Supporting cardiomyopathy screening behavior in adult survivors of childhood cancer: an eHealth motivational interviewing-framed pilot intervention

Purpose: The Healthy Hearts pilot study evaluated the effect of an eHealth motivational interviewing-framed intervention on cardiomyopathy screening-related knowledge, health beliefs, intrinsic motivation, and behavioral action steps among adult survivors of childhood cancer.

Methods: We consented N = 73 survivors to participate in a single-arm pilot study. Participants completed an online baseline survey (n = 68) assessing knowledge, health beliefs, and intrinsic motivation related to cancer therapy-induced cardiomyopathy and screening echocardiograms. Then, they engaged in two sessions with a fully automated web-based health intervention platform based on motivational interviewing techniques to build motivation. Participants completed an online post-intervention survey (n = 61) re-assessing knowledge, health beliefs, and intrinsic motivation and a 1-month follow-up survey (n = 59) assessing actions taken toward obtaining an echocardiogram and intervention satisfaction.

Results: Participant age averaged 40.5 years (SD = 7.2). Most self-identified as women (n = 42) and non-Hispanic white (n = 62). Paired t-tests revealed statistically significant pre-post changes in several health beliefs and elements of intrinsic motivation. Specifically, we observed decreases in perceived barriers (p < .001) and increases in knowledge (p < .001), perceived benefits (p < .001), self-efficacy (p < .001), perceived importance (p = .001), confidence (p = .02), and intentions (p < .001). By 1-month follow-up, 38.6% of participants had engaged in behavioral action steps (e.g., set echocardiogram appointment). Intervention satisfaction was moderately high (M = 3.9, SD = 0.9, median = 4, min = 2, max = 5).

Conclusions: Results provide preliminary indications of efficacy of the eHealth motivational interviewing-framed intervention on uptake of screening echocardiograms among adult survivors of childhood cancer.

Implications for cancer survivors: An eHealth motivational interviewing-framed intervention could increase childhood cancer survivors' ability to receive high-quality support for engaging in cardiomyopathy screening.