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Buiret G, Meniscus L, Riffard G, Caudroit J. [Encouragement of adapted physical activity for three months after the end of treatment in patients with head and neck cancer: A pre-post interventional study]. Bull Cancer 2024; 111:384-392. [PMID: 38316578 DOI: 10.1016/j.bulcan.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/07/2024]
Abstract
CONTEXT In our institution, patients with upper aero-digestive tract cancer receive adapted physical activity (APA) awareness training as part of their holistic oncology care program. The main aim of this study was to show that raising awareness of APA helped to increase self-reported PA levels, as assessed by questionnaire. METHOD This retrospective study included 67 patients with localized Head and Neck cancer. The intervention consisted of an APA teacher; a face-to-face consultation before the start of oncological treatment, four monthly telephone interventions in the three months following the end of treatment. The pre-post evaluation focused on self-reported APA practices before and three months after the end of oncology treatment. RESULTS APA awareness training significantly increased average total PA, average moderate PA intensity, average weekly walking frequency, average walking intensity, and significantly reduced daily sitting time. The search for correlations between body composition or type of treatments and changes in PA levels showed no significant results. CONCLUSION This study showed that a basic APA awareness training integrated into a holistic oncology care program could increase patients' self-reported PA levels. The next step will be to verify the objectivity of the increase in self-reported PA, and then to assess its effect on quality of life and survival.
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Affiliation(s)
- Guillaume Buiret
- Service ORL et chirurgie cervicofaciale, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26953 Valence, France; Centre hospitalier de Valence, plateforme de cancérologie, 179, boulevard du Maréchal-Juin, 26953 Valence, France.
| | - Lisa Meniscus
- Service ORL et chirurgie cervicofaciale, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26953 Valence, France; Centre hospitalier de Valence, plateforme de cancérologie, 179, boulevard du Maréchal-Juin, 26953 Valence, France; Département APA-S, laboratoire sur les vulnérabilités et l'innovation dans le Sport (L-ViS, EA-7428), UFR STAPS, université Lyon1 - UFR STAPS, 27-29, boulevard du 11 nov 1918, 69622 Villeurbanne cedex, France
| | - Ghislain Riffard
- Service ORL et chirurgie cervicofaciale, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26953 Valence, France; Centre hospitalier de Valence, plateforme de cancérologie, 179, boulevard du Maréchal-Juin, 26953 Valence, France
| | - Johan Caudroit
- Département APA-S, laboratoire sur les vulnérabilités et l'innovation dans le Sport (L-ViS, EA-7428), UFR STAPS, université Lyon1 - UFR STAPS, 27-29, boulevard du 11 nov 1918, 69622 Villeurbanne cedex, France
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Su CC, Guo SE, Kuo YW. Effects of internet-based digital health interventions on the physical activity and quality of life of colorectal cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2024; 32:168. [PMID: 38374448 DOI: 10.1007/s00520-024-08369-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/11/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE The recent trend of Internet-based digital health interventions has driven researchers to implement them to promote physical activity (PA) and improve patients' health outcomes. This systematic review and meta-analysis aim to evaluate the effects of Internet-based digital health interventions on PA and quality of life (QoL) in colorectal cancer (CRC) survivors. METHODS We searched for relevant studies investigating the effects of internet-based digital health interventions published until Dec. 2022 in electronic databases (PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and CEPS) according to PRISMA guidelines. The Joanna Briggs Institute critical appraisal checklist was used to examine the quality of the included studies. We performed the fixed and random effects model for meta-analysis. RESULTS Among 746 identified studies, eight published between 2018 and 2022 were included. These covered 991 internet-based digital health interventions and 875 controls. After 6 months of internet-based digital health interventions, CRC survivors' performance in PA (standardized mean difference (SMD) = 0.23, 95% confidence interval [CI] = 0.09-0.38) and QoL (SMD = 0.11, 95% CI = 0.01-0.22) indicators improved significantly. CONCLUSIONS Internet-based digital health improved the PA behaviour and QoL of patients with CRC. Because of differences in intervention outcomes, additional randomized controlled trials are warranted to provide suggestions for clinical practice. Internet-based digital health interventions are promising for promoting PA in CRC survivors.
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Affiliation(s)
- Ching-Ching Su
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan
- Department of Hematology and Oncology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan
| | - Su-Er Guo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
- Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, No. 84 Gungjuan Rd., Taishan Dist., New Taipei City, 24301, Taiwan.
| | - Ya-Wen Kuo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
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Kindred MM, Nkwonta CA, Beal ML, Messias DKH, Pinto BM. Designing viable, durable physical activity programs for cancer survivors: reflections from program participants and organizational leaders. Support Care Cancer 2024; 32:84. [PMID: 38177609 DOI: 10.1007/s00520-023-08264-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/16/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE Despite recommendations for cancer survivors to participate in routine physical activity (PA), offering programs that fit both survivors' needs and sponsoring organizations' resources remains a challenge. The purpose of this study is to explore the perspectives of cancer survivors and organizational stakeholders with the intent of developing PA peer-led programs that organizations can implement into their programming. METHODS This study explored cancer survivors' (n = 11) and cancer care organizational stakeholders' (n = 27) perspectives on the design and feasibility of PA programs targeted for cancer survivors. Semi-structured interview guides were developed for survivors and stakeholders; interviews lasted approximately 30 min. Two analysts used a thematic analysis approach and independently conducted a line-by-line coding of each transcript. With guidance from a senior analyst, the codes were collapsed into themes and subthemes. RESULTS The qualitative analysis of the interview data resulted in seven major themes relating to PA program development and success. Survivor-related themes included the following: (1) developing PA programs based on cancer survivors' characteristics and experiences; (2) perceived value and importance of accessible, face-to-face instruction; (3) ensuring success based on physical abilities and limitations of the survivor; and (4) the value of physician recommendation for PA participation. Organization-related themes included the following: (1) incorporating participant and community input into program offerings; (2) program feasibility and sustainability; (3) incorporating organizational experience when adopting new program initiatives. CONCLUSION These findings highlight the challenges of developing viable PA programs for cancer survivors and may guide organizations in future program development and implementation.
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Affiliation(s)
- M Madison Kindred
- Department of Kinesiology, Augusta University, 3109 Wrightsboro Road, Augusta, GA, USA.
| | - Chigozie A Nkwonta
- Roy Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, USA
| | - Marissa L Beal
- Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, USA
| | - DeAnne K H Messias
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC, USA
| | - Bernardine M Pinto
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC, USA
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Golsteijn RHJ, Bolman C, Peels DA, Volders E, de Vries H, Lechner L. Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: A randomized controlled trial. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:690-704. [PMID: 37591482 PMCID: PMC10658345 DOI: 10.1016/j.jshs.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/18/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Physical activity (PA) can improve the physical and psychological health of prostate and colorectal cancer survivors, but PA behavior change maintenance is necessary for long-term health benefits. OncoActive is a print- and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated, personalized feedback aimed at integrating PA into daily life to increase and maintain PA. We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group, and we explored whether PA was maintained during a 6-month non-intervention follow-up period. METHODS Prostate or colorectal cancer patients were randomly assigned to an OncoActive (n = 249) or a usual care waitlist control group (n = 229). OncoActive participants received PA advice and a pedometer. PA outcomes (i.e., ActiGraph and self-report moderate-to-vigorous intensity PA (MVPA) min/week and days with ≥30 min PA) and health-related outcomes (i.e., fatigue, depression, physical functioning) were assessed at baseline, 6 months, and 12 months. Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome (ActiGraph MVPA min/week) and all additional outcomes. RESULTS At 12 months, OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week, self-report MVPA min/week, or ActiGraph days with PA. Only self-report days with PA were significantly higher in OncoActive compared to the control group. For health-related outcomes only long-term fatigue was significantly lower in OncoActive. When exploratively examining PA within OncoActive, the previously found PA effects at the end of the intervention (6 months follow-up) were maintained at 12 months. Furthermore, all PA outcomes improved significantly from baseline to 12 months. The control group showed small but non-significant improvements from 6 months to 12 months (and from baseline to 12 months), resulting in a decline of differences between groups. CONCLUSION The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up, possibly because of natural improvement in the control group. At long-term follow-up, fatigue was significantly lower in OncoActive compared to control group participants. Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.
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Affiliation(s)
| | - Catherine Bolman
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Denise Astrid Peels
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Esmee Volders
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, 6200 MD, the Netherlands
| | - Lilian Lechner
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
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Weemaes ATR, Sieben JM, Beelen M, Mulder LTMA, Lenssen AF. Determinants of physical activity maintenance and the acceptability of a remote coaching intervention following supervised exercise oncology rehabilitation: a qualitative study. J Cancer Surviv 2023:10.1007/s11764-023-01455-5. [PMID: 37733263 DOI: 10.1007/s11764-023-01455-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE The purpose of the study was to investigate perceived determinants of physical activity (PA) maintenance following supervised exercise oncology rehabilitation and the acceptability of a remote coaching intervention during this period. METHODS A phenomenological qualitative study with semi-structured interviews was conducted. Nineteen participants (16 women, 3 men) were recruited from the intervention (n = 12) and control group (n = 7) of a randomized controlled trial on the effectiveness of remote coaching following hospital-based, supervised exercise oncology rehabilitation. Participants in the intervention group received a 6-month remote coaching intervention after completing the exercise program, aimed at stimulating PA maintenance. The interviews were based on the Capability, Opportunity, and Motivation model of Behaviour (COM-B model) and the framework of acceptability (TFA) and were coded using template analysis. RESULTS Key themes regarding determinants of PA maintenance were self-efficacy, PA habits, accountability, physical complaints, and facilities. Remote coaching was perceived acceptable because it stimulated PA maintenance by offering a source of structure and social support and thereby increased accountability. Moreover, it improved confidence to perform PA, leading to increased levels of self-efficacy. The remote nature of the intervention was perceived as convenient by some of the participants, while others would have preferred additional physical appointments. CONCLUSIONS Cancer survivors considered remote coaching acceptable to stimulate PA maintenance following supervised rehabilitation. Interventions should focus on increasing accountability, self-efficacy, forming habits, and helping cancer survivors to overcome barriers. IMPLICATIONS FOR CANCER SURVIVORS The ability to maintain PA beyond supervised exercise oncology programs depends on many determinants. Remote coaching interventions have potential to target individually relevant determinants following exercise programs in cancer survivors.
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Affiliation(s)
- Anouk T R Weemaes
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Judith M Sieben
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands
| | - Milou Beelen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Louisa T M A Mulder
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Antoine F Lenssen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Perperidi M, Saliari D, Christakis C, Huybrechts I, Saloustros E, Theodorakis Y, Androutsos O. Identifying the effective behaviour change techniques in nutrition and physical activity interventions for the treatment of overweight/obesity in post-treatment breast cancer survivors: a systematic review. Cancer Causes Control 2023; 34:683-703. [PMID: 37149509 PMCID: PMC10267275 DOI: 10.1007/s10552-023-01707-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/19/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE Updated evidence for the treatment of obesity in cancer survivors includes behavioural lifestyle interventions underpinning at least one theoretical framework. The aim of this systematic review was to assess the effectiveness of theory-based lifestyle interventions for the treatment of overweight/obesity in breast cancer survivors and to report effective behavioural change techniques (BCTs) and components used in these interventions. METHODS Four databases were searched for RCTs published between database inception and July 2022. The search strategy included MeSH terms and text words, using the PICO-framework to guide the eligibility criteria. The PRISMA guidelines were followed. Risk-of-bias, TIDier Checklist for interventions' content, and the extent of behaviour change theories and techniques application were assessed. To evaluate the effectiveness of interventions, trials were categorised as "very," "quite," or "non" promising according to their potential to reduce body weight, and BCTs promise ratios were calculated to assess the potential of BCTs within interventions to decrease body weight. RESULTS Eleven RCTs met the inclusion criteria. Seven trials were classified as "very", three as "quite" and one study was "non" promising. Studies' size, design, and intervention strategies varied greatly, but the weight-loss goal in all studies was ≥ 5% of the initial body weight through a 500-1000 kcal/day energy deficit and a gradually increased exercise goal of ≥ 30 min/day. Social Cognitive Theory was the most commonly used theory (n = 10). BCTs ranged from 10 to 23 in the interventions, but all trials included behaviour goal setting, self-monitoring, instructions on the behaviour, and credible source. The risk-of-bias was "moderate" in eight studies and "high" in three. CONCLUSION The present systematic review identified the components of theory-based nutrition and physical activity behaviour change interventions that may be beneficial for the treatment of overweight/obesity in breast cancer survivors. The strategies mentioned, in addition to reported behavioural models and BCTs, should be considered when developing weight-loss interventions for breast cancer survivors.
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Affiliation(s)
- Maria Perperidi
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Dimitra Saliari
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Christos Christakis
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Emmanouil Saloustros
- Department of Oncology, Medical School, University Hospital of Larissa, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Thessaly, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 1C Argonafton, 42132, Trikala, Thessaly, Greece.
