{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:14:10Z","timestamp":1793042050900,"version":"4.5.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII) through the project","award":["PI21\/00894"],"award-info":[{"award-number":["PI21\/00894"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Public University of Navarre under the agreement established with the Conference of Rectors of Spanish Universities"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital health interventions have shown promise for improving quality of life, especially in the short term after treatment. However, evidence regarding long-term breast cancer survivors (LT-BCSs; disease free &amp;gt;5\u2009years) remains limited. This study aimed to evaluate the effectiveness of an eHealth intervention targeting health promotion and late sequelae management to improve LT-BCSs\u2019 quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a randomized controlled clinical trial, 201 LT-BCSs (mean = 11\u2009years posttreatment) were randomly assigned to an intervention group (n\u2009=\u2009102) using the CUMACA-M mobile application with specific health advice and recommendations for LT-BCSs, or a control group (n\u2009=\u200999) receiving usual care. Quality of life was measured with the Quality of Life\u2013Cancer Survivors (QOL-CS) scale at baseline and after 3\u2009months. Analyses followed an intention-to-treat approach using t tests, nonparametric tests, and effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 3 months, no statistically or clinically significant differences between the groups in the overall quality of life score (QOL-CS) were found (difference-in-differences\u2009=\u20090.11; 95% confidence interval = \u22120.10 to 0.32; P\u2009=\u2009.303). In the intervention group, a small intragroup decrease in spiritual well-being was observed (\u22120.25; \u22120.49 to \u22120.02), of uncertain clinical significance; no significant differences between groups were detected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This eHealth intervention did not improve the quality of life of LT-BCSs, suggesting that more personalized, interactive, or professionally supported strategies may be needed. Future research should evaluate the long-term outcomes and effectiveness of hybrid or personalized digital strategies in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT05322460; https:\/\/clinicaltrials.gov\/study\/NCT05322460.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag020","type":"journal-article","created":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T12:34:47Z","timestamp":1768739687000},"page":"1025-1031","source":"Crossref","is-referenced-by-count":2,"title":["EHealth intervention for quality of life in long-term breast cancer survivors: randomized controlled trial"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-7285","authenticated-orcid":false,"given":"Gustavo Adolfo","family":"Pimentel-Parra","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Public University of Navarre and IdiSNA Navarra Institute for Health Research , Pamplona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5161-2272","authenticated-orcid":false,"given":"Nelia","family":"Soto-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Public University of Navarre and IdiSNA Navarra Institute for Health Research , Pamplona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2263-156X","authenticated-orcid":false,"given":"Paula","family":"Escalada-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Public University of Navarre and IdiSNA Navarra Institute for Health Research , Pamplona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-7493","authenticated-orcid":false,"given":"Leticia","family":"San Mart\u00edn-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Public University of Navarre and IdiSNA Navarra Institute for Health Research , Pamplona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6022-559X","authenticated-orcid":false,"given":"Cristina","family":"Garc\u00eda-Vivar","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Public University of Navarre and IdiSNA Navarra Institute for Health Research , Pamplona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"2026060902505338000_djag020-B1","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1016\/S0140-6736(05)67887-7","article-title":"Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials","volume":"366","author":"Abe","year":"2005","journal-title":"The Lancet"},{"key":"2026060902505338000_djag020-B2","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/s1470-2045(03)01037-4","article-title":"Why is breast-cancer mortality declining?","volume":"4","author":"Jatoi","year":"2003","journal-title":"Lancet Oncology"},{"key":"2026060902505338000_djag020-B3","volume-title":"World Cancer Report: Cancer Research for Cancer Prevention. 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