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Misir A, Viechtbauer W, de Vries H, Mesters I. Twelve Month Efficacy of Computer-Tailored Communication in Boosting Fruit and Vegetable Consumption Among Adults Aged Forty and over: A Three-Level Meta-Analysis and Systematic Review of Randomized Controlled Trials. Adv Nutr 2024; 15:100150. [PMID: 37979693 PMCID: PMC10756964 DOI: 10.1016/j.advnut.2023.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/29/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023] Open
Abstract
Computer-tailored health communication (CTC) can enhance fruit and vegetable (F&V) intake and, consequently, health by providing personalized feedback. However, few studies have examined the long-term effects of such interventions in middle-aged and older adults. This research aimed to assess the 12-mo efficacy of CTC in promoting F&V consumption and potentially identify who among middle-aged and older adults changed their diet after the intervention. The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) on 2021-12-09, code CRD42022330491. The research was performed without external funding. We searched 6 databases (MEDLINE via PubMed, EMBASE, Scopus, Web of Science Core Collection, Cochrane Library, and PsycINFO) for randomized controlled trials (RCTs) comparing CTC interventions for increasing F&V intake with usual care/no intervention control in adults aged ≥40, measured 12 mo after the pretest. The search covered the period from 1 January 1990 to 1 January 2022. We selected 16 RCTs with 25,496 baseline participants for the review systematic literature reviews (SLR) and 11 RCTs with 19 measurements for the meta-analysis (MA). We assessed risk of bias with the JBI Critical Appraisal Checklist. The SLR revealed that at 1-y postCTC intervention, most of the treatment groups increased F&V intake more than the control groups. The overall bias in the data set was not high. The MA model on 11 RCTs revealed a significant effect size for F&V consumption in intervention groups compared with control, standardized mean difference of 0.21 (confidence interval [CI]: 0.12, 0.30), P = 0.0004. The evidence suggests that CTC is a suitable strategy for public interventions aiming to increase F&V intake in adults aged ≥40. The design of CTC for public interventions should consider the process of change and stages of change addressing awareness, attitudes, self-efficacy, and social influence as promising concepts for influencing behavior change.
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Affiliation(s)
- Andreja Misir
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands.
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
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ten Hoor GA, Varol T, Mesters I, Schneider F, Kok G, Ruiter RAC. Just-in-Time, but Still Planned: Lessons Learned From Speeding up the Development and Implementation of an Intervention to Promote COVID-19 Vaccination in University Students. Health Promot Pract 2023; 24:921-931. [PMID: 35603718 PMCID: PMC10071181 DOI: 10.1177/15248399221095077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The process of developing a behavior change intervention can cover a long time period. However, in times of need, this development process has to be more efficient and without losing the scientific rigor. In this article, we describe the just-in-time, planned development of an online intervention in the field of higher education, promoting COVID-19 vaccination among university students, just before they were eligible for being vaccinated. We demonstrate how intervention development can happen fast but with sufficient empirical and theoretical support. In the developmental process, Intervention Mapping (IM) helped with decision-making in every step. We learned that the whole process is primarily depending on the trust of those in charge in the quality of the program developers. Moreover, it is about applying theory, not about theory-testing. As there was no COVID-19-related evidence available, evidence from related fields helped as did theoretical knowledge about change processes, next to having easy access to the target population and important stakeholders for informed qualitative and quantitative research. This project was executed under unavoidable time pressure. IM helped us with systematically developing an intervention, just-in-time to positively affect vaccine acceptance among university students.
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Affiliation(s)
| | - Tugce Varol
- Maastricht University, Maastricht, The Netherlands
| | - Ilse Mesters
- Maastricht University, Maastricht, The Netherlands
| | | | - Gerjo Kok
- Maastricht University, Maastricht, The Netherlands
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Hiensch AE, Beckhaus J, Witlox L, Monninkhof EM, Schagen SB, van Vulpen JK, Sweegers MG, Newton RU, Aaronson NK, Galvão DA, Steindorf K, Stuiver MM, Mesters I, Knoop H, Goedendorp MM, Bohus M, Thorsen L, Schulz KH, Schmidt ME, Ulrich CM, Sonke GS, van Harten WH, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, Kersten MJ, Nollet F, Wiskemann J, Buffart LM, May AM. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis. J Cancer Surviv 2023:10.1007/s11764-023-01392-3. [PMID: 37160571 DOI: 10.1007/s11764-023-01392-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics. METHODS IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline. RESULTS Minimal significant beneficial exercise effects on self-reported CF (β=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, β=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=-0.14 [-0.25; -0.04]) or 24 weeks or longer (β=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (β=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (β=-0.19 [-0.31; -0.06]). No other significant moderators were identified. CONCLUSIONS This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline. IMPLICATIONS FOR CANCER SURVIVORS This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.
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Affiliation(s)
- Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Julia Beckhaus
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lenja Witlox
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jonna K van Vulpen
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Maike G Sweegers
- Division of Psychosocial Research and Epidemiology & Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology & Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer, Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Karl-Heinz Schulz
- Athleticum - Competence Center for Sports- and Exercise Medicine and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Gabe S Sonke
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Kerri M Winters-Stone
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, location: Vrije Universiteit, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Centers, Location University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Division of Medical Oncology, University Clinic Heidelberg and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Laurien M Buffart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.
- Department of Physiology, Radboudumc, Nijmegen, The Netherlands.
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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van den Biggelaar YJPG, Kuiper JG, van der Sangen MJC, Luiten EJT, Siesling S, van Herk-Sukel M, Voogd AC, Mesters I. 5-year adherence to adjuvant endocrine treatment in Dutch women with early stage breast cancer: A population-based database study (2006-2016). Breast Dis 2023; 42:331-339. [PMID: 37927248 DOI: 10.3233/bd-230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Hormonal receptor (HR) positive breast tumors are common. Adjuvant hormonal therapy (AHT) with tamoxifen or Aromatase Inhibitors (AIs) is beneficial depending on the stage of the tumor. Despite the fact that AHT has been shown to improve survival and recurrence, Dutch adherence rates, which were mostly dependent on Tamoxifen prescriptions until 2006, plummeted from 80% after one year to 50% after five years. Nonadherence with AHT reduces its effectiveness. This research presents more recent adherence statistics (from 2006 to 2016), on a larger sample (7,996 vs 1,451), as well as factors that influence AHT adherence. In addition to tamoxifen data, AIs are now included. OBJECTIVE As low use of adjuvant endocrine therapy is a potentially important and modifiable risk factor for poor outcome, it is important to monitor the rate as an indicator of women's burden of disease and the direction of adherence trends. METHODS The Netherlands Cancer Registry (NCR) was used to find women with early-stage breast cancer who started AHT within a year of surgery and were linked to the PHARMO Database Network (n = 8,679). The Kaplan-Meier approach was used to measure AHT adherence five years after treatment was started, with a 60-day gap between refills as our primary outcome. Furthermore, the Medication Possession Rate (MPR) was determined using a cutoff of ≥80%. Analysis was performed on influential factors of adherence. RESULTS The proportion of persistent women declined over time to reach 46.6% at the end of the fifth year and 53.3% of the women had a MPR ≥80% during the fifth year. Older and being diagnosed in 2006-2010 were associated with AHT adherence. CONCLUSION Dutch 5-year AHT adherence appears to remain poor. Improving AHT adherence in HR+ breast cancer survivors is a critical medical need.
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Affiliation(s)
| | | | | | - Ernest J T Luiten
- Department of Surgery, Breast Care Center Tawam Hospital, Abu Dhabi, United Arab Emirates
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - Myrthe van Herk-Sukel
- Department of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Adri C Voogd
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Varol T, Crutzen R, Schneider F, Mesters I, Ruiter RA, Kok G, ten Hoor GA. Selection of determinants of students' adherence to COVID-19 guidelines and translation into a brief intervention. Acta Psychol (Amst) 2021; 219:103400. [PMID: 34419688 PMCID: PMC8367745 DOI: 10.1016/j.actpsy.2021.103400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022] Open
Abstract
Background When reopening universities in times of COVID-19, students still have to adhere to COVID-19 behavioral guidelines. We explored what behavioral determinants (and underlying beliefs) related to the adherence to guidelines are both relevant and changeable, as input for future interventions. Methods A cross-sectional online survey was conducted (Oct–Nov 2020), identifying behavioral determinants (and underlying beliefs) of university students' adherence to COVID-19-guidelines, including keeping 1.5 m distance, getting tested, and isolating (N = 255). Results Attitude, perceived norm, self-efficacy, and several beliefs (e.g., risk perception beliefs ‘I am not afraid because I am young’ [r = −0.33; p < .001]; attitudinal beliefs, e.g., ‘I feel responsible for telling people to adhere to guidelines’ [r = 0.37; p < .001]; self-efficacy beliefs, e.g., ‘COVID-19-prevention guidelines are difficult to adhere to’ [r = −0.30; p < .001]) were associated with intention to adhere to guidelines, and for those beliefs there was room for improvement, making them suitable as possible intervention targets. Conclusions Students mostly adhere to COVID-19 guidelines, but there is room for improvement. Interventions need to enhance students' adherence behavior by targeting the most relevant determinants as identified in this study. Based on these findings, a small intervention was introduced targeting the determinants of students' adherence to guidelines.
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van der Kruk SR, Butow P, Mesters I, Boyle T, Olver I, White K, Sabesan S, Zielinski R, Chan BA, Spronk K, Grimison P, Underhill C, Kirsten L, Gunn KM. Psychosocial well-being and supportive care needs of cancer patients and survivors living in rural or regional areas: a systematic review from 2010 to 2021. Support Care Cancer 2021; 30:1021-1064. [PMID: 34392413 PMCID: PMC8364415 DOI: 10.1007/s00520-021-06440-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/13/2021] [Indexed: 01/16/2023]
Abstract
Purpose To summarise what is currently known about the psychosocial morbidity, experiences, and needs of people with cancer and their informal caregivers, who live in rural or regional areas of developed countries. Methods Eligible studies dating from August 2010 until May 2021 were identified through several online databases, including MEDLINE, EMBASE, PsychINFO, and RURAL (Rural and Remote Health Database). Results were reported according to the PRISMA guidelines and the protocol was registered on PROSPERO (CRD42020171764). Results Sixty-five studies were included in this review, including 20 qualitative studies, 41 quantitative studies, and 4 mixed methods studies. Qualitative research demonstrated that many unique psychosocial needs of rural people remain unmet, particularly relating to finances, travel, and accessing care. However, most (9/19) quantitative studies that compared rural and urban groups reported no significant differences in psychosocial needs, morbidity, or quality of life (QOL). Five quantitative studies reported poorer psychosocial outcomes (social and emotional functioning) in urban cancer survivors, while three highlighted poorer outcomes (physical functioning, role functioning, and self-reported mental health outcomes) in the rural group. Conclusion Recent research shows that rural people affected by cancer have unique unmet psychosocial needs relating to rurality. However, there was little evidence that rural cancer survivors report greater unmet needs than their urban counterparts. This contrasts to the findings from a 2011 systematic review that found rural survivors consistently reported worse psychosocial outcomes. More population-based research is needed to establish whether uniquely rural unmet needs are due to general or cancer-specific factors.