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7
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Valle CG, Diamond MA, Heiling HM, Deal AM, Hales DP, Nezami BT, LaRose JG, Rini CM, Pinto BM, Tate DF. Physical activity maintenance among young adult cancer survivors in an mHealth intervention: Twelve-month outcomes from the IMPACT randomized controlled trial. Cancer Med 2023; 12:16502-16516. [PMID: 37317660 PMCID: PMC10469755 DOI: 10.1002/cam4.6238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Most physical activity (PA) interventions in young adult cancer survivors (YACS) have focused on short-term outcomes without evaluating longer-term outcomes and PA maintenance. This study examined the effects of an mHealth PA intervention at 12 months, after 6 months of tapered contacts, relative to a self-help group among 280 YACS. METHODS YACS participated in a 12-month randomized trial that compared self-help and intervention groups. All participants received an activity tracker, smart scale, individual videochat session, and access to a condition-specific Facebook group. Intervention participants also received lessons, tailored feedback, adaptive goal setting, text messages, and Facebook prompts for 6 months, followed by tapered contacts. Accelerometer-measured and self-reported PA (total [primary outcome], moderate-to-vigorous [MVPA], light, steps, sedentary behaviors) were collected at baseline, 6, and 12 months. Generalized estimating equation analyses evaluated group effects on outcomes from baseline to 12 months. RESULTS From baseline to 12 months, there were no between- or within-group differences in accelerometer-measured total PA min/week, while increases in self-reported total PA were greater in the intervention versus self-help group (mean difference = +55.8 min/week [95% CI, 6.0-105.6], p = 0.028). Over 12 months, both groups increased accelerometer-measured MVPA (intervention: +22.5 min/week [95% CI, 8.8-36.2] vs. self-help: +13.9 min/week [95% CI, 3.0-24.9]; p = 0.34), with no between-group differences. Both groups maintained accelerometer-measured and self-reported PA (total, MVPA) from 6 to 12 months. At 12 months, more intervention participants reported meeting national PA guidelines than self-help participants (47.9% vs. 33.1%, RR = 1.45, p = 0.02). CONCLUSION The intervention was not more effective than the self-help group at increasing accelerometer-measured total PA over 12 months. Both groups maintained PA from 6 to 12 months. Digital approaches have potential for promoting sustained PA participation in YACS, but additional research is needed to identify what strategies work for whom, and under what conditions.
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Affiliation(s)
- Carmina G. Valle
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Molly A. Diamond
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hillary M. Heiling
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Allison M. Deal
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Derek P. Hales
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Brooke T. Nezami
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Christine M. Rini
- Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityChicagoIllinoisUSA
| | | | - Deborah F. Tate
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Nelson V, Cross AJ, Powell J, Shaw C. Can people living with and beyond colorectal cancer make lifestyle changes with the support of health technology: A feasibility study. J Hum Nutr Diet 2023; 36:554-565. [PMID: 35320595 DOI: 10.1111/jhn.13008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rates of cancer survival are increasing, with more people living with and beyond cancer. Lifestyle recommendations for cancer survivors are based largely on extrapolation from cancer prevention recommendations. This feasibility study was designed to investigate diet and physical activity variables linked to primary prevention and digital behaviour change interventions in cancer survivors and delivered by an oncology dietitian to plan for future research. METHODS In this 2-month feasibility study, participants who had completed treatment for colorectal cancer were invited to complete online food diaries, underwent physical activity assessment, attended fortnightly telephone consultations with an oncology dietitian and completed an evaluation form. The baseline food diaries were used to help participants pick two lifestyle changes to focus on throughout the intervention. Demographic and clinical data were analysed using descriptive statistics. RESULTS In total, 996 patients were screened for eligibility; of these, 78 were eligible to approach and 69 were approached, resulting in 20 participants consenting to take part. Overall, the intervention was acceptable with 65% of participants completing an online food diary and 70% engaging with the dietitian over the telephone. The intervention received good feedback, with 100% of those completing the evaluation form reporting they felt supported and found it helpful. CONCLUSIONS The present study offers preliminary evidence that a lifestyle intervention delivered by an oncology dietitian using digital behaviour change interventions (DBCIs) to cancer survivors is feasible and accepted by participants and providers.
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Affiliation(s)
- Victoria Nelson
- Department of Nutrition and Dietetics, The Royal Marsden NHS Foundation Trust, London, UK
- The Royal Marsden School, The Royal Marsden NHS Foundation Trust, London, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Surgery & Cancer, Cancer Screening & Prevention Research Group, Imperial College London, London, UK
| | | | - Clare Shaw
- Department of Nutrition and Dietetics, The Royal Marsden NHS Foundation Trust, London, UK
- Biomedical Research Centre, The Royal Marsden and Institute of Cancer Research, London, UK
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Kim JS, Kim M, Seo Y. User evaluation of a mobile education application for the management of metabolic syndrome among cancer survivors. Eur J Oncol Nurs 2023; 63:102276. [PMID: 36898267 DOI: 10.1016/j.ejon.2023.102276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE This study aimed to develop a smartphone education application for managing metabolic syndrome among cancer survivors and obtain user evaluation based on quantitative and qualitative data. METHODS Ten cancer survivors and 10 oncology nurse specialists responded to a structured usability evaluation tool (Mobile Application Rating Scale: MARS). Quantitative data analysis was performed through descriptive statistics using SPSS version 25.0. We conducted semi-structured interviews of the cancer survivors and oncology nurse specialists. Qualitative data of interview responses were coded as the app's strengths and weaknesses, information, motivation, and behavioral change. RESULTS The overall usability evaluation score of the app was 3.66 ± 0.39 for cancer survivors and 3.79 ± 0.20 for oncology nurse specialists. Both cancer survivors and oncology nurse specialists scored the area of functionality as the highest and engagement as the lowest. Additionally, the qualitative usability evaluation suggested that the app should be visually improved by including figures and tables to enhance readability and providing videos and more specific guidelines to directly elicit behavioral change. CONCLUSIONS Metabolic syndrome in cancer survivors can be effectively managed by using the educational application developed in this study by improving the shortcomings of the app for cancer survivors.
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Affiliation(s)
- Ji-Su Kim
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, 06974, Seoul, Republic of Korea.
| | - Minhae Kim
- Department of Nursing, National Cancer Center, Gyeonggi-do, Republic of Korea.
| | - Yeji Seo
- Department of Nursing, Semyung University, 65 Semyeong-ro, Jecheon-si, Chungcheongbuk-do, Republic of Korea.
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Feasibility of Investigational Procedures and Efficacy of a Personalized Omega-3 Dietary Intervention in Alleviating Pain and Psychoneurological Symptoms in Breast Cancer Survivors. Pain Manag Nurs 2023; 24:78-88. [PMID: 35450801 DOI: 10.1016/j.pmn.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) are at risk for psychoneurological symptoms (PNS) and inflammation for years following cancer treatment. Fish, particularly salmon, provides a rich source of omega-3 long chain fatty acids (omega-3LC), which has an anti-inflammatory effect. However, the benefit of omega-3LC on PNS is not well-known. AIMS This study evaluated the feasibility and the initial efficacy of a personalized meal plan with dietary omega-3LC in reducing PNS. METHODS A prospective, randomized controlled trial design (n = 46) was used to evaluate the feasibility of a personalized meal plan using two omega-3LC dose levels (high and low omega-3LC) in reducing PNS including pain, depression, fatigue, sleep, and stress. RESULTS The recruitment rate was 4.9% with overall retention rate of 74% and 67.1% adherence to personalized meal plan and dietary procedures. Of participants who completed the investigation, 94% completed fish adherence logs and consumed ≥70% of the assigned quantity of fish. Saliva collection was 97.8% at baseline and 100% at follow-up. BCS in the high omega-3LC group had a significant decrease in pain (p < .01), perceived stress (p < .05), sleep (p < .001), depression (p < .001), and fatigue (p < .01) over the course of intervention. There were trends of PNS improvement in the low omega-3LC group but the differences did not reach statistical significance. CONCLUSION Our results support the feasibility of our investigational design, procedures, and intervention. The outcomes provide preliminary support for an expanded research effort using fish as a source of omega-3LC and personalized dietary planning as a vehicle for symptom self-management in BCS.
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11
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Cooper KB, Lapierre S, Carrera Seoane M, Lindstrom K, Pritschmann R, Donahue M, Christou DD, McVay MA, Jake-Schoffman DE. Behavior change techniques in digital physical activity interventions for breast cancer survivors: a systematic review. Transl Behav Med 2023; 13:268-280. [PMID: 36694356 DOI: 10.1093/tbm/ibac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Given the broad benefits of physical activity (PA) but low PA levels among breast cancer survivors (i.e., women who have received a breast cancer diagnosis), innovative and evidence-based techniques are needed to motivate and support exercise. This study systematically reviews the use of behavior change techniques (BCTs) in digital PA interventions for breast cancer survivors. Studies were retrieved from five electronic databases and were included if they (i) sampled exclusively female breast cancer survivors aged >18 years, (ii) involved a digital intervention with the primary purpose of increasing PA, (iii) included a BCT component, (iv) used a randomized or quasi-randomized design, and (v) were published from January 2000 to May 2022. Two coders independently extracted data. Twenty primary studies met the inclusion criteria and were included in this review. All interventions used at least one BCT (mean 4 ± 1, range 2-13); self-monitoring (85%) and goal setting (79%) were the most common BCTs. Twelve of 20 (60%) studies reported improvements in PA behavior in the intervention vs. control group, and self-monitoring and goal setting were the most commonly used BCTs in these studies. Of the 93 total BCTs, 66 were not used in any interventions in the review, including critical constructs for PA behavior change (e.g., biofeedback). BCTs, important facilitators of PA behavior change, are being underutilized in digital PA interventions for breast cancer survivors. Future research should incorporate more diverse BCTs to explore if they can add to the effectiveness of digital interventions for this population.
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Affiliation(s)
- Kellie B Cooper
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Stephanie Lapierre
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | | | - Katie Lindstrom
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Ricarda Pritschmann
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Marissa Donahue
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Megan A McVay
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
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12
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Henkin JS, Botton CE, Simon MS, Rocha GG, Silveira CB, Gehrke RS, Freitas GB, Trajano GS, Pinto RS, Pinto SS. Telehealth multicomponent exercise and health education in breast cancer patients undergoing primary treatment: rationale and methodological protocol for a randomized clinical trial (ABRACE: Telehealth). Trials 2023; 24:42. [PMID: 36658611 PMCID: PMC9851110 DOI: 10.1186/s13063-022-07015-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/14/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Current guidelines emphasize cancer patients should increase their physical activity levels, encouraging physical exercise practice as a complementary therapy to mitigate adverse effects during treatment. Telehealth can be a feasible method to improve adherence and interventional support for breast cancer patients, of which most do not meet sufficient physical activity levels after diagnosis. The Adaptations to Breast Cancer and Exercise Using Telehealth (ABRACE: Telehealth) study aims to investigate the effects of a 12-week telehealth multicomponent training program plus a health education program (MTHE), compared to a health education program alone (HE), on physical and psychological outcomes in breast cancer patients undergoing treatment. METHODS This study is a randomized controlled trial. Women undergoing primary treatment (during or after chemotherapy) for breast cancer (stages I-III) will be randomly assigned to MTHE (twice a week) or HE (once a week). MTHE components are mobility, aerobic, balance, resistance, and flexibility home-based exercises, supervised by video call. The primary study outcome is cancer-related fatigue. The secondary outcomes are quality of life, symptoms of depression and anxiety, physical activity level, cancer-related cognitive impairment, and functional capacity. Other outcomes are adherence to interventions and a follow-up questionnaire evaluating the individual perception in motivation, lifestyle changes, and main barriers to participation. All outcomes will be remotely assessed before and after intervention. Our analysis will follow the intention-to-treat approach and per-protocol criteria, with additional sub-group analysis. DISCUSSION To our knowledge, this is the first randomized clinical trial in breast cancer patients using a face-to-face videoconference strategy to supervise physical exercise. Our hypothesis is of superiority for the effects of MTHE on primary and secondary outcomes compared to the effects of only the health education intervention. TRIAL REGISTRATION Adaptations to Breast Cancer and Exercise Using Telehealth (ABRACE: Telehealth), NCT04641377. Registered on 23 November 2021, https://clinicaltrials.gov/ct2/show/NCT04641377.
