Feasibility and acceptability of a web-based dietary intervention with text messages for colorectal cancer: a randomized pilot trial

Background: Diet is associated with colorectal cancer (CRC) survival. Yet, adherence to nutrition guidelines is low among CRC survivors. Methods: We conducted a pilot trial among CRC survivors to evaluate a 12-week remote dietary intervention. Participants received print materials and were randomized (1:1) to intervention (website, text messages) or wait-list control. Primary outcomes included feasibility and acceptability. We also explored change in diet from 0 to 12 and 24 weeks and change from 0 to 12 weeks in anthropometry and circulating biomarkers. Trial Registration: NCT02965521. Results: We randomized 50 CRC survivors (25 intervention, 25 control). Retention was 90% at 12 weeks and 84% at 24 weeks. Participants had a median age of 55 years and were 66% female, 70% non-Hispanic white, and 96% had a college degree. The intervention arm responded to a median 15 (71%) of 21 text messages that asked for a reply (IQR: 8, 19) and visited the website a median of 13 (15%) days [interquartile range (IQR): 1, 33] out of the 84 study days. Conclusions: In conclusion, we developed a web-based dietary intervention for CRC survivors. Our pilot results suggest CRC survivors may engage more with text messages than a study website. Research to improve tailoring of text messages, while maintaining scalability, is needed. Impact: Remote dietary interventions using text messages may be feasible for CRC survivors.