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Affiliation(s)
- Shannen R. van der Kruk
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW Australia
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Terry Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA Australia
| | - Kate White
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Sabe Sabesan
- College of Medicine and Dentistry (CMD), James Cook University, QLD, Townsville, Australia
| | - Rob Zielinski
- Central West Cancer Care Centre, Orange Base Hospital, Orange, NSW Australia
- Western Sydney University, Sydney, NSW Australia
| | - Bryan A. Chan
- School of Medicine, Griffith University, Brisbane, QLD Australia
| | - Kristiaan Spronk
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
| | - Peter Grimison
- Department of Medical Oncology, Chris O’Brien Lifehouse, Sydney, NSW Australia
| | | | | | - Kate M. Gunn
- Cancer Research Institute, University of South Australia, Adelaide, SA Australia
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
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van der Kruk SR, Gunn KM, Mesters I, Lynch BM, Vallance JK, Boyle T. Associations between baseline demographic, clinical and lifestyle factors, and changes in fatigue, depression, and health-related quality of life in long-term cancer survivors: a cohort study. Support Care Cancer 2021; 29:4711-4722. [PMID: 33515106 DOI: 10.1007/s00520-021-06015-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/19/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To investigate the longitudinal associations between demographic, clinical and lifestyle factors, and changes in patient-reported outcomes (PROs) in cancer survivors 6-9 years post-diagnosis in Western Australia. METHODS A total of 290 individuals participated in this study. Three-quarters of participants were female, and 55%, 31%, and 14% were survivors of breast cancer, colon cancer, and non-Hodgkin lymphoma (NHL), respectively. PROs (fatigue, depression, and health-related quality of life (HRQOL)) were reported at two time points (2012-13 and 2017). Descriptive statistics were used to assess the overall changes over time and linear mixed models were used to identify factors associated with changes over time, after adjusting for confounders. RESULTS No significant changes were observed in PROs between time point 1 and follow-up at the population level, yet a notable proportion of participants (23% for fatigue, 10% for depression, and 39% for HRQOL) reported a negative minimal clinically important difference (MCID). Being non-Caucasian and having had NHL were associated with negative changes over time. Being obese and having had radiotherapy were related to improved outcomes. CONCLUSION Cancer survivors whose levels of fatigue, depression, and quality of life are compromised during cancer treatment may require intervention even 6-9 years post-treatment. Our results suggest particular attention should be paid to those who are non-Caucasian and who have had NHL. This is crucial for providing appropriate care and to support those who are at increased risk of deteriorating naturally over time.
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Affiliation(s)
- Shannen R van der Kruk
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- Cancer Research Institute, University of South Australia, Adelaide, SA, Australia
| | - Kate M Gunn
- Cancer Research Institute, University of South Australia, Adelaide, SA, Australia
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Physical Activity Laboratory, Melbourne, VIC, Australia
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia.
- Cancer Research Institute, University of South Australia, Adelaide, SA, Australia.
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.
- School of Public Health, Curtin University, Perth, WA, Australia.
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van Keulen HM, van Breukelen G, de Vries H, Brug J, Mesters I. A randomized controlled trial comparing community lifestyle interventions to improve adherence to diet and physical activity recommendations: the VitalUM study. Eur J Epidemiol 2020; 36:345-360. [PMID: 33377998 PMCID: PMC8032577 DOI: 10.1007/s10654-020-00708-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/08/2020] [Indexed: 11/27/2022]
Abstract
Worldwide, adherence to national guidelines for physical activity (PA), and fruit and vegetable consumption is recommended to promote health and reduce the risk for (chronic) disease. This study reports on the effectiveness of various social-cognitive interventions to improve adherence to guidelines and the revealed adherence predictors. Participants (n = 1,629), aged 45–70 years, randomly selected and recruited in 2005–2006 from 23 Dutch general practices, were randomized (centralized stratified allocation) to four groups to receive a 12-month lifestyle intervention targeting guideline adherence for PA and fruit and vegetable consumption. Study groups received either four computer-tailored print communication (TPC) letters (n = 405), four telephone motivational interviewing (TMI) sessions (n = 407), a combined intervention (two TPC letters and two TMI sessions, n = 408), or no intervention (control group, n = 409). After the baseline assessment, all parties were aware of the treatment groups. Outcomes were measured with self-report postal questionnaires at baseline, 25, 47 and 73 weeks. For PA, all three interventions were associated with better guideline adherence than no intervention. Odds ratios for TPC, TMI and the combined intervention were 1.82 (95% CI 1.31; 2.54), 1.57 (95% CI 1.13; 2.18), and 2.08 (95% CI 1.50; 2.88), respectively. No pedometer effects were found. For fruit and vegetable consumption, TPC seemed superior to those in the other groups. Odd ratio for fruit and vegetable consumption were 1.78 (95% CI 1.32; 2.41) and 1.73 (95% CI 1.28; 2.33), respectively. For each behaviour, adherence was predicted by self-efficacy expectations, habit strength and stages of change, whereas sex, awareness and the number of action plans predicted guideline adherence for fruit and vegetable intake. The season predicted the guideline adherence for PA and fruit consumption. The odds ratios revealed were equivalent to modest effects sizes, although they were larger than those reported in systematic reviews. This study indicated that less resource intensive interventions might have the potential for a large public health impact when widely implemented. The strengths of this study were the participation of lower educated adults and evaluation of maintenance effects. (Trial NL1035, 2007-09-06).
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Affiliation(s)
- Hilde Marijke van Keulen
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, PO Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Child Health, Now Employed by TNO, PO Box 3005, 2301 DA, Leiden, The Netherlands
| | - Gerard van Breukelen
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, National Institute for Public Health and the Environment (RIVM), Utrecht RIVM and VU Medical Center, Amsterdam, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
- CAPHRI Care and Public Health Research Institute, PO Box 616, 6200 MD, Maastricht, The Netherlands.
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VAN Vulpen JK, Sweegers MG, Peeters PHM, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, Galvão DA, Chinapaw MJ, Steindorf K, Irwin ML, Stuiver MM, Hayes S, Griffith KA, Mesters I, Knoop H, Goedendorp MM, Mutrie N, Daley AJ, McConnachie A, Bohus M, Thorsen L, Schulz KH, Short CE, James EL, Plotnikoff RC, Schmidt ME, Ulrich CM, VAN Beurden M, Oldenburg HS, Sonke GS, VAN Harten WH, Schmitz KH, Winters-Stone KM, Velthuis MJ, Taaffe DR, VAN Mechelen W, Kersten MJ, Nollet F, Wenzel J, Wiskemann J, Verdonck-DE Leeuw IM, Brug J, May AM, Buffart LM. Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data. Med Sci Sports Exerc 2020; 52:303-314. [PMID: 31524827 DOI: 10.1249/mss.0000000000002154] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. METHODS We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. RESULTS Exercise interventions had statistically significant beneficial effects on fatigue (β = -0.17; 95% confidence interval [CI], -0.22 to -0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = -0.29; 95% CI, -0.39 to -0.20) than supervised interventions with a longer duration. CONCLUSIONS In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration.
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Affiliation(s)
- Jonna K VAN Vulpen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | | | - Petra H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, CANADA
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Mai J Chinapaw
- Amsterdam UMC, Vrije Universiteit, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, THE NETHERLANDS
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, GERMANY
| | | | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | - Sandi Hayes
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, AUSTRALIA
| | | | - Ilse Mesters
- Department of Epidemiology, Maastricht University, THE NETHERLANDS
| | - Hans Knoop
- Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam, THE NETHERLANDS
| | | | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UNITED KINGDOM
| | - Amanda J Daley
- School of Sport, Exercise and Health Sciences, University of Loughborough, Loughborough, Leicestershire, UNITED KINGDOM
| | - Alex McConnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | | | | | - Karl-Heinz Schulz
- Athleticum-Competence Center for Sports- and Exercise Medicine and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, GERMANY
| | - Camille E Short
- Freemasons Foundation Centre of Men's Health, School of Medicine, University of Adelaide, SA, AUSTRALIA
| | - Erica L James
- School of Medicine & Public Health, the University of Newcastle, Callaghan, NSW, AUSTRALIA
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, NSW, AUSTRALIA
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, GERMANY
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | | | | | - Gabe S Sonke
- Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | | | - Kathryn H Schmitz
- Department of Public Health Science, College of Medicine and Cancer Institute, Pennsylvania State University, Hershey, PA
| | - Kerri M Winters-Stone
- Knight Cancer Institute, School of Nursing, Oregon Health & Science University, Portland, OR
| | - Miranda J Velthuis
- Netherlands comprehensive cancer organisation (IKNL), Utrecht, THE NETHERLANDS
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Willem VAN Mechelen
- Amsterdam UMC, Vrije Universiteit, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, THE NETHERLANDS
| | - Marie José Kersten
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, THE NETHERLANDS
| | - Frans Nollet
- Amsterdam UMC, University of Amsterdam Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | | | | | | | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
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10
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Rewald S, Lenssen AT, Emans PJ, de Bie RA, van Breukelen G, Mesters I. Aquatic Cycling Improves Knee Pain and Physical Functioning in Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 101:1288-1295. [DOI: 10.1016/j.apmr.2019.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/25/2019] [Accepted: 12/27/2019] [Indexed: 11/28/2022]
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11
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de Jonge LPJWM, Mesters I, Govaerts MJB, Timmerman AA, Muris JWM, Kramer AWM, van der Vleuten CPM. Supervisors' intention to observe clinical task performance: an exploratory study using the theory of planned behaviour during postgraduate medical training. BMC Med Educ 2020; 20:134. [PMID: 32354331 PMCID: PMC7193388 DOI: 10.1186/s12909-020-02047-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/21/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Direct observation of clinical task performance plays a pivotal role in competency-based medical education. Although formal guidelines require supervisors to engage in direct observations, research demonstrates that trainees are infrequently observed. Supervisors may not only experience practical and socio-cultural barriers to direct observations in healthcare settings, they may also question usefulness or have low perceived self-efficacy in performing direct observations. A better understanding of how these multiple factors interact to influence supervisors' intention to perform direct observations may help us to more effectively implement the aforementioned guidelines and increase the frequency of direct observations. METHODS We conducted an exploratory quantitative study, using the Theory of Planned Behaviour (TPB) as our theoretical framework. In applying the TPB, we transfer a psychological theory to medical education to get insight in the influence of cognitive and emotional processes on intentions to use direct observations in workplace based learning and assessment. We developed an instrument to investigate supervisors intention to perform direct observations. The relationships between the TPB measures of our questionnaire were explored by computing bivariate correlations using Pearson's R tests. Hierarchical regression analysis was performed in order to assess the impact of the respective TPB measures as predictors on the intention to perform direct observations. RESULTS In our study 82 GP supervisors completed our TPB questionnaire. We found that supervisors had a positive attitude towards direct observations. Our TPB model explained 45% of the variance in supervisors' intentions to perform them. Normative beliefs and past behaviour were significant determinants of this intention. CONCLUSION Our study suggests that supervisors use their past experiences to form intentions to perform direct observations in a careful, thoughtful manner and, in doing so, also take the preferences of the learner and other stakeholders potentially engaged in direct observations into consideration. These findings have potential implications for research into work-based assessments and the development of training interventions to foster a shared mental model on the use of direct observations.
