Enablers for participants’ engagement with EMPOWER-SMS COVID-19 and suggestions for improvement.
cancer, cancers, breast cancer
TREATMENT SIDE EFFECTS, CANCERS, BREAST CANCER, BREAST CANCER, CANCER

Feeling supportedIt made me feel supported and that someone cared that I am still not well (everyone expects you to be better a couple of weeks after chemo) some messages were just the right thing at the right time.Very timely, our support group was cancelled due to COVID-19, it was nice to received even a text message, I felt supported.Sometimes a cancer diagnosis can be isolating, it is great to feel supportedIt reminded me that there was someone thinking of my wellbeingFeeling less aloneReminded me I wasn’t alone in dealing with cancer and it’s fallout, that many others are also dealing with it.I looked forward to seeing the messages. It made me feel more connected as I live alone :)Even though I am 11 years post BC I struggle everyday as my life has completely changed - these messages helped me feel not so isolated and alone.
Gentle health remindersReminders to take time out for myself during the day, and importance of eating well and exercisingThey were reminders about aspects of health and wellbeing that were simple, easy to follow and not too formal in tone.I liked that the messages gently reminded me to take care of 'me' during the busyness in my life.Motivation to change behaviorsI loved receiving the messages, it has really helped me to prioritise myself and do small things each day for my recovery.It helped reinforce things I should be doing. No one else knew that I changed my behaviour because I was told in a message, I just looked like I was doing it on my ownI just liked getting a little nudge to stop and think how I was going, and if I needed to do or change something to increase my wellbeingReassurance of doing the right thingsThe messages confirmed that I am on the right trackIt made me feel like I was supported, even though I didn't really learn anything new. I come from a nursing background […] but it did give me confidence that what I knew already was correct.
Wide variety of useful information - felt very friendly & personalThe variety of suggestions that were relevant with dealing with a cancer diagnosis, treatment side effects and range of effects during and the aftermath and ongoing day to day living; emotionally, socially, physically, sensory and sexually!!I liked the variety of themes but especially mental health re[garding] covid
Links to more in-depth information. Found very helpful.Great size messages and useful links. Quick and easy to access
I liked being able to scroll back through the messages at times when I felt that I needed support.
Control Over Program StructureProgram LengthI would have loved to see it continue until I decided to stop it rather than it being stopped. I'll miss it :-(It was too short. I am saying this because to change my mindset to do some of the things suggested would take longer. When you first read the message, you think that's good/not so good idea. But it needs to be reinforced a bit (even if some of the messages were repeated.)Keep it going for 6 months even 12 months. We are still really vulnerable for a long time post active treatment and these messages were like my silent friend.Frequency of SMS text message deliveryI wonder if it would be possible to tailor frequency of messages and length of program to roughly where someone is up to. More frequent for longer for those closer to active treatment, less frequent for less time for someone further out. Approaching 5 years from completing treatment, I valued this, but would have got far more benefit in the first couple of yearsToo many messages. Maybe a set time 3 times a week or consider consistency based on requirements or experienceTime of the dayTexts arriving in the middle of the workday didn't allow me to really take in the content. Would have preferred they be sent at night around 8pm.More specific SMS Text message contentSome messages too generic to participant journey. A more targeted approach would be more appropriate when the program is released to all patientsA little bit broad, perhaps being a little more specific re[garding] exercise, eating etc.SMS text messages personalized for people who finished treatment 3+ years agoI am 4 years post diagnosis so messages around keeping healthy and positive were more beneficialBased on the quantitative and qualitative feedback survey results, there were few barriers to participant engagement. However, some participants would have preferred control over the program structure, including the program length, frequency of SMS text message delivery, and the time-of-the-day SMS text messages were delivered. Participants suggested the option to control these factors to best suit individuals’ preferences, schedules, and lifestyle (Maybe add some links to relevant research or in-depth discussion on the topic presentedIt would be great to see something like this rolled out whilst undergoing treatment. As sometimes the online networks can be overwhelming and depressing when you read the sad stories.I’m 7 years out from diagnosis. When I’m feeling good, I don’t like being reminded about Breast Cancer. […] I absolutely LOVED getting messages about exercise, mindfulness, healthy eating etc. The type of “healthy message” I might get even if I didn’t have cancer. Perhaps there could be an option to eliminate cancer references for those who just want healthy lifestyle messages?Other participants found it acceptable to receive some SMS text messages that were not directly relevant to them:Some of the messages weren’t personally relevant, but that is to be expected. I just ignored those I felt weren’t for me.Suggestions were also made by participants to expand the program to other types of cancers, to have a program for carers or families of cancer survivors.Just continue to provide to all breast cancer patients and expand the program to all of those who experience a cancer diagnoses as well as their supports/carers!! More work but it is an excellent resource for all!