Adherence, engagement, and acceptability
breast cancer
BREAST CANCER
Overall, participants were highly adherent to completing mentoring sessions and reported positive experiences working with their mentors. Participants noted that working with a peer who was diagnosed at a similar age and life stage was unique from other survivorship programming; however, many sought deeper connections with their mentors. Peer mentors’ training was focused on delivery of the exercise intervention and introductions were structured to keep the focus on the mentee and her behavior change journey. Future iterations of this program should train mentors in how to appropriately share their own experiential knowledge about exercising after breast cancer treatment to leverage the mutual identification only a peer mentor can provide (Ginis et al., Although women did not frequently initiate posts in the Fitbit Community, and thus were not considered adherent to completing this intervention component per our a priori definition, many participated in other ways that facilitated social support and behavior change techniques associated with success in a PA intervention (Finne et al., While most participants stated that the fully remote format was more convenient than in-person, many women faced numerous conflicting priorities and schedule-related barriers that hindered their engagement. The next iteration of this intervention could consider more asynchronous peer mentoring contacts (e.g., email, text, Fitbit private message, etc.) that may more easily fit into busy schedules and require less coordination than video calls. Participants had high adherence to wearing the Fitbit (> 85% wore it on at least 75% of intervention days), and described that sharing their Fitbit activity data with their mentor helped them feel motivated and accountable. While data were collected in real time, this intervention did not provide real-time feedback. To meet participants’ preferences and increase scalability, future studies could consider using technology to deliver tailored, data-driven feedback. The frequency and intensity of intervention contacts to promote accountability could be adaptive and tailored to participants’ preferences, or adjusted dynamically based on a participant’s progress toward their individual PA goals, such as through “continuous tuning interventions” that use a participant’s data and real-time optimization algorithms to “tune” the intervention to meet their individual needs (Chevance et al., 