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Affiliation(s)
- Laury P J W M de Jonge
- Department of General Practice, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Marjan J B Govaerts
- Department of Educational Research and Development, Maastricht University, Maastricht, The Netherlands
| | - Angelique A Timmerman
- Department of General Practice, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Jean W M Muris
- Department of General Practice, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Anneke W M Kramer
- Department of Family Medicine, Leiden University, Leiden, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Research and Development, Maastricht University, Maastricht, The Netherlands
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12
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Skrabal Ross X, Gunn KM, Olver I, Willems RA, Lechner L, Mesters I, Bolman CAW. Online psychosocial interventions for posttreatment cancer survivors: an international evidence review and update. Curr Opin Support Palliat Care 2020; 14:40-50. [PMID: 31789944 DOI: 10.1097/spc.0000000000000478] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW The present review describes recent research on online psychosocial interventions for posttreatment cancer survivors from January 2018 to June 2019. RECENT FINDINGS Twenty-three studies were included in the review (the majority included were feasibility studies and only five randomized controlled trials had large samples). Websites were the most common platforms for intervention delivery (9/23) and cognitive behavioral therapy was the most frequently used therapeutic approach (11/23). Three interventions based on this framework and delivered via websites or combined website-telehealth platforms showed to be effective in improving psychosocial issues (fear of cancer recurrence, insomnia, sleep quality, and prospective memory failures) in posttreatment cancer survivors. Web-based self-compassion writing was also found to be effective in addressing body image distress and body appreciation in breast cancer survivors. Feasibility studies mostly showed online interventions to be plausible and acceptable to cancer survivors. A good representation of online interventions for young adult cancer survivors (30%) was found. SUMMARY Online interventions show promise in addressing the psychosocial needs of cancer survivors. Despite new online interventions being found to be feasible and acceptable and some showing promise in addressing important psychosocial issues in cancer survivors posttreatment, more rigorous studies are required to inform supportive care for this population.
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Affiliation(s)
| | - Kate M Gunn
- Cancer Research Institute
- Department of Rural Health, University of South Australia
| | - Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
| | - Ilse Mesters
- Faculty of Health, Medicine and Life Sciences, Department of Epidemiology, Research Institute CaPHRI, Maastricht University, Maastricht, the Netherlands
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen
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13
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Bernard P, Savard J, Steindorf K, Sweegers MG, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, May AM, Galvao DA, Chinapaw MJ, Stuiver MM, Griffith KA, Mesters I, Knoop H, Goedendorp MM, Bohus M, Thorsen L, Schmidt ME, Ulrich CM, Sonke GS, van Harten W, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, Kersten MJ, Nollet F, Wenzel J, Wiskemann J, Verdonck-de Leeuw IM, Brug J, Buffart LM. Effects and moderators of exercise on sleep in adults with cancer: Individual patient data and aggregated meta-analyses. J Psychosom Res 2019; 124:109746. [PMID: 31443811 DOI: 10.1016/j.jpsychores.2019.109746] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects. METHODS Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using data from the Predicting OptimaL cAncer RehabIlitation and Supportive care project, IPD of 2173 adults (mean age = 54.8) with cancer from 17 RCTs were analyzed. A complementary systematic search was conducted (until November 2018) to study the overall effects and test the representativeness of analyzed IPD. Effect sizes of exercise effects on self-reported sleep outcomes were calculated for all included RCTs. Linear mixed-effect models were used to evaluate the effects of exercise on post-intervention outcome values, adjusting for baseline values. Moderator effects were studied by testing interactions for demographic, clinical and intervention-related characteristics. RESULTS For all 27 eligible RCTs from the updated search, exercise interventions significantly decreased sleep disturbances in adults with cancer (g = -0.09, 95% CI [-0.16; -0.02]). No significant effect was obtained for sleep quality. RCTs included in IPD analyses constituted a representative sample of the published literature. The intervention effects on sleep disturbances were not significantly moderated by any demographic, clinical, or intervention-related factor, nor by sleep disturbances. CONCLUSIONS This meta-analysis provides some evidence that, compared to control conditions, exercise interventions may improve sleep disturbances, but not sleep quality, in cancer patients, although this effect is of a small magnitude. Among the investigated variables, none was found to significantly moderate the effect of exercise interventions on sleep disturbances.
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Affiliation(s)
- P Bernard
- Université Laval Cancer Research Center, Québec, Québec, Canada; School of Psychology, Université Laval, Québec, Québec, Canada; CHU de Québec - Université Laval Research Center, Québec, Québec, Canada; Physical Activity Sciences Department, Université du Québec à Montréal, Montréal, Quebec, Canada; Research centre, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada.
| | - J Savard
- Université Laval Cancer Research Center, Québec, Québec, Canada; School of Psychology, Université Laval, Québec, Québec, Canada; CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - M G Sweegers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - K S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P B Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A M May
- Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - D A Galvao
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - M J Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - M M Stuiver
- Department of Physiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K A Griffith
- School of Nursing, University of Maryland, Baltimore, USA
| | - I Mesters
- Department of Epidemiology, Maastricht University, The Netherlands
| | - H Knoop
- Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - M M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg t University, Mannheim, Germany
| | - M Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg t University, Mannheim, Germany; Faculty of Health, University of Antwerp, Belgium
| | - L Thorsen
- National Advisory Unit on Late Effects after Cancer, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - M E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - C M Ulrich
- Huntsman Cancer Institute and University of Utah, Department of Population Health Sciences, Salt Lake City, USA
| | - G S Sonke
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - W van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Huntsman Cancer Institute and University of Utah, Department of Population Health Sciences, Salt Lake City, USA
| | | | - M J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - D R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - W van Mechelen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - M J Kersten
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, The Netherlands
| | - F Nollet
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - J Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
| | - J Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - I M Verdonck-de Leeuw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology-Head and Neck Surgery, The Netherlands; Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - J Brug
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - L M Buffart
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
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14
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Buffart LM, Sweegers MG, May AM, Chinapaw MJ, van Vulpen JK, Newton RU, Galvão DA, Aaronson NK, Stuiver MM, Jacobsen PB, Verdonck-de Leeuw IM, Steindorf K, Irwin ML, Hayes S, Griffith KA, Lucia A, Herrero-Roman F, Mesters I, van Weert E, Knoop H, Goedendorp MM, Mutrie N, Daley AJ, McConnachie A, Bohus M, Thorsen L, Schulz KH, Short CE, James EL, Plotnikoff RC, Arbane G, Schmidt ME, Potthoff K, van Beurden M, Oldenburg HS, Sonke GS, van Harten WH, Garrod R, Schmitz KH, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, José Kersten M, Nollet F, Wenzel J, Wiskemann J, Brug J, Courneya KS. Targeting Exercise Interventions to Patients With Cancer in Need: An Individual Patient Data Meta-Analysis. J Natl Cancer Inst 2018; 110:1190-1200. [PMID: 30299508 PMCID: PMC6454466 DOI: 10.1093/jnci/djy161] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/23/2018] [Accepted: 08/14/2018] [Indexed: 12/12/2022] Open
Abstract
Background Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.
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Affiliation(s)
- Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Maike G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jonna K van Vulpen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Rob U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | | | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology (NKA) and Center for Quality of life, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Paul B Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, MD
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute and Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | | | - Sandi Hayes
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | | | | | | | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Ellen van Weert
- University Medical Centre Groningen, University of Groningen, Center for Rehabilitation, Groningen, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UK
| | - Amanda J Daley
- School of Sports, Exercise and Health Sciences, University of Loughborough, Loughborough, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology (LT) and Department of Clinical Service (LT), Oslo University Hospital, Oslo, Norway
| | - Karl-Heinz Schulz
- Athleticum – Competence Center for Sports- and Exercise Medicine and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Camille E Short
- Freemasons Foundation Centre of Men’s Health, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | | | - Ronald C Plotnikoff
- School of Medicine & Public Health (ELJ) and Priority Research Centre for Physical Activity and Nutrition (RCP), The University of Newcastle, Callaghan, NSW, Australia
| | - Gill Arbane
- Lane Fox Respiratory Research Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Karin Potthoff
- Department of Medical Oncology (KP, JmW) and Department of Radiation Oncology (KP), National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Marc van Beurden
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Hester S Oldenburg
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Gabe S Sonke
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology (NKA) and Center for Quality of life, Netherlands Cancer Institute, Amsterdam, the Netherlands
- University of Twente, Enschede, the Netherlands
| | - Rachel Garrod
- Department of Respiratory Medicine, Kings College London, London, UK
| | - Kathryn H Schmitz
- Department of Public Health Science, College of Medicine and Cancer Institute, Pennsylvania State University, Hershey, PA
| | - Kerri M Winters-Stone
- Knight Cancer Institute and School of Nursing, Oregon Health & Science University, Portland, OR
| | - Miranda J Velthuis
- Department of Medical Oncology (KP, JmW) and Department of Radiation Oncology (KP), National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
- Department of Public Health Science, College of Medicine and Cancer Institute, Pennsylvania State University, Hershey, PA
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Frans Nollet
- Department of Rehabilitation, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | | | - Johannes Brug
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, the Netherlands
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
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15
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Sacomori C, Berghmans B, de Bie R, Mesters I, Cardoso FL. Predictors for adherence to a home-based pelvic floor muscle exercise program for treating female urinary incontinence in Brazil. Physiother Theory Pract 2018; 36:186-195. [PMID: 29863450 DOI: 10.1080/09593985.2018.1482583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objective: To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI). Design: Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME. Setting: Patients were referred from public primary or secondary care providers in Florianópolis, Brazil. Participants: Adult women with UI. Intervention: Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates. Main Outcome Measures: Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level. Results: 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy (r = 0.299); age (r = 0.242); and educational level (r = -0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence (R2 = 0.217). Conclusions: Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives.
