Development and evaluation of a WeChat-based intervention program for prevention of breast cancer-related lymphedema

Purpose Mobile health applications have been widely adopted among breast cancer survivors for disease management; however, their use specifically for the prevention of breast cancer-related lymphedema (BCRL) remains sparse. This study is aimed at developing a WeChat-based intervention program for the prevention of BCRL based on the common-sense model (CSM). Methods This study was designed based on intervention mapping. First, a longitudinal investigation was conducted to determine the predictive effect of illness perception on BCRL prevention behaviors among breast cancer survivors. An intervention program was then constructed based on the CSM and longitudinal results. Finally, a WeChat mini-program was developed, and 15 patients were recruited to test its usability and user satisfaction through usability tests based on typical tasks and the Post-Study System Usability Questionnaire (PSSUQ), respectively. Results The longitudinal study revealed that identity, personal control, illness coherence, and behavioral and physical factors in the causes dimension could positively predict prevention behaviors, whereas treatment control and uncontrollable factors exhibited negative predictive effects. This study then developed an individualized intervention program and a WeChat mini-program (named "Nantian e-Care") consisting of five modules: "resources," "questionnaires," "homepage," "consultation," and "personal center." Patients could read BCRL-related educational content, watch functional exercise videos, self-measure arm circumference, and consult questions. The five-task completion rates were 80.00 similar to 100.00%, the average completion time was 9.47 similar to 33.31 s, and the scores of PSSUQ were greater than 5 points (full score 7 points). Conclusions This study proposed a feasible intervention program for the prevention of BCRL and developed a customized WeChat mini-program with high usability and user satisfaction.