A Tailored, Web-based Program (COMPASS) to Improve Exercise and Dietary Changes in Stage I-III Pancreatic Cancer Patients Receiving Neoadjuvant Chemotherapy

Accrual will be measured by the number of eligible patients who enroll in the study divided by the total number approached for recruitment. Successful accrual will be defined as recruiting 30 pancreatic cancer patients

Measured by the number of participants who enroll and complete the study intervention during their neoadjuvant chemotherapy treatment. Successful retention will be if 80% (24) participants complete the study's intervention while in neoadjuvant chemotherapy.

A minimum of 2 and maximum of 4 virtual listening sessions, at least one of men and one of women will be conducted. Each group will consist of 8-10 individuals and will explore questions of ease of use, whether they felt the portal was engaging and effectively encouraged positive behaviors. Information will also be sought about how the portal may be improved.

This survey will assess which parts of the web portal and intervention participants felt were most useful. The survey includes questions about each component of the web portal and intervention, with responses ranging from "Strongly Disagree" to "Strongly Agree," as well as open-ended questions that allow participants to provide additional thoughts or comments about the web portal.

Adherence will be defined as the proportion of participants who achieve at least one prescribed weekly exercise goal or nutrition recommendation during ≥80% of the weeks of their neoadjuvant chemotherapy period. Values range from 0% to 100%, with higher percentages indicating greater adherence to the study intervention.

Will be measured by the number of times participants logged into the web portal during the intervention period.

The number of clicks on specific web portal components, most frequently visited web pages, average time spent on the web portal and on different sections, time spent logging information or syncing Fitbit data

Will be assessed using the Community Health Activities Model Program physical activity survey as total energy expended in moderate to vigorous physical activity per week (kcal/week)

Will be assessed using the Diet Questionnaire for Oncology Participants. This survey assesses the frequency of consumption of specific foods or food groups (e.g., bread, cereal, milk, fruit juice) and how much of each food they typically eat per week.

Physical activity will be measured using a Fitbit device for energy expenditure (kcal/week)

Physical activity will be measured using a Fitbit activity monitor and reported as average daily step count. Daily step count represents the total number of steps accumulated during a day. Possible values range from 0 steps to no defined upper limit. Higher values (average daily steps) indicate greater physical activity.

Will be measured using a 6-item measure of Self-efficacy for Exercise. Summed scores range from 6-30, and higher scores indicate higher self-efficacy

Will be assessed using the Physical Activity Stage Assessment (PASA) measure. Participants select one of five statements that best describes their current exercise behavior and readiness to engage in regular physical activity. Values range from 1 to 5, with higher values indicating greater engagement in and maintenance of regular exercise.

The Healthy Eating and Weight Self-Efficacy (HEWSE) questionnaire assesses participants' self-efficacy by asking them to rate their confidence in performing various tasks on a 1-5 Likert scale. A score of 1 indicates strong disagreement with their ability to accomplish the task, while a score of 5 indicates strong agreement. Higher scores indicate greater self-efficacy for healthy eating and weight management behaviors.

Will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). This outcome will assess overall quality of life and cancer-related symptoms. Scores range from 0 to 100. For the global health status and functional scales, higher scores indicate better quality of life and functioning. For symptom scales, higher scores indicate greater symptom burden and worse outcomes.

Will be assessed using the Participant-Reported Outcomes Measurement Information System (PROMIS) measures for Sleep Disturbance, Depression, Anxiety, and Fatigue. Participants respond to 8-13 questions regarding their symptoms, with responses ranging from "Not at all" to "Very much." Scores are converted to standardized T-scores, with higher scores indicating greater symptom severity and worse outcomes.

Will be assessed using the Participant-Reported Outcomes Measurement Information System Cognitive Function (PROMIS-CF) survey. This 32-item questionnaire assesses perceived difficulties with memory, cognitive processing, and the impact of cognitive problems on daily and social activities. Scores range from 0 to 100, with higher scores indicating better cognitive function and fewer perceived cognitive difficulties.

Will be assessed using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity 4 (FACT-GOG-NXT-4). This 4-item survey captures symptoms of peripheral neuropathy, including sensory, motor, and auditory problems and cold sensitivity. Higher scores indicate more symptoms

Will be assessed using the Participant-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity and Pain Interference measures. The Pain Intensity measure assesses the severity of pain, while the Pain Interference measure assesses the extent to which pain affects daily activities, social activities, and overall functioning. Scores range from 0 to 100, with higher scores indicating greater pain severity and greater interference of pain with daily functioning, representing worse outcomes.

These data will be available via the electronic health record and may be extracted to explore the impact of COMPASS on clinical outcomes including grade 3+ toxicities, dose delays and dose reductions.

Tolerance and safety will be assessed by adverse event reporting administered monthly by a survey administered by the web portal. Adverse events will be classified as related, possibly related, or not related to the intervention and graded as mild, moderate or severe.