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Affiliation(s)
- Cinara Sacomori
- School of Kinesiology, Universidad Bernardo O'Higgins, Santiago de Chile, Chile
| | - Bary Berghmans
- Pelvic care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rob de Bie
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Fernando Luiz Cardoso
- Department of Health Sciences, Centre of Health and Sports Sciences, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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16
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Mesters I, Gijsbers B, Bartholomew LK. Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping. Front Public Health 2018; 6:87. [PMID: 29616209 PMCID: PMC5869925 DOI: 10.3389/fpubh.2018.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/05/2018] [Indexed: 12/01/2022] Open
Abstract
Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.
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Affiliation(s)
- Ilse Mesters
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Barbara Gijsbers
- Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - L Kay Bartholomew
- Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, United States
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17
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van Vulpen JK, Sweegers MG, Kalter J, Peeters PH, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, Steindorf K, Stuiver MM, Hayes S, Mesters I, Knoop H, Goedendorp M, Mutrie N, Thorsen L, Schmidt M, Sonke GS, Bohus M, James EL, Oldenburg HS, Velthuis MJ, Nollet F, Wenzel J, Wiskemann J, Galvão DA, Chinapaw MJ, Irwin ML, Griffith KA, van Weert E, Daley AJ, McConnachie A, Schulz KH, Short CE, Plotnikoff RC, Potthoff K, van Beurden M, van Harten WH, Schmitz KH, Winters-Stone KM, Taaffe DR, van Mechelen W, Kersten MJ, Verdonck-de Leeuw IM, Brug J, Buffart LM, May AM. Abstract P6-12-06: Effect and moderators of exercise on fatigue in patients with breast cancer: Meta-analysis of individual patient data. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background - Fatigue is one of the most common and disabling complaints in patients with breast cancer and can effectively be reduced by physical exercise, with small to moderate effect sizes. To identify heterogeneity in responses to exercise and to further personalize exercise prescriptions, moderators of exercise effects on fatigue should be investigated. However, most randomized controlled trials (RCTs) are not adequately powered for such analyses. Therefore we conducted meta-analyses using the individual patient data of several exercise RCTs. The aim is to investigate the effect and moderators of physical exercise on cancer-related fatigue in patients with breast cancer.
Methods - Within the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium, principal investigators of 34 exercise RCTs worldwide have shared their individual patient data. Twenty-two of these RCTs included patients with breast cancer with a total sample size of 3,061. Different questionnaires to assess level of fatigue were used, which was acknowledged by using z-scores in the analysis. A one-step individual patient data meta-analysis, using a linear mixed-effect model adjusted for baseline fatigue, with a random intercept on study (to account for study clustering) was undertaken to investigate effect of exercise on fatigue. The result, a between-group difference in z-scores, corresponds to a Cohen's d effect size. An interaction term was included in the model to assess potential moderators including demographic (age, marital status, education), clinical (body mass index, presence of distant metastasis), intervention-related (intervention timing, delivery mode and duration), and exercise-related (exercise type, frequency, intensity, duration) characteristics.
Results – Exercise significantly reduced fatigue reported by women with breast cancer (β= -0.15, 95% CI -0.21;-0.09). This effect did not differ significantly between patients with different demographic and clinical characteristics (p-valuesinteraction >0.05). Also, neither timing (during or post-treatment) and duration of the intervention, nor exercise-related factors moderated intervention effects on fatigue. Supervised exercise had significantly larger effects on fatigue than unsupervised exercise (βdifference= -0.17, 95%CI -0.28;-0.05). Compared to the control group, supervised exercise significantly improved fatigue (β = -0.21, 95%CI = -0.28;-0.14), while unsupervised exercise did not (β = -0.04, 95%CI = -0.14;0.06).
Conclusion – Exercise significantly reduces fatigue in patients with breast cancer across subgroups formed on the basis of age, marital status, education level, body mass index, and presence of distant metastasis. The effect of exercise is significantly larger when performed under supervision. Hence, exercise, and preferably supervised exercise, represents a viable intervention for the prevention and treatment of fatigue among patients with breast cancer.
Citation Format: van Vulpen JK, Sweegers MG, Kalter J, Peeters PH, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, Steindorf K, Stuiver MM, Hayes S, Mesters I, Knoop H, Goedendorp M, Mutrie N, Thorsen L, Schmidt M, Sonke GS, Bohus M, James EL, Oldenburg HS, Velthuis MJ, Nollet F, Wenzel J, Wiskemann J, Galvão DA, Chinapaw MJ, Irwin ML, Griffith KA, van Weert E, Daley AJ, McConnachie A, Schulz K-H, Short CE, Plotnikoff RC, Potthoff K, van Beurden M, van Harten WH, Schmitz KH, Winters-Stone KM, Taaffe DR, van Mechelen W, Kersten M-J, Verdonck-de Leeuw IM, Brug J, Buffart LM, May AM. Effect and moderators of exercise on fatigue in patients with breast cancer: Meta-analysis of individual patient data [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-06.
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Affiliation(s)
- JK van Vulpen
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - MG Sweegers
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - J Kalter
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - PH Peeters
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - KS Courneya
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - RU Newton
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - NK Aaronson
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - PB Jacobsen
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - K Steindorf
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - MM Stuiver
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - S Hayes
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - I Mesters
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - H Knoop
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - M Goedendorp
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - N Mutrie
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - L Thorsen
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - M Schmidt
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - GS Sonke
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - M Bohus
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - EL James
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - HS Oldenburg
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - MJ Velthuis
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - F Nollet
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - J Wenzel
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - J Wiskemann
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - DA Galvão
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - MJ Chinapaw
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - ML Irwin
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - KA Griffith
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - E van Weert
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - AJ Daley
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - A McConnachie
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - K-H Schulz
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - CE Short
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - RC Plotnikoff
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - K Potthoff
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - M van Beurden
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - WH van Harten
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - KH Schmitz
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - KM Winters-Stone
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - DR Taaffe
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - W van Mechelen
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - M-J Kersten
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - IM Verdonck-de Leeuw
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - J Brug
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - LM Buffart
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
| | - AM May
- University Medical Center Utrecht, Utrecht, Netherlands; VU University Medical Center, Amsterdam, Netherlands; University of Alberta, Edmonton, Canada; Edith Cowan University, Joondalup, Australia; Netherlands Cancer Institute, Amsterdam, Netherlands; Moffitt Cancer Center and Research Institute, Tampa; German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany; Yale School of Public Health, New Haven; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia; University of Maryland, Baltimore; Maastricht University, Maastricht, Netherlands; University of Groningen, Groningen, Netherlands; Academic Medical Center, Amsterdam, Netherlands; University of Edinburgh, Edinburgh, United Kingdom; University of Birmingham, Birmingham, United Kingdom; University of Glasgow, Glasgow, United Kingdom; Heidelberg University, Mannheim, Germany; Oslo University Hospital, Oslo, Norway; University Medical Center Hamburg-Eppendorf, Ham
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18
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Keeman MC, Bolman CAW, Mesters I, Willems RA, Kanera IM, Lechner L. Psychometric properties of the Dutch extended Cancer Survivors' Unmet Needs measure (CaSUN-NL). Eur J Cancer Care (Engl) 2018; 27:e12807. [PMID: 29356219 PMCID: PMC5900905 DOI: 10.1111/ecc.12807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/01/2022]
Abstract
Information and support needs increase emotional distress and can impede cancer survivors’ adjustment. To investigate the information and support needs of Dutch cancer survivors, the Cancer Survivors’ Unmet Needs measure (CaSUN) was translated into Dutch and applied in two Dutch studies with cancer survivors (N = 255; N = 467). The CaSUN‐NL entailed the original five CaSUN scales, extended with respectively a returning to work and lifestyle scale. This study aimed to determine the psychometric properties of the CaSUN‐NL. To assess validity, a maximum likelihood factor analysis was employed. Construct validity was analysed using Pearson's and Spearman's correlation coefficients. To assess reliability, test–retest (Kappa coefficient) and internal consistency (Cronbach's alpha) values were determined. Factor analysis revealed the original five factors. Test–retest reliability was low (r ≤ .15, 93% retest response). Internal consistency values were high (Cronbach's alpha = 0.92–0.94), except for lifestyle. Significant correlations were found between total number of unmet needs with anxiety (r = .55), depression (r = .49), negative adjustment (r = .50), quality of life (r = −.52) and age (r = −.24). The CaSUN‐NL is valid and reliable to investigate the unmet information and support needs of Dutch cancer survivors.
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Affiliation(s)
- M C Keeman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - C A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - I Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Optimizing Patient Care, Maastricht University, Maastricht, The Netherlands
| | - R A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - I M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands.,Research Center of Nutrition, Lifestyle, and Exercise; Zuyd University of Applied Science, Heerlen, The Netherlands
| | - L Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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19
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Mesters I, Keulen HMV, de Vries H, Brug J. Counselor competence for telephone Motivation Interviewing addressing lifestyle change among Dutch older adults. Eval Program Plann 2017; 65:47-53. [PMID: 28697374 DOI: 10.1016/j.evalprogplan.2017.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 05/23/2017] [Accepted: 06/19/2017] [Indexed: 05/11/2023]
Abstract
Counselor competence in telephone Motivation Interviewing (MI) to change lifestyle behaviors in a primary care population was assessed using the Motivational Interviewing Treatment Integrity (MITI) rating system. Counselor behavior was evaluated by trained raters. Twenty minutes of a random sample of 336 MI sessions were coded representing 232 counselees. Ninety-four sessions (28%) were double coded to assess inter-rater agreement. The MI fidelity was examined by comparing the MI fidelity scores direction, empathy, spirit, % open questions, % complex reflections, reflections-to-questions ratio, % MI-adherent responses with the matching beginner proficiency MITI threshold. The inter-rater agreements for the MI fidelity summary scores were good (spirit, reflections-to-questions ratio), fair (empathy, % open questions, % MI-adherent responses) or poor (direction, % complex reflection). The MI fidelity scores for direction, empathy, spirit and the percentage of complex reflections exceeded the MITI threshold, but lower scores were found for the percentage of open questions, the reflections-to-questions ratio and the percentage of MI-adherent responses. In conclusion, evidence that MI was implemented was revealed. However, the inter-rater agreements scores and some fidelity scores leave room for improvement indicating that raters and counselors may need more ongoing training and feedback to achieve and maintain adequate competence. These findings apply to more complex skills (as rating complex reflections) in particular.