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Affiliation(s)
- João S. Henkin
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Cíntia E. Botton
- grid.414449.80000 0001 0125 3761Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Clinical Research Center, Porto Alegre, Rio Grande do Sul Brazil
| | - Mariana S. Simon
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Guilherme G. Rocha
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Caroline B. Silveira
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Ricardo S. Gehrke
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Gabriella B. Freitas
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Gabriel S. Trajano
- grid.1024.70000000089150953School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Ronei S. Pinto
- grid.8532.c0000 0001 2200 7498Exercise Research Laboratory (LAPEX), Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Felizardo, 750 – Bairro Jardim Botânico, Porto Alegre, Rio Grande do Sul CEP: 90690-200 Brazil
| | - Stephanie S. Pinto
- grid.411221.50000 0001 2134 6519Neuromuscular Assessment Laboratory, Physical Education School, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul Brazil
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13
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Leske M, Koczwara B, Morris J, Beatty L. Modality preferences for health behaviour interventions for post-treatment cancer survivors: a theoretical investigation. Support Care Cancer 2023; 31:143. [PMID: 36729337 PMCID: PMC9892669 DOI: 10.1007/s00520-023-07607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023]
Abstract
PURPOSES User preferences for how programs are delivered are an important consideration when developing healthy living interventions. The aim of this study was to investigate (a) if cancer survivors prefer telephone or internet delivery for a healthy living intervention and (b) what factors were associated with delivery preference. METHODS Australian cancer survivors (18 + years) were invited to complete an online or hardcopy cross-sectional survey measuring social and clinical demographic factors and validated measures of self-efficacy, health literacy, and social support. RESULTS Of the 168 respondents, the majority were female (n = 147, 92%) and breast cancer survivors (n = 122, 80%) and preferred internet delivery (n = 109, 65%). Participants who preferred internet delivery had a longer time since diagnosis (M = 9.85 years, SD = 8.20) compared to those who preferred telephone (M = 6.80 years, SD = 5.54), p = .03. However, logistic regression analyses demonstrated that no other variables (age, gender, socio-economic status, BMI, education, self-efficacy, health literacy, nor social support) had a direct association on delivery preference. CONCLUSIONS Cancer survivors appear to prefer internet delivery to telephone, particularly for those further along the survivorship trajectory. Future intervention development should therefore consider the internet modality for delivering accessible health interventions and offer the program to long-term cancer survivors. Whether these findings are replicable in the current post-pandemic phase is an important avenue for future research.
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Affiliation(s)
- Morgan Leske
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia.
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, SA Australia ,Department of Medical Oncology, Southern Adelaide Local Health Network, Adelaide, SA Australia
| | | | - Lisa Beatty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA Australia
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14
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Ibrahim M, Cardiff K, Nhan I, Savarimuthu V, Yao K, Kasai S, Posel N, Soicher J. Development of an evidence-based educational resource in oncology: 'Living safely with bone metastases'. PEC INNOVATION 2022; 1:100064. [PMID: 37213771 PMCID: PMC10194355 DOI: 10.1016/j.pecinn.2022.100064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 07/11/2022] [Indexed: 05/23/2023]
Abstract
Objective To create an evidence-based patient education resource to better support cancer patients with bone metastases in carrying out safe movements during activities of daily living, to maintain their bone health and reduce the risk of fractures. Methods A quality improvement project was conducted in three phases: Development of the Resource, Preliminary Feedback and Revision, and French Canadian Translation. Results The educational resource Living Safely with Bone Metastases focuses on safe movement, activities of daily living, and exercise, organized within the sections Move with care, Stay safe in different environments and Follow an exercise program prescribed by a physiotherapist. Translation yielded a Canadian French version Vivre en toute sécurité avec des métastases osseuses. Conclusion Living Safely with Bone Metastases is an accessible online and paper resource for patients and healthcare professionals, in order to promote ongoing disease management of individuals with bone metastases. Innovation Cancer patients with bone metastases are at high risk of pathological fractures however resources on fracture prevention are lacking. Living Safely with Bone Metastases is an innovative health education resource that fills an important gap in oncology practice and has the potential to reduce the occurrence of fractures.
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Affiliation(s)
- Marize Ibrahim
- Oncology Physiotherapy, Hope and Cope, Segal Cancer Centre, Jewish General Hospital, 3755 Côte Sainte Catherine, Montreal H3T 1E2, Canada
| | - Katrina Cardiff
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal H3G 1Y5, Canada
| | - Isabelle Nhan
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal H3G 1Y5, Canada
| | - Vanissa Savarimuthu
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal H3G 1Y5, Canada
| | - Kathryn Yao
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal H3G 1Y5, Canada
| | - Shie Kasai
- Patient Education Office, McGill University Health Centre, 4920 de Maisonneuve West, Suite 301, Montreal H3Z 1N1, Canada
| | - Nancy Posel
- Patient Education Office, McGill University Health Centre, 4920 de Maisonneuve West, Suite 301, Montreal H3Z 1N1, Canada
| | - Judith Soicher
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal H3G 1Y5, Canada
- Corresponding author at: School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Room D39, Canada.
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15
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Chapel B, Alexandre F, Heraud N, Ologeanu-Taddei R, Cases AS, Bughin F, Hayot M. Standardization of the assessment process within telerehabilitation in chronic diseases: a scoping meta-review. BMC Health Serv Res 2022; 22:984. [PMID: 35918690 PMCID: PMC9344755 DOI: 10.1186/s12913-022-08370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background Telerehabilitation (TR) interventions are receiving increasing attention. They have been evaluated in various scientific areas through systematic reviews. However, there is a lack of data on how to standardize assessment and report on their domains to guide researchers across studies and bring together the best evidence to assess TR for chronic diseases. Aims and objectives The aim of this study was to identify domains of assessment in TR and to qualitatively and quantitatively analyze how and when they are examined to gain an overview of assessment in chronic disease. Methods A scoping meta-review was carried out on 9 databases and gray literature from 2009 to 2019. The keyword search strategy was based on "telerehabilitation", “evaluation", “chronic disease" and their synonyms. All articles were subjected to qualitative analysis using the Health Technology Assessment (HTA) Core Model prior to further analysis and narrative synthesis. Results Among the 7412 identified articles, 80 studies met the inclusion criteria and addressed at least one of the noncommunicable diseases (NCD) categories of cardiovascular disease (cardiovascular accidents), cancer, chronic respiratory disease, diabetes, and obesity. Regarding the domains of assessment, the most frequently occurring were “social aspect” (n = 63, 79%) (e.g., effects on behavioral changes) and “clinical efficacy” (n = 53, 66%), and the least frequently occurring was “safety aspects” (n = 2, 3%). We also identified the phases of TR in which the assessment was conducted and found that it most commonly occurred in the pilot study and randomized trial phases and least commonly occurred in the design, pretest, and post-implementation phases. Conclusions Through the HTA model, this scoping meta-review highlighted 10 assessment domains which have not been studied with the same degree of interest in the recent literature. We showed that each of these assessment domains could appear at different phases of TR development and proposed a new cross-disciplinary and comprehensive method for assessing TR interventions. Future studies will benefit from approaches that leverage the best evidence regarding the assessment of TR, and it will be interesting to extend this assessment framework to other chronic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08370-y.
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Affiliation(s)
- Blandine Chapel
- University of Montpellier, Montpellier Research of Management, Montpellier, France.
| | - François Alexandre
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | - Nelly Heraud
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | | | - Anne-Sophie Cases
- University of Montpellier, Montpellier Research of Management, Montpellier, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
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16
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Dennett AM, Harding KE, Peiris CL, Shields N, Barton C, Lynch L, Parente P, Lim D, Taylor NF. Efficacy of Group Exercise-Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e38553. [PMID: 35849441 PMCID: PMC9345024 DOI: 10.2196/38553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background Access to rehabilitation to support cancer survivors to exercise is poor. Group exercise–based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy. Objective We aimed to evaluate the efficacy of a group exercise–based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors. Methods A parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed. Results The trial commenced in April 2022. As of June 2022, we enrolled 14 participants. Conclusions This trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtr International Registered Report Identifier (IRRID) PRR1-10.2196/38553
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Affiliation(s)
- Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Katherine E Harding
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Christian Barton
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Lauren Lynch
- Community Health, Eastern Health, Healesville, Australia
| | - Phillip Parente
- Department of Cancer Services, Eastern Health, Box Hill, Australia.,Eastern Health Clinical School, Monash University, Clayton, Australia
| | - David Lim
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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17
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Burton M, Valet M, Caty G, Aboubakar F, Reychler G. Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review. J Telemed Telecare 2022:1357633X221094200. [PMID: 35546542 DOI: 10.1177/1357633x221094200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Evidence is shown for the benefits of physical activity, for patients with lung cancer, at different times through the course of the disease. Telerehabilitation can overcome some of barriers often met by patients to practice physical activity. The objective of this systematic review is to assess feasibility and safety of telerehabilitation for patients with lung cancer, its effects on physical capacity, quality of life, symptoms severity, depression and anxiety, survival, lung function, post-operative outcomes, dyspnoea and body composition. Secondary aim was to distinguish the telerehabilitation efficacy between the different phases of the disease. DATA SOURCE AND SELECTION CRITERIA Pubmed, PEDro, Scopus, ScienceDirect, randomized controlled trials and non-randomized controlled trials, written in French or English, of telerehabilitation among patients with lung cancer. RESULTS Eight studies were included. Telerehabilitation is safe but was characterized by a low recruitment and attendance rate (<70%). It enhances quality of life, muscle mass, depression and anxiety but it does not improve physical capacity (except in preoperative period), symptoms severity, survival, lung function or dyspnoea. After surgery, it ameliorates quality of life, depression and anxiety. During systemic treatments of lung cancer, it improves quality of life, symptoms severity and muscle mass. CONCLUSION Telerehabilitation could be proposed in patients with lung cancer as a complementary intervention of hospital-based programme to increase physical activity volume, compliance and self-efficacy. In case the classic programmes are not possible, it could also be an alternative approach for patients unable to participate to a hospital or community-based training programme.
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Affiliation(s)
- Madeleine Burton
- Secteur de kinésithérapie et ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Maxime Valet
- Service de Médecine physique et Réadaptation, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal lab (NMSK), Brussels, Belgium
| | - Gilles Caty
- Service de Médecine Physique et Réadaptation, 82451Centre Hospitalier de Wallonie picarde, Tournai, Belgium
| | - Frank Aboubakar
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Département de médecine interne et de maladies infectieuses, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Gregory Reychler
- Secteur de kinésithérapie et ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
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18
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Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, Neuhouser ML, Bandera EV, Wang Y, Robien K, Basen-Engquist KM, Brown JC, Courneya KS, Crane TE, Garcia DO, Grant BL, Hamilton KK, Hartman SJ, Kenfield SA, Martinez ME, Meyerhardt JA, Nekhlyudov L, Overholser L, Patel AV, Pinto BM, Platek ME, Rees-Punia E, Spees CK, Gapstur SM, McCullough ML. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin 2022; 72:230-262. [PMID: 35294043 DOI: 10.3322/caac.21719] [Citation(s) in RCA: 220] [Impact Index Per Article: 110.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/22/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis.
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Affiliation(s)
- Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California at San Diego, La Jolla, California
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kristen R Sullivan
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Carol L Howe
- Department of Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
- Department of Family and Community Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ying Wang
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Kimberly Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Karen M Basen-Engquist
- Division of Cancer Prevention and Population Sciences, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Justin C Brown
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Kerry S Courneya
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy E Crane
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Coral Gables, Florida
| | - David O Garcia
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Barbara L Grant
- Cancer Care Center, St Alphonsus Regional Medical Center, Boise, Idaho
| | - Kathryn K Hamilton
- Carol G. Simon Cancer Center, Morristown Medical Center, Morristown, New Jersey
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
| | - Stacey A Kenfield
- Department of Urology, University of California at San Francisco, San Francisco, California
| | - Maria Elena Martinez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
- Moores Cancer Center, University of California at San Diego, La Jolla, California
| | | | - Larissa Nekhlyudov
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Alpa V Patel
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Bernardine M Pinto
- College of Nursing, University of South Carolina, Columbia, South Carolina
| | - Mary E Platek
- School of Health Professions, D'Youville College, Buffalo, New York
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Erika Rees-Punia
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Colleen K Spees
- College of Medicine, The Ohio State University, Columbus, Ohio
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19
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Male D, Fergus K, Yufe S. 'Weighing' Losses and Gains: Evaluation of the Healthy Lifestyle Modification After Breast Cancer Pilot Program. Front Psychol 2022; 13:814671. [PMID: 35401377 PMCID: PMC8992775 DOI: 10.3389/fpsyg.2022.814671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This pilot study sought to develop and evaluate a novel online group-based intervention (Healthy Lifestyle Modification after Breast Cancer; HLM-ABC) to help breast cancer survivors (BCSs) make healthy lifestyle changes intended to yield not only beneficial physical outcomes (i.e., weight loss, reduced body mass index) but also greater behavioral (e.g., increased physical activity, healthier eating), and psychosocial well-being (e.g., self-efficacy, motivation, body image). Methods An exploratory single-arm, mixed-method triangulation design was employed to evaluate the feasibility and preliminary effectiveness of the HLM-ABC intervention for overweight BCSs. Fourteen women participated in the 10-week intervention and completed quantitative measures of the above-mentioned outcomes at baseline, post-treatment, 6-month, and 12-month follow-up time points. Qualitative data were obtained post-treatment via semi-structured interviews and a treatment satisfaction questionnaire. Results Participants lost an average of 2.83% of their baseline weight (M = 196.65; SD = 38.59) by 1-year follow-up (M = 191.29; SD = 33.91), equal to a small effect size (d = -0.37). Despite achieving only modest weight loss, participants achieved meaningful gains in the form of increased physical activity (d = 0.2), discovery of gratifying movement, more intuitive eating habits (d = 1.12), greater bodily and emotional awareness, and positive shifts in beliefs about being able to make healthy choices regarding food (d = 0.63) and physical activity (d = 0.38). Furthermore, they demonstrated a slight improvement in body image (d = 0.36) and described feeling more self-compassionate, empowered, and acknowledging of variables beyond control (i.e., hormonal therapy, unsatisfactory surgery) that can present barriers to change. Conclusion After completing a 10-week online program, participants achieved meaningful and lasting changes on a number of healthful indicators, even when this did not correspond with a significant reduction in weight. Findings highlight the complex, multifaceted nature of "health" and lend support for promotion of healthier lifestyle following cancer treatment that encompasses not only physical weight, but also behavior, psychosocial well-being, and (often unmodifiable) circumstances such as life-preserving hormonal treatments.
