Interest in and barriers to participation in a Facebook-delivered weight loss program among female cancer survivors with overweight or obesity

Dietary Intervention Improves Gastrointestinal Symptoms after Treatment of Cancer in the Pelvic Organs

Gastrointestinal (GI) symptoms are common in patients receiving radiotherapy, chemotherapy, and/or surgery for cancer in the pelvic organs. The aim of the present prospective cohort study was to report the efficacy of dietary intervention in patients with chronic GI sequelae to treatment of cancer in pelvic organs and insufficient symptomatic effect of medical treatment. Eighty-eight patients were offered specialist dietitian guidance. Gastrointestinal symptoms and quality of life were assessed before and after intervention by validated questionnaires. The main dietary interventions were low-fat diet (n = 44; 50%), modification of dietary fiber content (n = 19; 33%), dietary restrictions with a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet (n = 18; 20%), gluten-free diet (n = 1; 1%), and other dietary advice (n = 6; 7%). Compared to baseline, dietary intervention improved quality of life (EQ5D scale) (p < 0.01), bowel function for the last four weeks (p < 0.02), stool frequency (p < 0.03), constipation (p < 0.05), incomplete rectal emptying at defecation (p < 0.02), and performing usual activities (p < 0.0). In conclusion, this observational study using tailored dietary intervention showed that symptoms can be reduced and quality of life can be improved in patients with chronic GI sequelae following treatment of cancer in the pelvic organs not responding sufficiently to medical treatment.

Features That Middle-aged and Older Cancer Survivors Want in Web-Based Healthy Lifestyle Interventions: Qualitative Descriptive Study

Background

With the increasing number of older cancer survivors, it is imperative to optimize the reach of interventions that promote healthy lifestyles. Web-based delivery holds promise for increasing the reach of such interventions with the rapid increase in internet use among older adults. However, few studies have explored the views of middle-aged and older cancer survivors on this approach and potential variations in these views by gender or rural and urban residence.

Objective

The aim of this study was to explore the views of middle-aged and older cancer survivors regarding the features of web-based healthy lifestyle programs to inform the development of a web-based diet and exercise intervention.

Methods

Using a qualitative descriptive approach, we conducted 10 focus groups with 57 cancer survivors recruited from hospital cancer registries in 1 southeastern US state. Data were analyzed using inductive thematic and content analyses with NVivo (version 12.5, QSR International).

Results

A total of 29 male and 28 female urban and rural dwelling Black and White survivors, with a mean age of 65 (SD 8.27) years, shared their views about a web-based healthy lifestyle program for cancer survivors. Five themes emerged related to program content, design, delivery, participation, technology training, and receiving feedback. Cancer survivors felt that web-based healthy lifestyle programs for cancer survivors must deliver credible, high-quality, and individually tailored information, as recommended by health care professionals or content experts. Urban survivors were more concerned about information reliability, whereas women were more likely to trust physicians’ recommendations. Male and rural survivors wanted information to be tailored to the cancer type and age group. Privacy, usability, interaction frequency, and session length were important factors for engaging cancer survivors with a web-based program. Female and rural participants liked the interactive nature and visual appeal of the e-learning sessions. Learning from experts, an attractive design, flexible schedule, and opportunity to interact with other cancer survivors in Facebook closed groups emerged as factors promoting program participation. Low computer literacy, lack of experience with web program features, and concerns about Facebook group privacy were important concerns influencing cancer survivors’ potential participation. Participants noted the importance of technology training, preferring individualized help to standardized computer classes. More rural cancer survivors acknowledged the need to learn how to use computers. The receipt of regular feedback about progress was noted as encouragement toward goal achievement, whereas women were particularly interested in receiving immediate feedback to stay motivated.

Conclusions

Important considerations for designing web-based healthy lifestyle interventions for middle-aged and older cancer survivors include program quality, participants’ privacy, ease of use, attractive design, and the prominent role of health care providers and content experts. Cancer survivors’ preferences based on gender and residence should be considered to promote program participation.

Recruiting Cancer Survivors to a Mobile Mindfulness Intervention in the United States: Exploring Online and Face-to-Face Recruitment Strategies

Cancer survivorship research faces several recruitment challenges, such as accrual of a representative sample, as well as participant retention. Our study explores patterns in recruited demographics, patient-reported outcomes (PROs), and retention rates for a randomized controlled trial (RCT) utilizing a mobile mindfulness intervention for the well-being of cancer survivors. In total, 123 participants were recruited using traditional and online strategies. Using the chi-square test of independence, recruitment type was compared with demographic and clinical variables, PROs, and retention at Time 2 and Time 3. Online recruitment resulted in almost double the yield compared to traditional recruitment. Online-recruited participants were more often younger, from the continental U.S., Caucasian, diagnosed and treated less recently, at a later stage of diagnosis, diagnosed with blood cancer, without high blood pressure, and with less reported pain. The recruitment method was not significantly associated with retention. Online recruitment may capture a larger, broader survivor sample, but, similar to traditional recruitment, may also lead to selection biases depending on where efforts are focused. Future research should assess the reasons underlying the higher yield and retention rates of online recruitment and should evaluate how to apply a mix of traditional and online recruitment strategies to efficiently accrue samples that are representative of the survivor population.

Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review

INTRODUCTION

To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment.

METHODS

A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020.

RESULTS

Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment.

CONCLUSION

Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.