Remote Monitoring of Cancer Patient Participation in a 12-Week Online Yoga Study: Challenges and Directions for Future Research

Introduction: The delivery of online interventions in cancer patients/survivors has increased. The measurement of participation in online interventions is important to consider, namely, the challenges of the remote assessment of activity. The purpose of this study was to report the measures used to assess intervention compliance and other physical activity participation in two online yoga studies, the relationship between the multimethod measures used, and the ability of cancer patients to complete these measures. Methods: The methods described are of two online yoga studies (feasibility and pilot). Cancer patients were asked to participate in 60 min/week of online yoga for 12 weeks, complete a weekly yoga log, wear a Fitbit daily for 12 weeks, and complete a weekly physical activity log. Finally, Clicky®, a web analytics software, was used to track online yoga participation. Results: Eighty-four people participated across both studies, with 63/84 participating in online yoga, averaging 57.5 ± 33.2 min/week of self-reported yoga participation compared to 41.4 ± 26.1 min/week of Clicky® yoga participation (Lin concordance = 0.28). All 84 participants averaged 95.5 ± 111.8 min/week of self-reported moderate/vigorous physical activity compared with 98.1 ± 115.9 min/week of Fitbit-determined moderate/vigorous physical activity (Lin concordance = 0.33). Across both studies, 82.9% of the yoga logs were completed, the Fitbit was worn on 75.2% of the days, and 78.7% of the physical activity logs were completed. Conclusions: Weak relationships between self-report and objective measures were demonstrated, but the compliance rates were above 75% for the study measures. Future research is needed, investigating the intricacies of self-report physical activity participation in remote interventions and the validation of a gold standard measurement for online interventions.