What motivates bladder cancer patients to be active? A qualitative study assessing attitudes towards physical activity and digital health technologies.

Introduction and objective: Patients undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) are often older, frail and deconditioned, leaving them with limited reserve to endure the demands of treatment. As a result, improving physical fitness in this population remains a critical need. Two emerging means to do so include the implementation of exercise programs pre- and postsurgery (i.e. (p)rehabilitation), and the use of digital health technologies (i.e. Fitbit®, Apple Watch™, exercise apps) to incentivize physical activity. However, little is known about the motivations of NAC/RC patients to be active or their perceptions towards digital health technologies.

Methods: We conducted semi-structured interviews with bladder cancer survivors who previously underwent NAC/RC. We asked participants to reflect upon their experience throughout the course of treatment as it pertained to (1) barriers of physical activity, (2) facilitators of physical activity, and (3) how digital health technologies can promote physical activity. These findings will inform the design of a Phase II exercise prehabilitation trial (GetMoving, NCT06040762).

Results: 9 patients were interviewed and common themes emerged. Patients undergoing NAC/RC desired a structured exercise plan outlining the duration, intensity and frequency of exercise to perform. Encouragement to exercise and "check ins" from their provider were critical in maintaining their motivation to exercise. Objective measurements of their fitness would help with setting fitness goals and adhering to training plans. All patients would use digital health technologies to improve their health.

Conclusions: We provide a novel study assessing the perceptions of bladder cancer survivors towards exercise motivations and digital health technologies.