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Affiliation(s)
- Ilse Mesters
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hilde M van Keulen
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; TNO, The Hague, The Netherlands.
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, Postbus 7057, 1007 MB Amsterdam, The Netherlands.
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20
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Willems RA, Lechner L, Verboon P, Mesters I, Kanera IM, Bolman CAW. Working mechanisms of a web-based self-management intervention for cancer survivors: a randomised controlled trial. Psychol Health 2017; 32:605-625. [DOI: 10.1080/08870446.2017.1293054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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21
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Kanera IM, Willems RA, Bolman CAW, Mesters I, Verboon P, Lechner L. Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial. Int J Behav Nutr Phys Act 2017; 14:19. [PMID: 28187725 PMCID: PMC5303303 DOI: 10.1186/s12966-017-0474-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 01/31/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The number of cancer survivors is growing. Negative physical and psychosocial consequences of cancer treatment can occur during survivorship. Following healthy lifestyle recommendations is beneficial to increase quality of life and to reduce the risk of cancer recurrence and comorbidities. To meet individual needs, web-based interventions can supply a large population of cancer survivors with easily accessible and personalized information. Evidence concerning the long-term effects of web-based cancer aftercare interventions on lifestyle outcomes is limited. The present study evaluates the 12-month effects of a fully automated web-based cancer aftercare intervention. We investigated whether the previously determined 6-month effects on moderate physical activity and vegetable intake were maintained over 12 months. Possible moderator effects of using specific intervention modules, gender, age, and education were also explored. METHOD A two-armed randomized controlled trial was conducted using online self-report questionnaires among survivors of various types of cancer (N = 462). The intervention group had access to the online intervention for 6 months, and the control group received access after 12-months. Multilevel linear regression analyses (complete cases and intention-to-treat) were conducted to explore 12- month effects. RESULTS A significant intervention effect after 12 months was found for moderate physical activity (complete cases: B = 128.475, p = .010, d = .35; intention-to-treat: B = 129.473, p = .011). Age was the only significant moderator (p = .010), with the intervention being effective among participants aged younger than 57 years (B = 256.549, p = .000, d = .59). No significant intervention effect remained for vegetable consumption after 12 months (complete cases: B = 5.860, p = .121; intention-to-treat: B = 5.560, p = .132). CONCLUSION The online cancer after care intervention is effective in increasing and maintaining moderate physical activity in the long term among early cancer survivors younger than 57 years. Short-term increases in vegetable consumption were not sustained in the long term. These findings indicate the value and potential of eHealth interventions for cancer survivors. Based on the study results, web-based self-management interventions could be recommended for younger cancer survivors (<57 years of age) as a possible method to increase physical activity. TRIAL REGISTRATION Dutch Trial Register NTR3375 . Registered 29 March 2012.
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Affiliation(s)
- Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Optimizing Patient Care, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Peter Verboon
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
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22
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Kanera IM, Willems RA, Bolman CA, Mesters I, Zambon V, Gijsen BC, Lechner L. Abstract and Metadata Correction of: Use and Appreciation of a Tailored Self-Management eHealth Intervention for Early Cancer Survivors: Process Evaluation of a Randomized Controlled Trial. J Med Internet Res 2016; 18:e242. [PMID: 27783559 PMCID: PMC6303669 DOI: 10.2196/jmir.6564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 08/29/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, Netherlands.
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Abstract
BACKGROUND Underdiagnosis of inherited high cholesterol (IHC) may be reduced if at-risk populations are aware of IHC existence and actively seek diagnosis. This study describes correlates of the public's IHC awareness. METHODS Telephone interviews were conducted with 4117 Dutch adults. RESULTS Half of the respondents were aware of IHC; however, their knowledge was superficial. Awareness was weakly predicted by family history of cardiovascular diseases (CVD), and not by own CVD status. Awareness was associated with higher health-related knowledge and experiences with cholesterol testing. CONCLUSIONS Professionals should help the public to relate their own and family CVD history to IHC.
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Kanera IM, Willems RA, Bolman CAW, Mesters I, Zambon V, Gijsen BC, Lechner L. Use and Appreciation of a Tailored Self-Management eHealth Intervention for Early Cancer Survivors: Process Evaluation of a Randomized Controlled Trial. J Med Internet Res 2016; 18:e229. [PMID: 27554525 PMCID: PMC5013245 DOI: 10.2196/jmir.5975] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/11/2016] [Accepted: 07/20/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND A fully automated computer-tailored Web-based self-management intervention, Kanker Nazorg Wijzer (KNW [Cancer Aftercare Guide]), was developed to support early cancer survivors to adequately cope with psychosocial complaints and to promote a healthy lifestyle. The KNW self-management training modules target the following topics: return to work, fatigue, anxiety and depression, relationships, physical activity, diet, and smoking cessation. Participants were guided to relevant modules by personalized module referral advice that was based on participants’ current complaints and identified needs. OBJECTIVE The aim of this study was to evaluate the adherence to the module referral advice, examine the KNW module use and its predictors, and describe the appreciation of the KNW and its predictors. Additionally, we explored predictors of personal relevance. METHODS This process evaluation was conducted as part of a randomized controlled trial. Early cancer survivors with various types of cancer were recruited from 21 Dutch hospitals. Data from online self-report questionnaires and logging data were analyzed from participants allocated to the intervention condition. Chi-square tests were applied to assess the adherence to the module referral advice, negative binominal regression analysis was used to identify predictors of module use, multiple linear regression analysis was applied to identify predictors of the appreciation, and ordered logistic regression analysis was conducted to explore possible predictors of perceived personal relevance. RESULTS From the respondents (N=231; mean age 55.6, SD 11.5; 79.2% female [183/231]), 98.3% (227/231) were referred to one or more KNW modules (mean 2.9, SD 1.5), and 85.7% (198/231) of participants visited at least one module (mean 2.1, SD 1.6). Significant positive associations were found between the referral to specific modules (range 1-7) and the use of corresponding modules. The likelihoods of visiting modules were higher when respondents were referred to those modules by the module referral advice. Predictors of visiting a higher number of modules were a higher number of referrals by the module referral advice (β=.136, P=.009), and having a partner was significantly related with a lower number of modules used (β=-.256, P=.044). Overall appreciation was high (mean 7.5, SD 1.2; scale 1-10) and was significantly predicted by a higher perceived personal relevance (β=.623, P=.000). None of the demographic and cancer-related characteristics significantly predicted the perceived personal relevance. CONCLUSIONS The KNW in general and more specifically the KNW modules were well used and highly appreciated by early cancer survivors. Indications were found that the module referral advice might be a meaningful intervention component to guide the users in following a preferred selection of modules. These results indicate that the fully automated Web-based KNW provides personal relevant and valuable information and support for early cancer survivors. Therefore, this intervention can complement usual cancer aftercare and may serve as a first step in a stepped-care approach. TRIAL REGISTRATION Nederlands Trial Register: NTR3375; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3375 (Archived by WebCite at http://www.webcitation.org/6jo4jO7kb).
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Affiliation(s)
- Iris Maria Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, Netherlands.
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Kanera IM, Bolman CAW, Willems RA, Mesters I, Lechner L. Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) intervention for cancer survivors: a randomized controlled trial. J Cancer Surviv 2016; 10:883-97. [PMID: 26984534 PMCID: PMC5018034 DOI: 10.1007/s11764-016-0535-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/03/2016] [Indexed: 11/26/2022]
Abstract
Purpose The web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) responds to the needs of cancer survivors and oncology care providers to improve the counseling related to self-management of lifestyle and psychosocial challenges. In present study, overall intervention effects and the effects of using specific components were evaluated on vegetable, fruit, whole grain bread, and fish consumption, physical activity (PA), and smoking behavior. Methods Cancer survivors from 21 Dutch hospitals were recruited for a randomized controlled trial (N = 432). Intervention effects after 6 months were evaluated using multilevel linear regression analysis (complete cases and intention-to-treat). By conducting moderation analyses, additional effects of following the behavior-related modules were explored. The false discovery rate correction was applied to account for multiple testing. Results After 6 months, 409 participants completed follow-up (dropout = 11.5 %). Indications were found that access to the intervention may result in increases of moderate PA and vegetable intake. The moderate PA increase was meaningful: 74.74 min p/w higher increase in the intervention condition. Effect sizes of moderate PA (d = .25) and vegetable (d = .37) consumption were comparable to prior effective interventions. Visiting behavior-related modules affected moderate PA, fruit, and fish consumption. However, after correction for multiple testing, significances expired. No significant intervention effect was found on smoking behavior due to low numbers of smokers. Implications for Cancer Survivors Although the effectiveness was only shown only to a limited extend, this study provided several indications that this theory-based, comprehensive, and personalized eHealth intervention provides valuable content to complement usual cancer aftercare.