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Affiliation(s)
- Dana Male
- Tom Baker Cancer Centre (TBCC), Department of Psychosocial Oncology, Alberta Health Services, Calgary, AB, Canada
- Psychosocial Oncology Laboratory, Department of Psychology, York University, Toronto, ON, Canada
| | - Karen Fergus
- Psychosocial Oncology Laboratory, Department of Psychology, York University, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Shira Yufe
- Psychosocial Oncology Laboratory, Department of Psychology, York University, Toronto, ON, Canada
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20
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Phillips SM, Penedo FJ, Collins LM, Solk P, Siddique J, Song J, Cella D, Courneya KS, Ackermann RT, Welch WA, Auster-Gussman LA, Whitaker M, Cullather E, Izenman E, Spring B. Optimization of a technology-supported physical activity promotion intervention for breast cancer survivors: Results from Fit2Thrive. Cancer 2022; 128:1122-1132. [PMID: 34812521 PMCID: PMC8837679 DOI: 10.1002/cncr.34012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/02/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The benefits of moderate to vigorous physical activity (MVPA) for breast cancer survivors are well established. However, most are insufficiently active. Fit2Thrive used the Multiphase Optimization Strategy methodology to determine the effect of 5 intervention components on MVPA in this population. METHODS Two hundred sixty-nine participants (mean age, 52.5 years; SD, 9.9 years) received a core intervention (the Fit2Thrive self-monitoring app and Fitbit) and were randomly assigned to 5 intervention components set to on/off in a full factorial experiment: support calls, deluxe app, buddy, online gym, and text messages. The intervention was delivered over 12 weeks with a 12-week follow-up. MVPA was measured via accelerometry at the baseline (T1), at 12 weeks (T2), and at 24 weeks (T3). The main effects and interaction effects at each time point were examined for all components. RESULTS Trial retention was high: 91.8% had valid accelerometer data at T2 or T3. Across all conditions, there were significant increases in MVPA (+53.6 min/wk; P < .001) and in the proportion of survivors meeting MVPA guidelines (+22.3%; P < .001) at T2 that were maintained but attenuated at T3 (MVPA, +24.6 min/wk; P < .001; meeting guidelines, +12.6%; P < .001). No individual components significantly improved MVPA, although increases were greater for the on level versus the off level for support calls, buddy, and text messages at T2 and T3. CONCLUSIONS The Fit2Thrive core intervention (the self-monitoring app and Fitbit) is promising for increasing MVPA in breast cancer survivors, but the components provided no additional increases in MVPA. Future research should evaluate the core intervention in a randomized trial and determine what components optimize MVPA behaviors in breast cancer survivors.
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Affiliation(s)
| | | | | | - Payton Solk
- Northwestern University Feinberg School of Medicine
| | | | - Jing Song
- Northwestern University Feinberg School of Medicine
| | - David Cella
- Northwestern University Feinberg School of Medicine
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21
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Williams V, Brown N, Moore JX, Farrell D, Perumean-Chaney S, Schleicher E, Fontaine K, Demark-Wahnefried W, Pekmezi D. Web-Based Lifestyle Interventions for Survivors of Cancer: Usability Study. JMIR Form Res 2022; 6:e30974. [PMID: 35188468 PMCID: PMC8902653 DOI: 10.2196/30974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/04/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Internet-based lifestyle programs are increasingly being used to deliver health behavior change interventions to survivors of cancer. However, little is known about website use in this population or its association with healthy lifestyle changes. OBJECTIVE The aim of this study is to describe lifestyle intervention website use (log-ins, time on website, and page views) among survivors of cancer and patterns of use by participant characteristics. In addition, associations were explored between website use and changes in healthy lifestyle knowledge and practice. METHODS A total of 35 survivors of cancer were recruited between August 2017 and 2018 to participate in a 2-week, single-arm pilot test of the SurvivorSHINE lifestyle intervention website. Knowledge and practices related to healthy diet and physical activity behaviors were measured at baseline and follow-up. Website use (eg, time spent on the website, frequency of log-ins, and page views) were collected from the SurvivorSHINE administrative site during the intervention period. Patterns of use were examined by participants' gender and race. Correlations between website use and changes in healthy lifestyle knowledge, physical activity, diet, and weight were explored. Mann-Whitney U tests were used to compare demographic factors on website use. RESULTS Participants logged into the SurvivorSHINE intervention website an average of 3.2 (SD 2) times over the 2-week period and spent a total average of 94 (SD 56) minutes viewing the website during the intervention. Examining website activity, 1905 page views were logged. The User Profile (344 page views) and Home sections (301 page views) were the most frequently visited components. No associations were observed between the frequency of log-ins or the total time on the website, improvements in knowledge related to healthy lifestyles, or changes in body weight or dietary intake. However, the total time on the website was positively correlated with improvements in accelerometer-measured physical activity (r=0.74; P=.02) and self-reported physical activity (r=0.35; P=.04). CONCLUSIONS Survivors of cancer demonstrated clear interest in a diet and exercise intervention website, as evidenced by their frequency of log-ins, page views on numerous features, and total viewing time. Moreover, increased website use was correlated with improvements in physical activity.
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Affiliation(s)
- Victoria Williams
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nashira Brown
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Justin Xavier Moore
- Department of Population Health Sciences, Augusta University, Augusta, GA, United States
| | | | - Suzanne Perumean-Chaney
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erica Schleicher
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Wendy Demark-Wahnefried
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
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22
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Terranova CO, Winkler EAH, Healy GN, Demark-Wahnefried W, Eakin EG, Reeves MM. Dietary and physical activity changes and adherence to WCRF/AICR cancer prevention recommendations following a remotely delivered weight loss intervention for female breast cancer survivors: The Living Well after Breast Cancer randomized controlled trial. J Acad Nutr Diet 2022; 122:1644-1664.e7. [PMID: 35182789 DOI: 10.1016/j.jand.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Diet, exercise, and weight management are key in improving outcomes for breast cancer survivors, with international recommendations for cancer survivors relating to these behaviors. However, few behavioral interventions have reported outcomes aligned specifically with these recommendations. OBJECTIVE To evaluate a remotely delivered weight loss intervention versus usual care for female breast cancer survivors, on changes in multiple diet and physical activity behaviors. DESIGN A randomized controlled trial with assessments at study baseline, 6-, 12- and 18 months (i.e., mid-intervention, post-intervention, and non-contact follow-up). PARTICIPANTS/SETTING Participants were recruited between October 2012 and December 2014 through hospitals in Brisbane (Australia) and the state-based cancer registry. Eligible participants (female, 18-75 years, BMI 25-45 kg/m2, diagnosed with stage I-III breast cancer in previous two years) were randomly allocated to intervention (n=79) or usual care (n=80). INTERVENTION Participants randomized to the intervention group received 22 counseling telephone calls targeting diet and physical activity aimed at achieving 5-10% weight loss, and optional text messages, over 12 months. Usual care participants received their standard medical care and brief feedback following each assessment, which was similar to that provided to intervention participants with the exception that usual care participants' results were not compared to national and study recommendations. MAIN OUTCOME MEASURES Dietary intake (24-hour recalls); physical activity (hip-worn Actigraph); sitting time (thigh-worn activPAL3); and, adherence to World Cancer Research Fund/American Cancer Research Institute (WCRF/AICR) recommendations for cancer survivors (0-7 score) were measured at each assessment, with data collected between November 2012 and October 2016. STATISTICAL ANALYSES PERFORMED Intervention effects were assessed by linear mixed models, accounting for repeated measures and baseline values. Significance was set at P<0.05. RESULTS At baseline, participants were (mean±SD) aged 55±9 years, with a BMI of 31.4±5.0 kg/m2, 10.7±5.0 months post-diagnosis, and primarily non-minority. At baseline, only 8% (n=12) of participants met ≥5/7 WCRF/AICR recommendations (mean±SD WCRF/AICR adherence score: 3.8±1.0). At 12 months, significant intervention effects were observed in walking/running ( +21 mins/week; 95%CI: 4, 38) and WCRF/AICR adherence scores (+0.3 points; 95%CI: 0.0, 0.6) only. At 18 months, significant intervention effects were observed for energy intake (-229 kcal/day energy; 95%CI: -373, -84), total fat (-10 g/day; 95%CI: -18, -2), and saturated fat (-5 g/day; 95%CI: -9, -1), and were sustained for WCRF/AICR adherence scores (+0.5 points; 95%CI: 0.2, 0.8). CONCLUSIONS This remotely delivered weight loss intervention led to sustained improvements in WCRF/AICR adherence scores, and some improvements in diet and physical activity. These findings provide support for the health benefit of programs targeting lifestyle behaviors in line with cancer survivor recommendations, and the potential for dissemination of such programs following treatment for early-stage female breast cancer.
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Affiliation(s)
- C O Terranova
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - E A H Winkler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - G N Healy
- School of Public Health, The University of Queensland, Brisbane, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - W Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - E G Eakin
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - M M Reeves
- School of Public Health, The University of Queensland, Brisbane, Australia
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23
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Edney LC, Roseleur J, Gray J, Koczwara B, Karnon J. Mapping a decade of interventions to address the supportive care needs of individuals living with or beyond cancer: a scoping review of reviews. Support Care Cancer 2022; 30:3793-3804. [PMID: 35029770 DOI: 10.1007/s00520-021-06713-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Individuals diagnosed with cancer have a range of supportive care needs that are often unmet despite substantial evidence supporting interventions to address them. Addressing this knowledge-translation gap represents a significant opportunity to improve health outcomes. A scoping review of reviews was conducted to map the breadth of evidence for interventions, highlighting those with an existing evidence base, as well as those requiring further research. METHODS Systematic or meta-analytic reviews that examined interventions targeting supportive care needs of adults and children with cancer published between 2009 and 2019 were identified via searches in Medline, PsycINFO, CINAHL, Scopus and Cochrane. RESULTS Five hundred fifty-one systematic reviews, including 250 meta-analyses, of interventions addressing supportive care needs, were included. Most reviews focused on interventions to address the physical and psychosocial needs of individuals with few reviews identified to address practical needs. Interventions using mental health therapies and physical activity were most commonly used to address all supportive care needs, followed by the use of pharmaceutical and medical devices, complementary and alternative therapies, information and education resources, dietary information and specific spirituality and return-to-work interventions. CONCLUSION This scoping review of reviews presents the first broad overview of the literature addressing the supportive care needs of people living with or beyond cancer. It provides a database that health service providers can search to identify appropriate interventions. Results highlight specific research gaps, particularly for practical needs, where reviews are needed. It highlights where a substantial evidence base exists that researchers and policy-makers can consider when implementing interventions.
