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NexJ Connected Wellness for Smartphone-Enabled Health Coaching Intervention (iMOVE) to Support Exercise Adherence in Breast Cancer Survivors

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In 2014, 3 in 5 Canadians perceived their health to be ‘very good’or ‘excellent’. However, only 2 in 10 adults were meeting the minimum physical activity recommendations outlined in the Canadian Physical Activity Guidelines. Although most of the general population could benefit from regular physical activity, there are specific benefits to be gained from exercise for certain populations such as cancer survivors.

Breast cancer is the most commonly diagnosed type of cancer in women. Breast cancer mortality rates have dropped significantly despite increasing incidence over the past few decades. Unfortunately, breast cancer survivors are often left with multiple complications resulting from the cancer as well as the required treatments, such as chronic pain and neuropathy. In order to mitigate long term complications experienced by breast cancer survivors and to improve cancer outcomes, experts recommend moderate-to-vigorous physical activity (MVPA). MVPA has repeatedly demonstrated to be a safe and effective method of improving quality of life, overall aerobic fitness, and mental health in cancer survivors.

Although breast cancer survivors are generally aware of the benefits of physical activity, recommended targets for physical activity are seldom met and maintained. There are numerous research trials emphasizing the benefits of MVPA, but very few have assessed the sustainability of physical activity-related behavior change in breast cancer survivors. Considering that the benefits of MVPA will continue only with the maintenance of behavioural change, there is a need to address this gap in the literature to better understand how physical activity interventions can produce positive long-term health outcomes.

Rapid advancement in health-tracking apps and wearable technologies are being increasingly used to promote better health and self-management of chronic disease. To date, studies have showcased the benefits of leveraging mobile technologies to promote physical activity across various population groups, including patients managing type 2 diabetes, asthma, and cardiovascular disease, but few studies have been conducted on breast cancer survivors.

In order to address this gap, Dr. Paul Ritvo (PhD, Psych) and colleagues from the Princess Margaret Cancer Centre (PMCC) in Toronto are assessing the efficacy of iMOVE, a health coaching intervention to promote exercise adherence in breast cancer survivors through an ongoing pilot randomized controlled trial (RCT) using NexJ Connected Wellness. (Read the full protocol paper here in the Journal of Medical Internet Research).

For the purpose of the pilot study, physically inactive breast cancer survivors are being recruited at the PMCC. Eligible participants are randomly allocated to the control or the intervention group, both of which are currently participating in a 12-week in-person exercise program consisting of weekly facility-based group exercise sessions (taking place at the Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research – ELLICSR) and individual home-based exercises. Eventually, individually tailored exercise prescriptions (initially based on the participants’ experiences and preferences) will progress towards current American College of Sports Medicine physical activity guidelines. Exercise prescriptions are adjusted by a registered kinesiologist (RKin) and certified exercise physiologist (CEP) to ensure participant safety and efficacy of the intervention.

What distinguishes the intervention group from the control groups is the additional technology-based health coaching intervention (iMOVE) using NexJ Connected Wellness. This three-part intervention is aimed at achieving sustainable behaviour change by utilizing evidence-based behaviour-change theories, including motivational interviewing (MI), cognitive-behavioural therapy (CBT), and relapse prevention therapy, facilitated by the connectivity between patient and health coach made possible by NexJ Connected Wellness.

In the intervention, telephone-based health coaching sessions provide participants with counseling from a trained health coach who works with the participant to build critical skills, self-efficacy and collaborative problem solving. Participants use NexJ Connected Wellness, which has been tailored for breast cancer survivors, to track their health behaviours. Through the platform, participants can effectively track physical activity, nutrition (through a food photo journal), pain, and psychological well-being (e.g. mood, energy) to support personal goal-setting. Health tracking functionality allows the participants to see change indicators in accordance to their physical activity levels, and health coaches to monitor patients remotely. Furthermore, participants use Fitbit wearable technology which integrates into NexJ Connected Wellness to further improve monitoring of daily physical activity by the health coach.

Overall, iMOVE combines NexJ Connected Wellness to support real time health coaching with wearable technology to encourage exercise adoption and adherence in breast cancer survivors. As the pilot RCT is ongoing, final results are pending completion of the trial.

If your organization is interested in using NexJ Connected Wellness to deliver personal health coaching for your patients, email us at or call 416-227-3700.



Government of Canada. (2016). Health status of Canadians 2016. Ottawa: Public Health Agency of Canada.

Ritvo, P., Obadia, M., Mina, D. S., Alibhai, S., Sabiston, C., Oh, P., … Jones, J. M. (2017).

Smartphone-enabled health coaching intervention (iMOVE) to promote long-term maintenance of physical activity in breast cancer survivors: Protocol for a feasibility pilot randomized controlled trial. Journal of Medical Internet Research, 6(8), 1-15. doi: 10.2196/resprot.6615