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Affiliation(s)
- Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Optimizing Patient Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
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Willems RA, Bolman CAW, Mesters I, Kanera IM, Beaulen AAJM, Lechner L. Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psychooncology 2016; 26:222-230. [PMID: 26988800 DOI: 10.1002/pon.4113] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the short-term effectiveness of the web-based computer-tailored intervention Kanker Nazorg Wijzer (Cancer Aftercare Guide). The intervention aims to support cancer survivors with managing psychosocial and lifestyle-related issues. In this study, the impact on quality of life, anxiety, depression, and fatigue were evaluated. METHODS Cancer survivors were recruited through 21 Dutch hospitals (November 2013-June 2014). Outcome measures included quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30), anxiety and depression (Hospital Anxiety and Depression Scale), and fatigue (Checklist Individual Strength). In a randomized controlled trial with an intervention group (n = 231) and a waiting list control group (n = 231), the short-term effectiveness was evaluated through multilevel linear regression analyses, controlling for selective dropout, baseline differences, and several demographic and disease-related characteristics. RESULTS In total, 188 participants of the intervention group and 221 of the control group completed the 6-month measurement (dropout = 11.5%). The intervention was effective in reducing depression (B = -0.63, p = 0.007, f2 = 0.019, d = 0.21) and fatigue (B = -4.36, p = 0.020, f2 = 0.013, d = 0.21). In addition, effects were found for emotional (B = 3.47, p = 0.022, f2 = 0.013, d = 0.15) and social functioning (B = 3.95, p = 0.011, f2 = 0.017, d = 0.15), although this evidence was less strong. There were indications that the effects of fatigue and social functioning were influenced by module use. CONCLUSIONS While effect sizes were small, they can be considered as clinically relevant. With the Cancer Aftercare Guide being an effective, low-intensive, and easy accessible intervention, it could serve as a first step in stepped care for needs assessment and initial support for psychosocial problems that are present after cancer treatment. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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Rewald S, Mesters I, Lenssen AF, Emans PJ, Wijnen W, de Bie RA. Effect of aqua-cycling on pain and physical functioning compared with usual care in patients with knee osteoarthritis: study protocol of a randomised controlled trial. BMC Musculoskelet Disord 2016; 17:88. [PMID: 26887576 PMCID: PMC4758142 DOI: 10.1186/s12891-016-0939-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/10/2016] [Indexed: 01/22/2023] Open
Abstract
Background Over the last decade aquatic exercise has become more and more popular. One of the latest trends is aqua-cycling, where participants sit on a water-resistant stationary bike and, while immersed chest deep in the water, combine continuous cycling with upper body exercises that utilise water resistance. Since stationary cycling and aquatic exercises are frequently recommended to patients with knee osteoarthritis, combining both would seem an obvious step, and an aqua-cycling exercise programme for patients with knee osteoarthritis has indeed been developed. This study protocol gives a detailed description of the exercise programme and the methodology of a study to compare this programme with treatment involving usual care only. Methods The study is a single-blind, parallel-group, randomised controlled trial of Maastricht University Medical Centre+, the Netherlands. Inclusion criteria: knee pain of four to seven on a 10-point pain rating scale; a Kellgren/Lawrence score between one to three; ability to cycle; good mental health; sufficient language skills; indication for physical therapy in conjunction with impairments due to OA. Exclusion criteria: any contra-indication for aquatic exercise; planned total knee replacement; corticosteroid injection <3 months and/or hyaluronic acid injection <6 months; severe joint complaints (other than knee joint); symptomatic and radiological apparent hip OA; inflammatory joint diseases; inability to safely enter and exit the pool; fear of water. Participants will receive two 45-min moderate intense aqua-cycling sessions weekly over a period of 12 weeks in addition to usual care or usual care only. Usual care consists of an individual intervention plan comprising lifestyle recommendations, medication routine and referral to a physical therapist. Participants will be assessed at baseline, and at 12 and 24 weeks after baseline. The primary outcome is self-reported knee pain and physical functioning. Secondary outcomes are lower limb muscle strength, functional capacity, self-reported disease severity, physical activity level, quality of life, self-efficacy and fear of movement. Daily diaries will collect information on knee pain, physical functioning, level of physical activity, pain medication routine and physical therapy (control group only) or exercise participation over two 30-day periods (during the intervention period). Discussion To our knowledge the present study is the first randomised controlled trial evaluating the effects of aqua-cycling in the pre-surgical stage of knee osteoarthritis. This trial will demonstrate if the newly designed aqua-cycling intervention, in supplement to usual care, can help to improve impairments due to knee osteoarthritis. Trial registration Netherlands Trial Register NTR3766 (21-12-2012). Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-0939-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefanie Rewald
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Ilse Mesters
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - A F Lenssen
- Department of Physiotherapy, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Pieter J Emans
- Department of Orthopaedic Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Wiel Wijnen
- Department of Orthopaedic Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Rob A de Bie
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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van de Glind IM, Heinen MM, Geense WW, Mesters I, Wensing M, van Achterberg T. Exploring the Range of Lifestyle Interventions Used in Dutch Health Care Practice. Health Promot Pract 2016; 17:235-43. [DOI: 10.1177/1524839915627264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The application of evidence-based lifestyle interventions is suboptimal, but little is known what interventions are actually used. This study aimed to explore the range of lifestyle interventions used in Dutch ambulatory health care settings. Method. We conducted interviews (n = 67) in purposefully selected hospitals, general practices, and community care organizations. Interviews focused on identifying activities to help patients stop smoking, reduce alcohol consumption, increase physical activity, eat a healthy diet, and lose weight. We also asked who developed the interventions. All reported activities were registered and analyzed. Results. Four categories of health promotion activities emerged: giving advice, making referrals, offering counseling, and providing lifestyle interventions organized separately from the care process. In total, 102 lifestyle interventions were reported. Forty-five interventions were developed by researchers, of which 30 were developed by the Dutch Expert Center on Tobacco Control. Providers did not know the source of 31 interventions. Eighteen interventions were developed by the providers themselves, and eight were based on evidence-based guidelines. Conclusions. Health promotion activities seemed to be widely present in Dutch health care, in particular smoking cessation interventions. Although health care providers use many different interventions, replacing nontested for evidence-based interventions is required.
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Affiliation(s)
- Irene M. van de Glind
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud M. Heinen
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wytske W. Geense
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Michel Wensing
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo van Achterberg
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium
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Dörenkamp S, Mesters I, de Bie R, Teijink J, van Breukelen G. Patient Characteristics and Comorbidities Influence Walking Distances in Symptomatic Peripheral Arterial Disease: A Large One-Year Physiotherapy Cohort Study. PLoS One 2016; 11:e0146828. [PMID: 26751074 PMCID: PMC4708998 DOI: 10.1371/journal.pone.0146828] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/22/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives The aim of this study is to investigate the association between age, gender, body-mass index, smoking behavior, orthopedic comorbidity, neurologic comorbidity, cardiac comorbidity, vascular comorbidity, pulmonic comorbidity, internal comorbidity and Initial Claudication Distance during and after Supervised Exercise Therapy at 1, 3, 6 and 12 months in a large sample of patients with Intermittent Claudication. Methods Data was prospectively collected in standard physiotherapy care. Patients received Supervised Exercise Therapy according to the guideline Intermittent Claudication of the Royal Dutch Society for Physiotherapy. Three-level mixed linear regression analysis was carried out to analyze the association between patient characteristics, comorbidities and Initial Claudication Distance at 1, 3, 6 and 12 months. Results Data from 2995 patients was analyzed. Results showed that being female, advanced age and a high body-mass index were associated with lower Initial Claudication Distance at all-time points (p = 0.000). Besides, a negative association between cardiac comorbidity and Initial Claudication Distance was revealed (p = 0.011). The interaction time by age, time by body-mass index and time by vascular comorbidity were significantly associated with Initial Claudication Distance (p≤ 0.05). Per year increase in age (range: 33–93 years), the reduction in Initial Claudication Distance was 8m after 12 months of Supervised Exercise Therapy. One unit increase in body-mass index (range: 16–44 kg/m2) led to 10m less improvement in Initial Claudication Distance after 12 months and for vascular comorbidity the reduction in improvement was 85m after 12 months. Conclusions This study reveals that females, patients at advanced age, patients with a high body-mass index and cardiac comorbidity are more likely to show less improvement in Initial Claudication Distances (ICD) after 1, 3, 6 and 12 months of Supervised Exercise Therapy. Further research should elucidate treatment adaptations that optimize treatment outcomes for these subgroups.
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Affiliation(s)
- Sarah Dörenkamp
- Department of Epidemiology, Functioning and Rehabilitation Programme, CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - Ilse Mesters
- Department of Epidemiology, Functioning and Rehabilitation Programme, CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Rob de Bie
- Department of Epidemiology, Functioning and Rehabilitation Programme, CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Joep Teijink
- Department of Epidemiology, Functioning and Rehabilitation Programme, CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
- Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Gerard van Breukelen
- Department of Methodology and Statistics, CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Van Koppen LH, Zandwijk PJJ, Van Mameren H, Mesters I, Winkens B, De Bie RA. Patients’ adherence to a walking programme for non-specific low back pain. European Journal of Physiotherapy 2016. [DOI: 10.3109/21679169.2015.1127419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kanera IM, Bolman CAW, Mesters I, Willems RA, Beaulen AAJM, Lechner L. Prevalence and correlates of healthy lifestyle behaviors among early cancer survivors. BMC Cancer 2016; 16:4. [PMID: 26732757 PMCID: PMC4702377 DOI: 10.1186/s12885-015-2019-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 12/15/2015] [Indexed: 02/01/2023] Open
Abstract
Background Healthy lifestyle behaviors have been demonstrated to be beneficial for positive health outcomes and the quality of life in cancer survivors. However, adherence to recommendations is low. More insight is needed in factors that may explain engagement in lifestyle behaviors to develop effective cancer aftercare interventions. This study assessed different factors, namely socio-demographic, cancer-related, psychological, social cognitive factors (attitude, social support, self-efficacy) and intention, in relationship to five lifestyle behaviors (smoking, physical activity, alcohol, and fruit and vegetable consumption). Methods Early survivors of various types of cancer were recruited from eighteen Dutch Hospitals (n = 255). Distal factors (socio-demographic, cancer related, psychological), proximal factors (social cognitive), intention and five lifestyle behaviors (smoking, physical activity, alcohol, fruit and vegetable consumption) were assessed through a self-reported questionnaire. Cross-sectional analyses (correlations and regression analyses) were conducted. Results The lifestyle of a small group (11 %) of the cancer survivors was coherent with all five health recommendations, the majority (>80 %) adhered to two, three of four recommendations, and only few (<7 %) adhered to one or none recommendation. The highest prevalence in followed recommendations have been detected in physical activity (87.4 %), refrain from smoking (82 %), and alcohol consumption (75.4 %). There was low adherence to the fruit recommendation (54.8 %) and to the vegetable recommendation (27.4 %). Only weak associations were found between the different behaviors. Each separate lifestyle behavior was influenced by different patterns of correlates. Self-efficacy, attitude, and intention were the strongest correlates in all examined behaviors, although with various contributions, while socio-demographic, cancer-related and psychological factors provided a much smaller contribution. Conclusions Outcomes of engagement in healthy lifestyle behaviors were more positive in this study compared to other research in cancer survivors; however, there is room for improvements in adherence to all five lifestyle behaviors. Especially fruit consumption was poor and vegetable consumption even worse. Our findings emphasized that all examined lifestyle behaviors need to be encouraged, with taken into account that each lifestyle behavior may be influenced by a specific set of mainly social cognitive factors or intention.