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Affiliation(s)
- Laura Catherine Edney
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Jacqueline Roseleur
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.
| | - Jodi Gray
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.,Flinders Medical Centre, Adelaide, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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24
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Rees-Punia E, Leach CR, Westmaas JL, Dempsey LF, Roberts AM, Nocera JR, Patel AV. Pilot Randomized Controlled Trial of Feasibility, Acceptability, and Preliminary Efficacy of a Web-Based Physical Activity and Sedentary Time Intervention for Survivors of Physical Inactivity-Related Cancers. Int J Behav Med 2022; 29:220-229. [PMID: 33954891 PMCID: PMC8099708 DOI: 10.1007/s12529-021-09999-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND This pilot study explored the feasibility, acceptability, and usability of a web-based intervention for survivors of physical inactivity-related cancers through a two-arm, 12-week randomized controlled trial. Secondarily, this study tested the change in physical activity (PA) and sedentary time with intervention exposure. METHODS Prior to randomization to the intervention (n = 45) or behavior "as usual" wait-listed control (n = 40) groups, participants completed baseline surveys and an accelerometer protocol. The intervention focused on increasing PA and decreasing sedentary time through social cognitive theory techniques. Follow-up acceptability/usability surveys (intervention group only) and accelerometers were sent after the intervention period. Information on intervention completion, adverse events, and user statistics were collected to determine feasibility. Median login time and mean acceptability/usability scores were calculated. RESULTS Participants (mean age = 60 ± 7 years) included female (n = 80, 94%) and male survivors of breast (82%), colon (6%), endometrial (6%), bladder (4%), and kidney (2%) cancer. Seventy-eight (91.7%) participants returned partially or fully complete post-intervention data. There were no reported injuries or safety concerns. Intervention participants logged into the website for a total of 95 min (Q1, Q3 = 11, 204). System usability scores (72 ± 3) indicated above average usability of the website. Changes in time spent active and sedentary were not statistically significantly different between groups (p = 0.45), but within-group changes suggested intervention group participants spent more time active and less time sedentary after the intervention. CONCLUSION Results of this pilot study suggest its feasibility and acceptability for survivors of several inactivity-related cancers. Additional research to determine long-term efficacy is warranted. This low-cost online-only intervention has the potential to have a very broad reach. TRIAL REGISTRATION Clinical Trials Number: NCT03983083. Date registered: June 12th, 2019.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, GA, USA.
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - J. Lee Westmaas
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Lauren F. Dempsey
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Amelia M. Roberts
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Joe R. Nocera
- Departments of Neurology and Rehabilitation Medicine, Emory University, Atlanta, GA USA ,Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA USA ,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, GA USA
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, GA USA
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25
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Choy KT, Lam K, Kong JC. Exercise and colorectal cancer survival: an updated systematic review and meta-analysis. Int J Colorectal Dis 2022; 37:1751-1758. [PMID: 35882678 PMCID: PMC9388423 DOI: 10.1007/s00384-022-04224-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The benefit of exercise to colorectal cancer patients has been advocated. However, comparative data to quantify the survival benefit is lacking. The aim of this review was to assess the effect of exercise on colorectal cancer survival. METHODS An up-to-date systematic review was performed on the available literature between 2000 and 2021 on PubMed, EMBASE, Medline, and Cochrane Library databases. All studies reporting on the impact of exercise and colorectal cancer outcomes in patients treated for non-metastatic colorectal cancer were analysed. The main outcome measures were the overall survival (OS), cancer specific survival (CSS) and disease free survival (DFS). RESULTS A total of 13 prospective observational studies were included, accounting for 19,135 patients. Compared to negligible physical activity, overall survival (OS) was significantly increased for both moderate and highest activity group (HR 0.82, 95% CI: 0.74-0.90, p < 0.001 and HR 0.64, 0.56-0.72, p < 0.001 respectively). This was also reflected in cancer specific survival (CSS) analysis, but not disease-free survival (DFS) analysis. CONCLUSION Exercise was associated with an increased in overall survival after a colorectal cancer resection. This would support the promotion of exercise interventions amongst colorectal cancer patients.
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Affiliation(s)
- Kay T. Choy
- Department of Surgery, Austin Hospital, Melbourne, VIC Australia
| | - Kenneth Lam
- Department of Surgery, St. Vincent’s Hospital, Melbourne, VIC Australia
| | - Joseph C. Kong
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC Australia ,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC Australia
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26
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Dennett A, Harding KE, Reimert J, Morris R, Parente P, Taylor NF. Telerehabilitation's Safety, Feasibility, and Exercise Uptake in Cancer Survivors: Process Evaluation. JMIR Cancer 2021; 7:e33130. [PMID: 34854817 PMCID: PMC8768007 DOI: 10.2196/33130] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/31/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Access to exercise for cancer survivors is poor despite global recognition of its benefits. Telerehabilitation may overcome barriers to exercise for cancer survivors but is not routinely offered. OBJECTIVE Following the rapid implementation of an exercise-based telerehabilitation program in response to COVID-19, a process evaluation was conducted to understand the impact on patients, staff, and the health service with the aim of informing future program development. METHODS A mixed methods evaluation was completed for a telerehabilitation program for cancer survivors admitted between March and December 2020. Interviews were conducted with patients and staff involved in implementation. Routinely collected hospital data (adverse events, referrals, admissions, wait time, attendance, physical activity, and quality of life) were also assessed. Patients received an 8-week telerehabilitation intervention including one-on-one health coaching via telehealth, online group exercise and education, information portal, and home exercise prescription. Quantitative data were reported descriptively, and qualitative interview data were coded and mapped to the Proctor model for implementation research. RESULTS The telerehabilitation program received 175 new referrals over 8 months. Of those eligible, 123 of 150 (82%) commenced the study. There were no major adverse events. Adherence to health coaching was high (674/843, 80% of scheduled sessions), but participation in online group exercise classes was low (n=36, 29%). Patients improved their self-reported physical activity levels by a median of 110 minutes per week (IQR 90-401) by program completion. Patients were satisfied with telerehabilitation, but clinicians reported a mixed experience of pride in rapid care delivery contrasting with loss of personal connections. The average health service cost per patient was Aus $1104 (US $790). CONCLUSIONS Telerehabilitation is safe, feasible, and improved outcomes for cancer survivors. Learnings from this study may inform the ongoing implementation of cancer telerehabilitation.
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Affiliation(s)
- Amy Dennett
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Katherine E Harding
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Jacoba Reimert
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia
| | - Rebecca Morris
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia
| | - Phillip Parente
- Department of Cancer Services, Eastern Health, Box Hill, Australia.,Eastern Health Clinical School, Monash University, Box Hill, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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27
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Carmack CL, Parker NH, Demark-Wahnefried W, Shely L, Baum G, Yuan Y, Giordano SH, Rodriguez-Bigas M, Pettaway C, Basen-Engquist K. Healthy Moves to Improve Lifestyle Behaviors of Cancer Survivors and Their Spouses: Feasibility and Preliminary Results of Intervention Efficacy. Nutrients 2021; 13:nu13124460. [PMID: 34960013 PMCID: PMC8709140 DOI: 10.3390/nu13124460] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 01/02/2023] Open
Abstract
Spouses offer a primary source of support and may provide critical assistance for behavior change. A diet-exercise intervention previously found efficacious in improving cancer survivors' lifestyle behaviors was adapted to utilize a couples-based approach. The aims were to test the feasibility of this couples-based (CB) intervention and compare its efficacy to the same program delivered to the survivor-only (SO). Twenty-two survivor-spouse couples completed baseline assessments and were randomized to the CB or SO interventions. The study surpassed feasibility benchmarks; 91% of survivors and 86% of spouses completed a 6-month follow-up. Survivors and spouses attended 94% and 91% of sessions, respectively. The SO survivors showed significant improvements on the 30-s chair stand and arm curl tests, weight, and fruit and vegetable (F and V) consumption. The CB survivors showed significant improvements on the 6-min walk and 2-min step tests, body weight, and fat and F and V consumption. Improvement in the 30-s chair stand and arm curl tests was significantly better for SO survivors. The SO spouses showed no significant changes in outcome measures, but the CB spouses showed significant improvements in moderate-to-strenuous physical activity, weight, and fat and F and V consumption. Weight loss was significantly greater in CB spouses compared to SO spouses. Findings demonstrate feasibility, warranting further investigation of CB approaches to promote lifestyle change among cancer survivors and spouses.
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Affiliation(s)
- Cindy L. Carmack
- Department of Palliative Care, Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Correspondence:
| | | | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Laura Shely
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA;
| | - George Baum
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.B.); (K.B.-E.)
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Sharon H. Giordano
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Miguel Rodriguez-Bigas
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Curtis Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.B.); (K.B.-E.)
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Riseth L, Ivar Lund Nilsen T, Mittet Ø, Steinsbekk A. The effect of initial support on fitness center use in new fitness center members. A randomized controlled trial. Prev Med Rep 2021; 24:101605. [PMID: 34976662 PMCID: PMC8683950 DOI: 10.1016/j.pmedr.2021.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 10/17/2021] [Indexed: 11/03/2022] Open
Abstract
There is a lack of research on what fitness centers do to support new members. The effect of initial support delivered via telephone and e-mail was investigated. There was an effect on bookings with a fitness trainer first six months. There was no effect on days with visits or membership duration during four years. More visits the first six months were associated with longer membership duration.
This provider and participant blinded parallel-group randomized controlled trial aimed to investigate if initial support given to new members via telephone and e-mail, compared to self-directed use, had an effect on booking with a fitness trainer, number of visits to the center, and membership duration. Participants included 356 new members, 174 randomized to the intervention group, and 182 to the control group. The intervention group received support to use the fitness center facilities through two phone calls and one e-mail over the first eight weeks of their membership. The control group got usual practice, which is self-directed use. Participants in the intervention group were more likely to book at least one session with a fitness trainer during the first six months (odds ratio 1.6, 95% confidence interval (CI) 1.0–2.5). However, the intervention did not influence the number of visits (mean difference after four years −11.7 days, 95% CI −34.8 to 11.3) or time to membership termination during the follow-up period (hazard ratio 1.1, 95% CI 0.8–1.3). In conclusion, initial support to use the fitness center facilities given to new fitness center members via telephone and e-mail increased the proportion of bookings with a fitness trainer during the first months of the membership, but it did not have an effect on the number of visits or membership termination during four years.
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Sezgin MG, Bektas H. The effect of web-based intervention programs on self-management and symptom management in patients with lymphoma: A systematic review of randomized controlled trials. Jpn J Nurs Sci 2021; 19:e12460. [PMID: 34738318 DOI: 10.1111/jjns.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/18/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022]
Abstract
AIM This systematic review aimed to systematically summarize studies obtained through a database search and examine the effect of web-based intervention programs on self-management and symptom management in patients with lymphoma. METHODS A systematic review of randomized controlled trials was carried out. Cochrane Central Register of Controlled Trials, Web of Science, PubMed, CINAHL, Scopus, ProQuest, Science Direct, and Ovid databases were reviewed until January 2021. The flow chart of the Preferred Reporting Items for Systematic Review and Meta-Analysis checklist was used in the search procedure without setting a year limit. Population, Intervention, Comparison, Outcomes and Study criteria were determined by two independent investigators and published randomized controlled studies in English with lymphoma diagnosis and web-based intervention programs for self-management and symptom management were included in the systematic review. The included studies were examined for their risk of bias with the help of the Cochrane Collaboration tool. A narrative synthesis of study findings was performed. RESULTS Six randomized controlled trials with 2382 participants were included in the systematic review. Web-based intervention programs in patients diagnosed with lymphoma were found to be generally implemented for determining the levels of self-management and symptom management. In all of the studies reviewed, it was found that the interventions had treatment outcomes. The risk of Bias 2 was evaluated as high risk in two studies that did not meet the criteria for blinding outcome evaluations. The included studies, while evaluating the effects of web-based intervention programs on patient outcomes, could not provide information about the underlying mechanisms by which these effects occur and how they occur. CONCLUSIONS All of the studies included were found to apply a technology designed to improve outcomes in patients with lymphoma. It is recommended that web-based intervention programs be individualized by adapting them to lymphoma types and stages, and serve as a guide for effective symptom management.
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Affiliation(s)
- Merve Gozde Sezgin
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Hicran Bektas
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Physical Activity Interventions for Colorectal Cancer Survivors: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cancer Nurs 2021; 44:E414-E428. [PMID: 34694086 PMCID: PMC8560161 DOI: 10.1097/ncc.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Physical activity (PA) has been shown to improve total mortality and colorectal-specific mortality risk; however, colorectal cancer (CRC) survivors have lower rates of PA compared with survivors with other types of cancers. Objective To examine the effect of PA interventions on CRC survivors. Methods A systematic review and meta-analysis were conducted to identify randomized controlled trials that met the inclusion criteria, which included an intervention designed to increase PA and more than 1 outcome of interest. Random effects of the meta-analyses were performed using Review Manager 5.3. Results Eight publications representing 7 randomized controlled trials of 803 participants were identified. All studies used a combination of behavioral change methods. Physical activity interventions significantly improved disease-specific quality of life, PA level, and maximum amount of oxygen and did not show significant improvements for fatigue and body mass index among CRC survivors. Conclusions We provided evidence that PA interventions were effective in improving disease-specific quality of life, PA level, and maximum amount of oxygen; however, they did not improve fatigue and body mass index. Further randomized controlled trials are needed to determine the optimal mode of delivering PA intervention for CRC survivors. Implications for Practice As the survival rate of patients with CRC increases, survivors of CRC need to increase PA in a community setting after completing primary treatments. Effective and efficient modes of PA intervention delivery could improve health-related outcomes and address specific barriers for CRC survivors.
