare.

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