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Affiliation(s)
- Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands.
| | - Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
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Mesters I, Willems R, Kanera I, Bolman C, Keeman M, Lechner L. Psychometric Quality of the Extended Cancer information Needs Questionnaire (CaSUN-NL). Arch Phys Med Rehabil 2015. [DOI: 10.1016/j.apmr.2015.08.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dörenkamp S, Mesters I, Teijink J, de Bie R. Patient-Related Variables and Comorbidities Influence Maximum Pain-Free Walking Distances in Symptomatic Peripheral Arterial Disease. Arch Phys Med Rehabil 2015. [DOI: 10.1016/j.apmr.2015.08.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sacomori C, Berghmans B, Mesters I, de Bie R, Cardoso FL. Strategies to enhance self-efficacy and adherence to home-based pelvic floor muscle exercises did not improve adherence in women with urinary incontinence: a randomised trial. J Physiother 2015; 61:190-8. [PMID: 26365268 DOI: 10.1016/j.jphys.2015.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/21/2015] [Accepted: 08/06/2015] [Indexed: 01/25/2023] Open
Abstract
QUESTION Do strategies to enhance self-efficacy and exercise mastery affect adherence to home-based pelvic floor muscle exercises in women with urinary incontinence? DESIGN Two-arm, parallel, randomised, controlled trial with intention-to-treat analysis. Randomisation was performed using computer-generated random numbers in five blocks of 20 women. PARTICIPANTS Eighty-six women with stress, urgency or mixed urinary incontinence. INTERVENTION All participants underwent three individual physiotherapy clinic visits at Day 0, 15 and 30, and 2 further months of home-based pelvic floor muscle exercises. The experimental group also received self-efficacy enhancing interventions, including a structured discussion on accomplishments and goals, a 9-minute video with testimonials, and a reminder. OUTCOME MEASURES The primary outcome - adherence to at least 20 fast and 20 slow contractions every day - was evaluated with a structured questionnaire at 15, 30 and 90 days after enrolment and completion of a daily diary. A validated questionnaire was used to assess urinary incontinence. Self-efficacy and pelvic floor muscle function were also measured. RESULTS Seven women withdrew from each group before the Day-30 assessment. There was no difference in adherence to pelvic floor muscle exercises at 90 days between the groups (MD 0.5 points, 95% CI -1.1 to 2.1) on the questionnaire, which was scored from 2 to 21. At Day 90, 56% of the experimental group and 44% of the control group were performing the exercises every day. Adherence scores of both groups decreased during the 2-month follow-up period without any supervised physiotherapy session (p<0.05). The groups did not differ on the remaining secondary outcomes. CONCLUSION Discussion of accomplishments and goals, a testimonial video and a reminder did not increase exercise adherence more than exercise mastery. TRIAL REGISTRATION Brazilian Registry of Clinical Trials UTN:U1111-1128-8684.
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Affiliation(s)
| | - Bary Berghmans
- Pelvic Care Center Maastricht, Maastricht University Medical Center
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Rob de Bie
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Fernando Luiz Cardoso
- Department of Health Sciences, Centre of Health and Sports Sciences, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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Dörenkamp S, Mesters I, Teijink J, de Bie R. Comorbidity Forces Physiotherapists to Deviate from Guidelines: a Vignette Study. Arch Phys Med Rehabil 2015. [DOI: 10.1016/j.apmr.2015.08.193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Willems RA, Bolman CAW, Mesters I, Kanera IM, Beaulen AAJM, Lechner L. The Kanker Nazorg Wijzer (Cancer Aftercare Guide) protocol: the systematic development of a web-based computer tailored intervention providing psychosocial and lifestyle support for cancer survivors. BMC Cancer 2015; 15:580. [PMID: 26260318 PMCID: PMC4532144 DOI: 10.1186/s12885-015-1588-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/30/2015] [Indexed: 12/14/2022] Open
Abstract
Background After primary treatment, many cancer survivors experience psychosocial, physical, and lifestyle problems. To address these issues, we developed a web-based computer tailored intervention, the Kanker Nazorg Wijzer (Cancer Aftercare Guide), aimed at providing psychosocial and lifestyle support for cancer survivors. The purpose of this article is to describe the systematic development and the study design for evaluation of this theory and empirical based intervention. Methods/design For the development of the intervention, the steps of the Intervention Mapping protocol were followed. A needs assessment was performed consisting of a literature study, focus group interviews, and a survey study to get more insight into cancer survivors’ health issues. This resulted in seven problem areas that were addressed in the intervention: cancer-related fatigue, return to work, anxiety and depression, social relationships and intimacy, physical activity, diet, and smoking. To address these problem areas, the principles of problem-solving therapy and cognitive behavioral therapy are used. At the start of the intervention, participants have to fill in a screening questionnaire. Based on their answers, participants receive tailored advice about which problem areas deserve their attention. Participants were recruited from November 2013 through June 2014 by hospital staff from 21 hospitals in the Netherlands. Patients were selected either during follow-up visits to the hospital or from reviews of the patients’ files. The effectiveness of the intervention is being tested in a randomized controlled trial consisting of an intervention group (n = 231) and waiting list control group (n = 231) with a baseline measurement and follow-up measurements at 3, 6, and 12 months. Discussion Using the Intervention Mapping protocol resulted in a theory and evidence-based intervention providing tailored advice to cancer survivors on how to cope with psychosocial and lifestyle issues after primary treatment. Trial registration Dutch Trial Register NTR3375
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Affiliation(s)
- Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
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Zandwijk P, Van Koppen B, Van Mameren H, Mesters I, Winkens B, De Bie R. The accuracy of self-reported adherence to an activity advice. European Journal of Physiotherapy 2015. [DOI: 10.3109/21679169.2015.1075588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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van de Glind I, Heinen M, Geense W, Mesters I, Wensing M, van Achterberg T. Making the connection-factors influencing implementation of evidence supported and non-evaluated lifestyle interventions in healthcare: a multiple case study. Health Educ Res 2015; 30:521-541. [PMID: 26025211 DOI: 10.1093/her/cyv020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
Many implementation barriers relate to lifestyle interventions (LIs) being developed by scientists. Exploring whether implementation of non-evaluated LIs is less complicated, might offer insight how to improve the use of effective interventions. This study aimed to identify influencing factors for implementation and compare factors between evidence supported and non-evaluated LIs. Evidence-supported (n = 7) and non-evaluated LIs (n = 7) in hospitals, general practices and community care organizations were included as cases. Semi-structured interviews (n = 46) were conducted. Additionally, documents (n = 207) were collected describing intervention, implementation process, and policy. We used a stepwise approach to inductively identify factors, organize them by diffusion phase, and an existing framework. A total of 37 factors were identified. 'Dissemination' factors were mainly observed in evidence-supported LIs. 'Compatibility to existing structures' ('adoption'), 'funding' and 'connection to existing care processes' ('implementation') was factors identified in all cases. 'Quality control' and 'ongoing innovation' ('maintenance') were reported in evidence-supported interventions. In all domains of the framework factors were observed. Factors identified in this study are in line with the literature. The findings do not support the assumption that implementation of non-evaluated LIs is perceived as less complex.
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Affiliation(s)
- Irene van de Glind
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wytske Geense
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Mesters
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michel Wensing
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo van Achterberg
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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Marcellis R, Van der Veeke M, Mesters I, Drent M, De Bie R, De Vries G, Lenssen A. Does physical training reduce fatigue in sarcoidosis? Sarcoidosis Vasc Diffuse Lung Dis 2015; 32:53-62. [PMID: 26237356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Sarcoidosis patients frequently experience fatigue, exercise intolerance and muscle weakness, resulting in reduced quality of life (QOL). Scientific studies on the benefits of physical training in sarcoidosis have been scarce, so the aim of this pilot study was to examine the impact of a 13-week physical training program on fatigue, physical functions and QOL in fatigued sarcoidosis patients and/or patients with exercise intolerance. METHODS 18 sarcoidosis patients participated in a 13-week physical training program. The Fatigue Assessment Scale (FAS), World Health Organization Quality of Life-BREF assessment instrument (WHOQOL-BREF),Medical Research Council (MRC) dyspnea scale, Visual Analogue Scale (VAS), six-minute walk test (6MWT), submaximal bicycle test and muscle strength of the quadriceps and elbow flexors were assessed at baseline and after the program. RESULTS FAS scores had decreased (mean difference -2.7 points, 95% CI -4.4 to -1.1) after completion of the training program, along with improvements in WHOQOLBREF psychological health domain (mean difference 0.9 points, 95% CI 0.2 to 1.7) and MRC dyspnea score (mean difference -0.4 points, 95% CI -0.8 to -0.1). 6MWD improved by 34.6 m (95% CI 20.3 to 49.0) and mean heart rate on the bicycle test improved (mean difference 8.4 beats/minute, 95% CI -13.8 to -3.0), as did quadriceps strength (mean difference 10.7 kg, 95% CI 5.5 to 15.9). CONCLUSION Fatigue reduced after a period of physical training in sarcoidosis patients. Moreover, psychological health and physical functions improved. Future studies are warranted to assess the benefits of physical training in sarcoidosis.
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Affiliation(s)
- Rik Marcellis
- Department of Physical Therapy Maastricht University Medical Centre (MUMC) Maastricht The Netherlands.