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Job JR, Eakin EG, Reeves MM, Fjeldsoe BS. Evaluation of the Healthy Living after Cancer text message-delivered, extended contact intervention using the RE-AIM framework. BMC Cancer 2021; 21:1081. [PMID: 34620115 PMCID: PMC8496009 DOI: 10.1186/s12885-021-08806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background Text message-delivered interventions have potential to prevent weight regain and maintain diet and physical activity behaviours through extending contact with participants following initial weight loss, lifestyle interventions. Using the RE-AIM Framework, this study evaluated the adoption, reach, implementation, effectiveness, and maintenance of an extended contact text-message intervention following the Healthy Living after Cancer (HLaC) program. HLaC was a 6-month, telephone-delivered intervention targeting healthy diet, physical activity and weight loss for adult cancer survivors, offered by Cancer Councils (CCs) in Australia. Methods HLaC completers (n = 182) were offered extended contact via text messages for 6-months (HLaC+Txt). Text message content/frequency was individually tailored to participant’s preferences, ascertained through two telephone-tailoring interviews with CC staff. Adoption (HLaC+Txt uptake among eligible CCs), reach (uptake by HLaC completers) and implementation (intervention cost/length; text dose) were assessed. The effectiveness of extended contact relative to historic controls was quantified by pre-to-post HLaC+Txt changes in self-reported: weight, moderate-vigorous physical activity (MVPA), fruit and vegetable intake, fat and fibre behaviour. Maintenance, following 6-months of noncontact for the intervention cohort, was assessed for these same variables. Semi-structured interviews with CC staff and participants contextualised outcomes. Results HLaC+Txt was adopted by all four CCs who had delivered HLaC. In total, 115 participants commenced HLaC+Txt, with reach ranging across CCs from 47 to 80% of eligible participants. The mean number of weeks participants received the text message intervention ranged across CCs from 18.5–22.2 weeks. Participants received (median, 25th,75th percentile) 83 (48, 119) texts, ranging across CCs from 40 to 112. The total cost of HLaC+Txt delivery was on average $AUD85.00/participant. No meaningful (p < 0.05) differences in self-reported outcomes were seen between HLaC+Txt and control cohorts. After 6-months no contact the intervention cohort had maintained weight, fruit intake, fat and fibre index scores relative to end of HLaC+Txt outcomes. Participants/CC staff perceived an important intervention component was maintaining accountability. Conclusions While feasible to implement, HLaC+Txt was not effective in the short term. However, intervention effects during the non-contact period suggest the program supports longer term maintenance of weight and diet behaviour. Intervention delivery in this real-world context highlighted key considerations for future implementation. Trial registration Australian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015). Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08806-4.
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Affiliation(s)
- Jennifer R Job
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia. .,CHSRI, The University of Queensland, RBWH, Level 8, Health Sciences Building, Herston, Q 4029, Australia.
| | - Elizabeth G Eakin
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Marina M Reeves
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Brianna S Fjeldsoe
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
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Feasibility, acceptability, and effects of behavior change interventions for improving multiple dietary behaviors among cancer survivors: a systematic review. Support Care Cancer 2021; 30:2877-2889. [PMID: 34581862 DOI: 10.1007/s00520-021-06582-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/15/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to systematically identify and synthesize evidence on the feasibility, acceptability, and effects of behavior change interventions for improving multiple dietary behaviors among cancer survivors. METHODS A total of 14 electronic databases and three trial registries were searched. Experimental studies that examined the feasibility, acceptability, and effects of behavior change interventions for improving multiple dietary behaviors among cancer survivors and published in English or Chinese peer-reviewed journals or protocols were considered eligible. The methodological quality of the included studies was evaluated using the revised Cochrane risk-of-bias assessment tool. Data were extracted and synthesized narratively. RESULTS Six studies, with a sample size ranging from 50 to 3088, were included. The studies had a high overall risk of bias. Six studies reported feasibility data, and the average eligibility, recruitment, and retention rates at post-intervention were 60.7%, 66.7%, and 90.7%, respectively. Only one study measured the acceptability and reported that 66.6% of participants were satisfied with the intervention. Five out of the six studies that measured fruit and vegetable consumption reported statistically significant positive intervention effects. Two studies reported inconsistent intervention effects on wholegrain consumption. Only one study measured the consumption of processed meat, sugar, and alcohol, which had statistically nonsignificant intervention effect. CONCLUSIONS Behavior change interventions for improving multiple dietary behaviors might be feasible and effective to increase fruit and/or vegetable consumption among cancer survivors. Further research is needed to examine the acceptability and effects of the intervention for modifying other dietary behavior.
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Grimmett C, Bates A, West M, Leggett S, Varkonyi-Sepp J, Campbell A, Davis J, Wootton S, Shaw C, Barlow R, Ashcroft J, Scott A, Moyes H, Hawkins L, Levett DZH, Williams F, Grocott MPW, Jack S. SafeFit Trial: virtual clinics to deliver a multimodal intervention to improve psychological and physical well-being in people with cancer. Protocol of a COVID-19 targeted non-randomised phase III trial. BMJ Open 2021; 11:e048175. [PMID: 34446487 PMCID: PMC8392740 DOI: 10.1136/bmjopen-2020-048175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The impact of the COVID-19 pandemic (caused by the SARS-CoV-2 virus) on individuals with cancer has been profound. It has led to increased anxiety, distress and deconditioning due to reduced physical activity. We aim to investigate whether SafeFit, a multimodal intervention of physical activity, nutrition and psychological support delivered virtually by cancer exercise specialists (CES), can improve physical and emotional functionings during the COVID-19 pandemic. METHODS AND ANALYSIS A phase III non-randomised intervention trial, target recruitment of 1050 adults with suspected or confirmed diagnosis of cancer. All recruited participants will receive the multimodal intervention delivered by CES for 6 months. Sessions will be delivered 1-to-1 using telephone/video conferencing consultations. CES will work with each participant to devise a personalised programme of (1) physical activity, (2) basic dietary advice and (3) psychological support, all underpinned by behaviour change support. PRIMARY OUTCOME Physical and emotional functioning as measured by the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-C30). SECONDARY OUTCOMES overall quality of life measured by EORTC-QLQ-C30 and EQ-5D-5L, health economics, patient activation, self-efficacy to self-manage chronic disease, distress, impact of COVID-19 on emotional functioning, self-reported physical activity, functional capacity and nutrition. Adherence to the intervention will also be measured and a process evaluation conducted. ETHICS AND DISSEMINATION Ethical approval was obtained from the Health Research Authority (reference number 20/NW/0254). Results of this trial will be disseminated through publication of peer-reviewed articles, presentations at scientific conferences, and to the public and people with cancer in collaboration with our patient and public involvement representatives and partners. TRIAL REGISTRATION NUMBER NCT04425616.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Andrew Bates
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Malcolm West
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Samantha Leggett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Judit Varkonyi-Sepp
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anna Campbell
- School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | | | - Stephen Wootton
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Cancer and Nutrition Collaboration, Southampton, UK
| | - Clare Shaw
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust, London, UK
| | - Rachael Barlow
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Joanna Ashcroft
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Andrew Scott
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Helen Moyes
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lesley Hawkins
- Critical Care/Anaesthesia and Perioperative Medicine Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Denny Z H Levett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sandy Jack
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Wang S, Yang T, Qiang W, Shen A, Zhao Z, Liu X. Benefits of Dietary Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Nutr Cancer 2021; 74:1580-1592. [PMID: 34319187 DOI: 10.1080/01635581.2021.1957129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The World Cancer Research Fund/American Institute of Cancer Research recommendations include guidance on diet, nutrition, and weight management for people with cancer. However, for women diagnosed with breast cancer there is a lack of comprehensive analyses on the effects of dietary interventions. The purpose of this study was to investigate the impact of changes in dietary behavior and body composition on breast cancer development. A comprehensive and systematic literature search of 12 electronic databases was undertaken on January 27, 2021 to identify randomized controlled trials (RCTs) of dietary interventions for breast cancer. The Cochrane risk bias assessment tool was used to evaluate the quality of the trials identified with the data analyzed by Review Manager 5.3 software. The results showed that dietary interventions probably did not modify servings of fruit (P = 0.08), fat intake (P = 0.10), total cholesterol level (P = 0.82), body weight (P = 0.08), waist circumference (P = 0.15), or waist-to-hip ratio (P = 0.32). However, a significant reduction in body mass index (P = 0.03), and hip circumference (P = 0.03), and improvement in energy intake (P = 0.02), vegetable servings (P < 0.0001), and fiber intake (P < 0.00001) were observed. Future studies should investigate the benefits of exercise in combination with dietary interventions in breast cancer patients.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1957129.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Aomei Shen
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Zihan Zhao
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofeng Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Nazarpour S, Mohammadipour F, Mohammadi R, Goudarzi F, Esmaeilbeigy D. The effect of telephone counselling and follow-up on empowering women with breast cancer undergoing chemotherapy. Health Care Women Int 2021; 43:1415-1432. [PMID: 34283702 DOI: 10.1080/07399332.2021.1941026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Empowering women with breast cancer leads to better adaptation to diagnosis and treatment, and reduces the symptoms of cancer. The purpose of the researchers is to determine the effect of a telephone counseling and follow-up program on empowerment of women with breast cancer undergoing chemotherapy. We used a non-randomized clinical trial design. Researchers applied the telephone counseling and follow-up to the intervention group for 8 weeks. At the end of study, the intervention group showed improvement in measures of cancer functional management and breast cancer specific function, along with satisfaction with the decision, general symptoms of cancer and specific symptoms of breast cancer.
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Affiliation(s)
- Shiva Nazarpour
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Mohammadipour
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fateme Goudarzi
- Department of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Darya Esmaeilbeigy
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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Adriaans DJ, Dierick-van Daele AT, van Bakel MJHM, Nieuwenhuijzen GA, Teijink JA, Heesakkers FF, van Laarhoven HW. Digital Self-Management Support Tools in the Care Plan of Patients With Cancer: Review of Randomized Controlled Trials. J Med Internet Res 2021; 23:e20861. [PMID: 34184997 PMCID: PMC8278296 DOI: 10.2196/20861] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/24/2020] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care. Objective The aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer. Methods Five databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively. Results A total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as high quality. Conclusions This review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.
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Affiliation(s)
- Danielle Jm Adriaans
- Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.,Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Angelique Tm Dierick-van Daele
- Fontys University of Applied Sciences, Eindhoven, Netherlands.,Department of Education and Research, Catharina Hospital, Eindhoven, Netherlands.,Fontys School of People and Health Studies, Eindhoven, Netherlands
| | | | | | - Joep Aw Teijink
- Department of Surgery, Catharina Hospital, Eindhoven, Netherlands
| | | | - Hanneke Wm van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
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Singleton A, Raeside R, Partridge SR, Hayes M, Maka K, Hyun KK, Thiagalingam A, Chow CK, Sherman KA, Elder E, Redfern J. Co-designing a Lifestyle-Focused Text Message Intervention for Women After Breast Cancer Treatment: Mixed Methods Study. J Med Internet Res 2021; 23:e27076. [PMID: 34125072 PMCID: PMC8240797 DOI: 10.2196/27076] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/07/2021] [Accepted: 05/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background Breast cancer is the most common cancer among women globally. Recovery from breast cancer treatment can be mentally and physically challenging. SMS text message programs offer a novel way to provide health information and support, but few programs are co-designed with consumer representatives. Objective This study aims to report the procedures and outcomes of a co-design process of a lifestyle-focused SMS text message program to support women’s mental and physical health after breast cancer treatment. Methods We followed an iterative mixed methods two-step process: (1) co-design workshop with consumers and health professionals and researchers to draft text messages and (2) evaluation of message content, which was scored (5-point Likert scale; 1=strongly disagree to 5=strongly agree) for ease of understanding, usefulness, and appropriateness, and readability (Flesch-Kincaid score). Additional free-text responses and semistructured interviews were coded into themes. Messages were edited or deleted based on the evaluations, with consumers’ evaluations prioritized. Results In step 1, co-designed text messages (N=189) were semipersonalized, and the main content themes were (1) physical activity and healthy eating, (2) medications and side effects, (3) mental health, and (4) general breast cancer information. In step 2, consumers (n=14) and health professionals and researchers (n=14) provided 870 reviews of 189 messages and found that most messages were easy to understand (799/870, 91.8%), useful (746/870, 85.7%), and appropriate (732/870, 84.1%). However, consumers rated 50 messages differently from health professionals and researchers. On the basis of evaluations, 37.6% (71/189) of messages were deleted, 36.5% (69/189) were edited, and 12 new messages related to fatigue, self-care, and cognition were created. The final 130 text messages had a mean 7.12 (SD 2.8) Flesch-Kincaid grade level and 68.9 (SD 15.5) ease-of-reading score, which represents standard reading ease. Conclusions Co-designing and evaluating a bank of evidence-based mental and physical health-themed text messages with breast cancer survivors, health professionals, and researchers was feasible and resulted in a bank of 130 text messages evaluated highly by participants. Some consumer evaluations differed from health professionals and researchers, supporting the importance of co-design.
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Affiliation(s)
- Anna Singleton
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rebecca Raeside
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Stephanie R Partridge
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Molly Hayes
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Katherine Maka
- Department of Physiotherapy, Westmead Hospital, Sydney, Australia.,Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | - Karice K Hyun
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Westmead Hospital, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Westmead Hospital, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kerry A Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | - Julie Redfern
- Consumer Engagement and Codesign Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia.,Research Education Network, Western Sydney Local Health District, Sydney, Australia
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Kong S, Lee JK, Kang D, Kim N, Shim YM, Park W, Choi D, Cho J. Comparing the Effectiveness of a Wearable Activity Tracker in Addition to Counseling and Counseling Only to Reinforce Leisure-Time Physical Activity among Breast Cancer Patients: A Randomized Controlled Trial. Cancers (Basel) 2021; 13:cancers13112692. [PMID: 34070937 PMCID: PMC8199478 DOI: 10.3390/cancers13112692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022] Open
Abstract
This randomized controlled trial aimed to compare the effectiveness of a wearable activity tracker (WAT) in addition to counseling (WAT+counseling) and counseling only for reinforcing leisure-time physical activity (LTPA) among breast cancer patients during radiotherapy (RT). A total of 152 breast cancer patients who were planning to undergo radiation therapy (RT) after surgery participated in the study. The WAT+counseling group (n = 76) underwent physical activity (PA) self-monitoring using a WAT and participated in counseling. The counseling-only group (n = 76) received telephone counseling once a week during RT and did not receive WAT. The WAT+counseling group had increased relative change in self-reported LTPA (102.8) compared with the counseling-only group (57.8) immediately after RT compared to baseline. Although the relative changes of self-reported LTPA of the WAT+counseling group were higher at three and six months after the end of RT compared to in the counseling-only group, the results were not significant. The mean average daily step count of the WAT+counseling group was 9351.7, which increased to 11,592.2 during RT and 12,240.1 after RT. In the subgroup analysis, patients who did not perform regular PA before cancer diagnosis had significantly increased step counts. This study shows the feasibility of WAT with counseling to reinforce PA among breast cancer patients.
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Affiliation(s)
- Sunga Kong
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (D.K.)
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
| | - Jae Kyung Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (D.K.)
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Nayeon Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 6351, Korea;
| | - Dooho Choi
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 6351, Korea;
- Correspondence: (D.C.); (J.C.); Tel.: +82-2-3410-2436 (D.C.); +82-2-3410-1448 (J.C.)
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (D.K.)
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Department of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Correspondence: (D.C.); (J.C.); Tel.: +82-2-3410-2436 (D.C.); +82-2-3410-1448 (J.C.)
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Ben-Arye E, Paller CJ, Lopez AM, White S, Pendleton E, Kienle GS, Samuels N, Abbawaajii N, Balneaves LG. The Society for Integrative Oncology Practice Recommendations for online consultation and treatment during the COVID-19 pandemic. Support Care Cancer 2021; 29:6155-6165. [PMID: 33852088 PMCID: PMC8044504 DOI: 10.1007/s00520-021-06205-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/05/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The Society for Integrative Oncology (SIO) Online Task Force was created in response to the challenges facing continuity of integrative oncology care resulting from the COVID-19 pandemic. The Task Force set out to guide integrative oncology practitioners in providing effective and safe online consultations and treatments for quality-of-life-concerns and symptom management. Online treatments include manual, acupuncture, movement, mind-body, herbal, and expressive art therapies. METHODS The SIO Online Practice Recommendations employed a four-phase consensus process: (1) literature review and discussion among an international panel of SIO members, identifying key elements essential in an integrative oncology visit; (2) development, testing, and refinement of a questionnaire defining challenges and strategies; (3) refinement input from integrative oncology experts from 19 countries; and (4) SIO Executive Committee review identifying the most high-priority challenges and strategies. RESULTS The SIO Online Practice Recommendations address ten challenges, providing practical suggestions for online treatment/consultation. These include overcoming unfamiliarity, addressing resistance among patients and healthcare practitioners to online consultation/treatment, exploring ethical and medical-legal aspects, solving technological issues, preparing the online treatment setting, starting the online treatment session, maintaining effective communication, promoting specific treatment effects, involving the caregiver, concluding the session, and ensuring continuity of care. CONCLUSIONS The SIO Online Practice Recommendations are relevant for ensuring continuity of care beyond the present pandemic. They can be implemented for patients with limited accessibility to integrative oncology treatments due to geographic constraints, financial difficulties, physical disability, or an unsupportive caregiver. These recommendations require further study in practice settings.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, Lin, Zebulon, & Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, 35 Rothschild St, Haifa, Israel.
| | | | - Ana Maria Lopez
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shelley White
- Wellness and Integrative Health Center, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Eva Pendleton
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gunver S Kienle
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Institute for Applied Epistemology and Medical Methodology, University of Witten/Herdecke, Freiburg, Germany
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nuria Abbawaajii
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
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Sotirova MB, McCaughan EM, Ramsey L, Flannagan C, Kerr DP, O'Connor SR, Blackburn NE, Wilson IM. Acceptability of online exercise-based interventions after breast cancer surgery: systematic review and narrative synthesis. J Cancer Surviv 2021; 15:281-310. [PMID: 32930924 PMCID: PMC7966228 DOI: 10.1007/s11764-020-00931-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE eHealth and mHealth approaches are increasingly used to support cancer survivors. This review aimed to examine adherence, acceptability and satisfaction with Internet-based self-management programmes for post-surgical cancer rehabilitation and to identify common components of such interventions. METHODS Nine electronic databases were searched from inception up to February 15, 2020, for relevant quantitative and qualitative studies evaluating Internet-based cancer rehabilitation interventions. Studies were required to include an exercise or physical activity-based self-management intervention and a measure of adherence, acceptability or user satisfaction with the programme. Two independent reviewers performed all data extraction and quality assessment procedures. Data were synthesized using a narrative approach. RESULTS Six hundred ninety-six potential papers were identified and screened. Eleven met the inclusion criteria. Interventions had wide variations in levels of adherence, but the majority were reported as being acceptable to the users. Increased acceptability and user satisfaction were associated with interventions which were seen as time and cost-efficient, requiring acquisition of minimal or no new skills, which used coherent language, or which provided tailored information. The majority contained behaviour change components such as goal setting. CONCLUSIONS Despite high levels of heterogeneity between studies, Internet-based approaches may be an acceptable method for the delivery of self-management interventions in post-surgical cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS There is a need for further studies exploring factors associated with increased user engagement and usage of digital interventions in cancer rehabilitation settings. These findings should be used to help develop interventions prior to testing their effectiveness in adequately powered randomized controlled trials.
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Affiliation(s)
- Mariya B Sotirova
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK.
| | - Eilís M McCaughan
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland, UK
| | - Lucia Ramsey
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
| | - Carrie Flannagan
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland, UK
| | - Daniel P Kerr
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
| | - Sean R O'Connor
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Nicole E Blackburn
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
| | - Iseult M Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
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Ibeggazene S, Turner R, Rosario D, Bourke L. Remote interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review and meta-analysis. BMC Cancer 2021; 21:308. [PMID: 33761906 PMCID: PMC7987748 DOI: 10.1186/s12885-021-07989-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/01/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has forced many cancer services to consider a transition to a remote format of delivery that is largely untested. Accordingly, we sought to perform a systematic review of the effects of remotely delivered interventions to improve exercise behaviour in sedentary adults living with and beyond cancer. METHODS Eligible studies were randomised controlled trials comparing a remotely delivered exercise intervention to a usual care comparison in sedentary people over 18 years old with a primary cancer diagnosis. Nine electronic databases were searched from inception to November 2020. RESULTS The review included three trials, totalling 186 participants. Two of the included trials incorporated prescriptions that meet current aerobic exercise recommendations, one of which also meets the guidelines for resistance exercise. No trials reported an intervention adherence of 75% or more for a set prescription that meets current exercise guidelines. CONCLUSION There is little evidence suggesting that remote exercise interventions promote exercise behaviours or improve physical function in sedentary adults living with and beyond cancer. The development and evaluation of novel remote exercise interventions is needed to establish their usefulness for clinical practice. Given the social response to the COVID-19 pandemic, further research in this area is urgently needed.
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Affiliation(s)
- Saïd Ibeggazene
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK.
| | - Rebecca Turner
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Derek Rosario
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Liam Bourke
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
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Gubler-Gut BE, Pöhlmann J, Flatz A, Schwenkglenks M, Rohrmann S. Cost-effectiveness of physical activity interventions in cancer survivors of developed countries: a systematic review. J Cancer Surviv 2021; 15:961-975. [PMID: 33624172 PMCID: PMC8521580 DOI: 10.1007/s11764-021-01002-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Physical activity has been shown to improve survival and quality of life of cancer patients. Due to differences in patient populations, healthcare settings, and types of intervention, cost-effectiveness analyses of physical activity interventions in cancer survivors are difficult to compare. Available evidence from breast cancer survivor research has shown inconsistent results, and transfer of results to other types of cancer is not straightforward. This paper systematically reviewed current evidence on the cost-effectiveness of physical activity interventions in cancer survivors independent of cancer type compared to usual care or another experimental intervention. METHODS The literature search was conducted in seven databases and enhanced by a search for gray literature. Eligible studies were restricted to developed countries and assessed using the CHEERS, CHEC, and PHILIPS checklists. The study protocol was pre-published in PROSPERO. RESULTS Seven studies, five cost-utility, and two combined cost-utility/cost-effectiveness analyses fully met the inclusion criteria. They covered eight different types of cancer and various interventions. The cost-effectiveness analyses were of moderate to high methodological quality. A high probability of cost-effectiveness was reported in two analyses. One intervention appeared to be not cost-effective, and one to be cost-effective only from an organizational perspective. Three other analyses reported a cost-effectiveness better than US$ 101,195 (€ 80,000) per QALY gained. CONCLUSIONS Physical activity interventions in cancer survivors of developed countries were cost-effective in some but not all clinical trials reviewed. IMPLICATIONS FOR CANCER SURVIVORS Cost-effectiveness of physical activity interventions appear to depend upon the intensity of the activity.
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Affiliation(s)
- Barbara E. Gubler-Gut
- Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland
| | - Johannes Pöhlmann
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse15, 8401 Winterthur, Switzerland
| | - Aline Flatz
- Swiss Cancer League, Effingerstrasse 40, 3001 Berne, Switzerland
| | - Matthias Schwenkglenks
- Institute of Pharmaceutical Medicine, University of Basel, Klingenbergstrasse 61, 4056 Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Sabine Rohrmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
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What do cancer survivors and their health care providers want from a healthy living program? Results from the first round of a co-design project. Support Care Cancer 2021; 29:4847-4858. [PMID: 33544245 DOI: 10.1007/s00520-021-06019-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Healthy lifestyles are an important part of cancer survivorship, though survivors often do not adhere to recommended guidelines. As part of the co-design of a new online healthy living intervention, this study aimed to understand cancer survivors', oncology healthcare professionals' (HCP) and cancer non-government organisation (NGO) representatives' preferences regarding intervention content and format. METHODS Survivors, HCP and NGO representatives participated in focus groups and interviews exploring what healthy living means to survivors, their experience with past healthy living programs and their recommendations for future program content and delivery. Sessions were audio recorded, transcribed verbatim and analysed thematically. RESULTS Six focus groups and eight interviews were conducted including a total of 38 participants (21 survivors, 12 HCP, 5 NGO representatives). Two overarching messages emerged: (1) healthy living goes beyond physical health to include mental health and adjustment to a new normal and (2) healthy living programs should incorporate mental health strategies and peer support and offer direction in a flexible format with long-term accessibility. There was a high degree of consensus between participant groups across themes. CONCLUSIONS These findings highlight the need for integration of physical and mental health interventions with flexibility in delivery. Future healthy living programs should investigate the potential for increased program adherence if mental health interventions and a hybrid of delivery options were included.