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Marcellis R, Van der Veeke M, Mesters I, Drent M, De Bie R, De Vries G, Lenssen A. Physical training in sarcoidosis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dörenkamp S, Mesters I, Teijink J, de Bie R. Difficulties of using single-diseased guidelines to treat patients with multiple diseases. Front Public Health 2015; 3:67. [PMID: 25973414 PMCID: PMC4413518 DOI: 10.3389/fpubh.2015.00067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/07/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sarah Dörenkamp
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , Netherlands ; Center for Evidence-Based Physiotherapy (CEBP), Maastricht University , Maastricht , Netherlands
| | - Ilse Mesters
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , Netherlands ; Center for Evidence-Based Physiotherapy (CEBP), Maastricht University , Maastricht , Netherlands
| | - Joep Teijink
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , Netherlands ; Department of Vascular Surgery, Catharina Hospital , Eindhoven , Netherlands
| | - Rob de Bie
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , Netherlands ; Center for Evidence-Based Physiotherapy (CEBP), Maastricht University , Maastricht , Netherlands
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Kalter J, Buffart LM, Korstjens I, van Weert E, Brug J, Verdonck-de Leeuw IM, Mesters I, van den Borne B, Hoekstra-Weebers JEHM, Ros WJG, May AM. Moderators of the effects of group-based physical exercise on cancer survivors' quality of life. Support Care Cancer 2015; 23:2623-31. [PMID: 25680762 PMCID: PMC4519631 DOI: 10.1007/s00520-015-2622-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 01/22/2015] [Indexed: 01/23/2023]
Abstract
Purpose This study explored demographic, clinical, and psychological moderators of the effect of a group-based physical exercise intervention on global quality of life (QoL) among cancer survivors who completed treatment. Methods Cancer survivors were assigned to a 12-week physical exercise (n = 147) or a wait-list control group (n = 62). The main outcome measure was global QoL, assessed with the EORTC QLQ-C30 at baseline and 12 weeks later. Potential moderators were age, gender, education level, marital status, employment status, type of treatment, time since treatment, the presence of comorbidities, fatigue, general self-efficacy, depression, and anxiety. Linear regression analyses were used to test effect modification of the intervention by each moderator variable using interaction tests (p ≤ 0.10). Results The physical exercise intervention effect on global QoL was larger for cancer survivors who received radiotherapy (β = 10.3, 95 % confidence interval (CI) = 4.4; 16.2) than for cancer survivors who did not receive radiotherapy (β = 1.8, 95 % CI = −5.9; 9.5, pinteraction = 0.10), larger for cancer survivors who received a combination of chemoradiotherapy (β = 13.0, 95 % CI = 6.0; 20.1) than for those who did not receive this combination of treatments (β = 2.5, 95 % CI = −3.7; 8.7, pinteraction = 0.02), and larger for cancer survivors with higher baseline levels of fatigue (β = 12.6, 95 % CI = 5.7; 19.6) than for those with lower levels (β = 2.4, 95 % CI = −3.9; 8.7, pinteraction = 0.03). No other moderating effects were found. Conclusions This study suggests that cancer treatment modality and baseline fatigue levels moderate the effect of a physical exercise program on cancer survivors’global QoL.
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Affiliation(s)
- Joeri Kalter
- EMGO+ Institute, Department of Epidemiology and Biostatistics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Rewald S, Mesters I, Emans P, Arts J, Lenssen A, Bie R. Aquatic circuit training including aqua-cycling in patients with knee osteoarthritis: A feasibility study. J Rehabil Med 2015; 47:376-81. [DOI: 10.2340/16501977-1937] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- Emmylou Beekman
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands The Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd University, Heerlen, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Rik Gosselink
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium Department of Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Leuven, Belgium
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Mesters I, Wahl S, Van Keulen HM. Socio-demographic, medical and social-cognitive correlates of physical activity behavior among older adults (45-70 years): a cross-sectional study. BMC Public Health 2014; 14:647. [PMID: 24965940 PMCID: PMC4089561 DOI: 10.1186/1471-2458-14-647] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 06/19/2014] [Indexed: 11/24/2022] Open
Abstract
Background Present study aimed to identify socio-demographic, medical and social-cognitive correlates of physical activity among Dutch older individuals. Methods A systematic random sample of 2,568 Dutch participants aged 45–70 years filled out the validated modified Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire on physical activity. Socio-demographic and social-cognitive correlates were measured with validated instruments; medical correlates were checked by a general practitioner. The study had a cross-sectional design and the data collection ran from March 2005 until August 2006. Linear regression analyses were conducted to identify correlates of PA. We separated the findings for men from those for women to explore potential gender-specific associations. Results Being female, living in North Limburg or North-Brabant, having a higher educational level, a higher perceived behavioral control, more knowledge about PA advantages, a stronger habitual PA behavior, having more action plans and a stronger intention to engage in PA were significantly associated with higher PA levels. Being older, being a smoker, having a higher body mass index (BMI), having a paid job, observing others being physically active and overestimating one's PA level were associated with being less physically active. Socio-demographic and medical correlates significantly explained 20% of the variance of PA behavior while social-cognitive correlates as attitude explained an additional 4% and intention together with actual control explained another 1% of the variance of PA behavior. Conclusion There may be stable individual differences that influence PA in view of the fact that several socio-demographic and medical factors were not completely mediated by the socio-cognitive factors. The current study may help to focus PA interventions for individuals aged 45–70 years on influential socio-demographic, medical and social-cognitive correlates. Physical activity was significantly associated with age, gender, education, BMI, work situation, region of residence, smoking, awareness, advantages, descriptive norm, perceived behavioral control, habit, action plans and intention.
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Affiliation(s)
- Ilse Mesters
- School for Public Health and Primary Care (Caphri), Department of Epidemiology, Maastricht University, PO Box 616, Maastricht 6200 MD, The Netherlands.
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Rewald S, Mesters I, Emans P, Lenssen T, de Bie R. AB1176-HPR Feasibility of Aqua Cycling in Patients with Knee Osteoarthritis - A Pilot Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hutchinson SG, Kuijlaars JS, Mesters I, Muris JWM, van Schayck CP, Dompeling E, Feron FJM. Addressing passive smoking in children. PLoS One 2014; 9:e93220. [PMID: 24809443 PMCID: PMC4014468 DOI: 10.1371/journal.pone.0093220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/04/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A significant number of parents are unaware or unconvinced of the health consequences of passive smoking (PS) in children. Physicians could increase parental awareness by giving personal advice. AIM To evaluate the current practices of three Dutch health professions (paediatricians, youth health care physicians, and family physicians) regarding parental counselling for passive smoking (PS) in children. METHODS All physicians (n = 720) representing the three health professions in Limburg, The Netherlands, received an invitation to complete a self-administered electronic questionnaire including questions on their: sex, work experience, personal smoking habits, counselling practices and education regarding PS in children. RESULTS The response rate was 34%. One tenth (11%) of the responding physicians always addressed PS in children, 32% often, 54% occasionally and 4% reported to never attend to it. The three health professions appeared comparable regarding their frequency of parental counselling for PS in children. Addressing PS was more likely when children had respiratory problems. Lack of time was the most frequently mentioned barrier, being very and somewhat applicable for respectively 14% and 43% of the physicians. One fourth of the responders had received postgraduate education about PS. Additionally, 49% of the responders who did not have any education about PS were interested in receiving it. CONCLUSIONS Physicians working in the paediatric field in Limburg, The Netherlands, could more frequently address PS in children with parents. Lack of time appeared to be the most mentioned barrier and physicians were more likely to counsel parents for PS in children with respiratory complaints/diseases. Finally, a need for more education on parental counselling for PS was expressed.
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Affiliation(s)
- Sasha G. Hutchinson
- Department of Paediatric Pulmonology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
- * E-mail:
| | - Jennifer S. Kuijlaars
- Department of Paediatric Pulmonology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Ilse Mesters
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jean W. M. Muris
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Constant P. van Schayck
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Edward Dompeling
- Department of Paediatric Pulmonology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Frans J. M. Feron
- Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
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Beekman E, Mesters I, Hendriks EJM, Muris JWM, Wesseling G, Evers SMAA, Asijee GM, Fastenau A, Hoffenkamp HN, Gosselink R, van Schayck OCP, de Bie RA. Exacerbations in patients with chronic obstructive pulmonary disease receiving physical therapy: a cohort-nested randomised controlled trial. BMC Pulm Med 2014; 14:71. [PMID: 24767519 PMCID: PMC4108017 DOI: 10.1186/1471-2466-14-71] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 04/10/2014] [Indexed: 11/30/2022] Open
Abstract
Background Physical exercise training aims at reducing disease-specific impairments and improving quality of life in patients with chronic obstructive pulmonary disease (COPD). COPD exacerbations in particular negatively impact COPD progression. Physical therapy intervention seems indicated to influence exacerbations and their consequences. However, information on the effect of physical therapy on exacerbation occurrence is scarce. This study aims to investigate the potential of a protocol-directed physical therapy programme as a means to prevent or postpone exacerbations, to shorten the duration or to decrease the severity of exacerbations in patients with COPD who have recently experienced an exacerbation. Besides, this study focuses on the effect of protocol-directed physical therapy on health status and quality of life and on cost-effectiveness and cost-utility in patients with COPD who have recently experienced an exacerbation. Methods/Design A prospective cohort of 300 COPD patients in all GOLD stages will be constructed. Patients will receive usual multidisciplinary COPD care including guideline-directed physical therapy. Patients in this cohort who have GOLD stage 2 to 4 (post-bronchodilator FEV1/FVC < 0.7 and FEV1 < 80% of predicted), who receive reimbursement by health insurance companies for physical therapy (post-bronchodilator Tiffeneau-index < 0.6) and who experience a COPD exacerbation will be asked within 56 days to participate in a cohort-nested prospective randomised controlled trial (RCT). In this RCT, the intervention group will receive a strict physical therapy programme for patients with COPD. This protocol-directed physical therapy (pdPT) will be compared to a control group that will receive sham-treatment, meaning no or very low-intensity exercise training (ST). An economic evaluation will be embedded in the RCT. Anthropometric measurements, comorbidities, smoking, functional exercise capacity, peripheral muscle strength, physical activity level, health related quality of life, patients’ perceived benefit, physical therapy compliance, motivation level, level of effective mucus clearance, exacerbation symptoms and health care contacts due to COPD will be recorded. Follow-up measurements are scheduled at 3 and 6 weeks, 3, 6, 12 and 24 months after inclusion. Discussion Ways to minimise potential problems regarding the execution of this study will be discussed. Trial registration The Netherlands National Trial Register NTR1972.
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Affiliation(s)
- Emmylou Beekman
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands.
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Beekman E, Mesters I, Gosselink R, Klaassen MPM, Hendriks EJM, Van Schayck OCP, de Bie RA. The first reference equations for the 6-minute walk distance over a 10 m course: Table 1. Thorax 2014; 69:867-8. [DOI: 10.1136/thoraxjnl-2014-205228] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Leeden MVD, Bart Staal J, Beekman E, Hendriks E, Mesters I, Rooij MD, Vries ND, Werkman M, Graaf-Peters VD, Bie RD, Hulzebos E, Sanden RNVD, Dekker J. Development of a framework to describe goals and content of exercise interventions in physical therapy: a mixed method approach including a systematic review. Physical Therapy Reviews 2013. [DOI: 10.1179/1743288x13y.0000000095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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