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Rahimy E, Usoz M, von Eyben R, Fujimoto D, Watanabe D, Karam A, Jairam-Thodla A, Mills M, Dorigo O, Diver EJ, Teng N, English D, Kidd E. Phase II trial evaluating efficacy of a Fitbit program for improving the health of endometrial cancer survivors. Gynecol Oncol 2021; 161:275-281. [PMID: 33551199 DOI: 10.1016/j.ygyno.2021.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the favorable prognosis of early stage endometrial cancer, mortality from cardiovascular disease is high. We aimed to evaluate the efficacy of a Fitbit program to improve physical activity in endometrial cancer survivors. METHODS Eligible patients were diagnosed with stage IA-IIIA endometrial adenocarcinoma, ≥3 months out from treatment. Participants received a Fitbit Alta and were randomized to receive communication via telephone or electronic methods (email/text). Communication was every two weeks for two months, then once during months four and five. Average daily steps were assessed weekly for nine months. RESULTS The 46 analyzable patients demonstrated a baseline of 5641 median daily average steps. Average steps increased by 22% at 6 months but decreased to baseline by nine months. Baseline activity level (daily steps and walks per week) was the greatest predictor of activity level. Only the telephone intervention participants demonstrated increased activity level at several timepoints, although not maintained by nine months. BMI was unchanged. There was mild improvement in physical and social well-being in those with low baseline well-being (p = 0.009 and 0.014, respectively), regardless of intervention group. Emotional well-being correlated with step count (p = 0.005). CONCLUSIONS Activity level was low and mildly improved on the Fitbit program with the telephone intervention, but effects did not persist by study completion. The program had the greatest impact on a select group of telephone intervention patients with high baseline walking frequency and low baseline step count. Others may require more intense intervention to promote more robust/persistent lifestyle changes.
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Affiliation(s)
- Elham Rahimy
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA.
| | - Melissa Usoz
- Duke University School of Medicine, Durham, NC, USA
| | - Rie von Eyben
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
| | - Dylann Fujimoto
- University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Darla Watanabe
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Amer Karam
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | | | - Margaret Mills
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Oliver Dorigo
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | | | - Nelson Teng
- Department of Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Diana English
- Department of Gynecologic Oncology, University of South Florida, Tampa, FL, USA
| | - Elizabeth Kidd
- Department of Radiation Oncology, Stanford University, Stanford, CA, USA
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Mendoza-Vasconez AS, Arredondo EM, Larsen B, Crespo N, Hurst S, Marcus BH. Lapse, Relapse, and Recovery in Physical Activity Interventions for Latinas: a Survival Analysis. Int J Behav Med 2021; 28:540-551. [PMID: 33415695 DOI: 10.1007/s12529-020-09943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Physical activity (PA) research extensively focuses on initiation of PA, yet lapse and relapse among PA intervention participants are less well understood, particularly among minority populations such as Latinas in the USA. This study aimed to (1) determine the probability of lapse during two PA interventions for Latinas; (2) assess demographic, psychosocial, and environmental predictors of the amount of time until first lapse; and (3) identify factors predictive of lapse recovery. METHODS Data from 176 Latina intervention participants were pooled. Survival functions and Kaplan-Meier curves were used to illustrate probability of lapse. Cox proportional hazard models assessed predictors of time to lapse. Logistic regressions identified predictors of lapse recovery. RESULTS The probability of lapse after 1 month of starting to exercise was 18%, escalating to 34% after 4 months. Predictors of earlier lapse included various psychosocial constructs (i.e., self-efficacy and various processes of change), but none of the measured environmental factors, and only one demographic factor (≥ 2 children under 18). Increased use of consciousness raising at 2 months was associated with lower likelihood of lapse recovery, yet use of behavioral processes of change at 6 months was associated with higher likelihood of recovery. CONCLUSIONS Lapsing may not be pre-determined by demographic and environmental characteristics. On the other hand, skills that can be learned through interventions, such as skills to improve self-efficacy, seem important in the delay or prevention of lapses. Results pertaining to lapse recovery are less clear.
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Affiliation(s)
- Andrea S Mendoza-Vasconez
- Stanford Prevention Research Center, Stanford University, 1265 Welch Rd, Palo Alto, CA, 94305, USA. .,School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA. .,Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA.
| | - Elva M Arredondo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Britta Larsen
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Noe Crespo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Samantha Hurst
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121, South Main Street, Providence, Rhode Island, 02903, USA
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Cheung DST, Takemura N, Lam TC, Ho JCM, Deng W, Smith R, Yan Y, Lee AWM, Lin CC. Feasibility of Aerobic Exercise and Tai-Chi Interventions in Advanced Lung Cancer Patients: A Randomized Controlled Trial. Integr Cancer Ther 2021; 20:15347354211033352. [PMID: 34549648 PMCID: PMC8461121 DOI: 10.1177/15347354211033352] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A majority of lung cancer patients are diagnosed at advanced stages. Although there is considerable evidence of the benefits of aerobic exercise and tai-chi for lung cancer patients, little is known about the comparative effectiveness of the 2 exercise modes in advanced lung cancer patients. OBJECTIVES To explore the feasibility and preliminary effects of aerobic exercise and tai-chi interventions on survival and well-being among advanced lung cancer patients. METHODS In an assessor-blinded, exploratory randomized controlled trial, 30 advanced lung cancer patients were randomized to an aerobic exercise group, a tai-chi group (both attending 12-week, twice-weekly supervised sessions), or a self-management control group (receiving written exercise guidelines). The primary outcomes focused on feasibility including intervention completion, exercise adherence, and adverse events, while the secondary outcomes addressed preliminary effects and included 1-year survival, cancer symptoms (Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Score, Brief Fatigue Inventory), quality of life (EORTC QLQ-C30, QLQ-LC13), physical performance (6-minute walk test, up-and-go, sit-to-stand, 1-leg standing), activity levels (actigraph), and circadian rhythms (salivary cortisol). RESULTS Intervention feasibility was established with a satisfactory completion rate at post-intervention for the aerobic exercise group (80%) and the tai-chi group (78%). The tai-chi group attained higher adherence than the exercise group in terms of attendance in supervised sessions (89% vs 75% of scheduled classes) and self-practice (225% vs 87% of the prescribed amount). Higher adherence to self-practice in the tai-chi group remained at the 6-month follow-up (81% vs 38% of the prescribed amount). No adverse event as a result of the intervention was reported. Effect-related outcomes did not show statistically significant changes in any group, except an improvement post-intervention in the up-and-go (-2.26, 95% CI: -4.04, -0.48) and sit-to-stand tests (4.52, 95% CI: 2.19, 6.85) in the aerobic exercise group. CONCLUSIONS The findings support the feasibility of aerobic exercise and tai-chi interventions in advanced lung cancer patients. A future study with a larger sample from multiple sites is recommended to confirm the comparative effects of the 2 exercise interventions relative to the self-management group and to enhance the generalizability of the findings.
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Affiliation(s)
| | | | - Tai Chung Lam
- The University of Hong Kong, Hong Kong,
China
- The University of Hong Kong-Shenzhen
Hospital, Shenzhen, China
| | | | - Wen Deng
- The University of Hong Kong, Hong Kong,
China
| | | | - Yinxia Yan
- The University of Hong Kong, Hong Kong,
China
| | - Anne Wing Mui Lee
- The University of Hong Kong, Hong Kong,
China
- The University of Hong Kong-Shenzhen
Hospital, Shenzhen, China
| | - Chia Chin Lin
- The University of Hong Kong, Hong Kong,
China
- Taipei Medical University, Taipei
- Alice Ho Miu Ling Nethersole Charity
Foundation Professorship in Nursing, Hong Kong, China
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Abstract
This narrative review of web-delivered weight management, diet quality, and physical activity interventions for cancer survivors relies on a systematic search of PubMed, Psych Info, and EBSCOhost which identified 19 unique web-delivered lifestyle interventions for cancer survivors. The sample sizes for these studies ranged from 11–492. Intervention duration ranged from 1–12 months; however, most interventions were 6–12 weeks in length. Ten studies were randomized controlled trials (RCTs), two were two-arm quasi RCTs, and seven employed a single-arm pre/post-test design. Many (N= 15) of the interventions were well-grounded in behavioral theory, which may have led to favorable behavior change. Most studies (15-of-19) targeted and reported increases in physical activity, while only a few targeted and reported improvements in diet quality (36.9% and 15.8%, respectively) and weight management (26.3% and 10.5%, respectively). A notable limitation was that most studies were conducted among populations that were primarily White and female. Future directions for Internet-based lifestyle interventions for cancer survivors include increasing: (a) focus on multiple behavior change, (b) representation of male and minority populations to improve generalizability of findings, (c) extended intervention duration and follow-up to evaluate long-term efficacy of web-based lifestyle interventions, and (d) sample size to allow for adequate statistical power.
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Cho D, Basen-Engquist K, Acquati C, Pettaway C, Ma H, Markofski M, Li Y, Canfield SE, Gregg J, McNeill LH. Cultural Adaptation of Evidence-Based Lifestyle Interventions for African American Men With Prostate Cancer: A Dyadic Approach. Am J Mens Health 2020; 14:1557988320945449. [PMID: 33148111 PMCID: PMC7653295 DOI: 10.1177/1557988320945449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022] Open
Abstract
Although a number of lifestyle interventions have been developed for cancer survivors, the extent to which they are effective for African American men with cancer is unclear. Given that African American men have the highest prostate cancer burden and the lack of proven interventions, this study developed a culturally-tailored lifestyle intervention for African American men with prostate cancer and their partners that aimed to improve healthy lifestyle behaviors (physical activity and healthy eating) and quality of life. The aim of the present study is to provide a detailed overview of the model-based process of intervention adaptation. Based on the IM Adapt approach (Highfield et al., 2015) and Typology of Adaptation (Davidson et al., 2013), the present study adapted existing, evidence-based interventions to address African American prostate cancer survivors' and their partners' potential unmet needs including anxiety/uncertainty about cancer progression, communication between partners, cultural sensitivity, and concordance/discordance of motivation and behaviors between partners. The intervention adaptation was a comprehensive and fluid process. To the best knowledge of the author, this is the first couple-based lifestyle intervention specifically developed for African American men with prostate cancer. The present study will be highly informative to future investigators by providing flexible and detailed information regarding lifestyle intervention adaptation for racial/ethnic minority men with prostate cancer and their partners.
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Affiliation(s)
- Dalnim Cho
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | | | - Curtis Pettaway
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | - Hilary Ma
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Yisheng Li
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Justin Gregg
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
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Dennett AM, Peiris CL, Shields N, Taylor NF. From Cancer Rehabilitation to Recreation: A Coordinated Approach to Increasing Physical Activity. Phys Ther 2020; 100:2049-2059. [PMID: 32737975 DOI: 10.1093/ptj/pzaa135] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/22/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022]
Abstract
Participation in adequate physical activity improves the health status of cancer survivors, enhances their survival, and reduces their risk of cancer recurrence. However, cancer survivors engage in low levels of physical activity and have limited access to rehabilitation services that could increase their participation. No optimal framework has been developed that supports physical activity participation among cancer survivors. Given the growth in numbers of cancer survivors, development of a framework may provide a pathway to facilitate timely and appropriate care. This perspective paper describes the development of the Cancer Rehabilitation to Recreation (CaReR) Framework and its practical implications. The CaReR Framework uses a tailored, stepped approach to guide health services and clinicians on the design and implementation of interventions to promote physical activity among cancer survivors. Implementation of the CaReR Framework will improve continuity and quality of care for cancer survivors and promote physical activity with the ultimate aim of improving health outcomes.
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Affiliation(s)
- Amy M Dennett
- School of Allied Health, Human Services, and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Level 2, 5 Arnold St, Box Hill, Victoria, Australia
| | - Casey L Peiris
- School of Allied Health, Human Services, and Sport, La Trobe University
| | - Nora Shields
- School of Allied Health, Human Services, and Sport, La Trobe University
| | - Nicholas F Taylor
- School of Allied Health, Human Services, and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health
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The Role of Telehealth During the COVID-19 Pandemic Across the Interdisciplinary Cancer Team: Implications for Practice. Semin Oncol Nurs 2020; 36:151090. [PMID: 33218886 PMCID: PMC7561334 DOI: 10.1016/j.soncn.2020.151090] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective This literature review aims to explore the role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer care team. Data Sources Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and gray literature were searched using Google Scholar up until September 2020. Conclusion Although the safe and effective delivery of cancer care via telehealth requires education and training for health care professionals and patients, telehealth has provided a timely solution to the barriers caused by the COVID-19 pandemic on the delivery of interdisciplinary cancer services. Globally, evidence has shown that telehealth in cancer care can leverage an innovative response during the COVID-19 pandemic but may provide a long-lasting solution to enable patients to be treated appropriately in their home environment. Telehealth reduces the travel burden on patients for consultation, affords a timely solution to discuss distressing side effects, initiate interventions, and enable possible treatment additions and/or changes. Implications for Nursing Practice Global public health disasters pose significant and unique challenges to the provision of necessary services for people affected by cancer. Oncology nurses can provide a central contribution in the delivery of telehealth through transformational leadership across all domains and settings in cancer care. Oncology nurses provide the “hub of cancer care” safely embedded in the interdisciplinary team. Telehealth provides a solution to the current global health crisis but could also benefit the future provision of services and broad reach clinical trials.
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