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Talty A, Morris R, Deighan C. Home-based self-management multimodal cancer interventions & cardiotoxicity: a scoping review. Cardiooncology 2024; 10:12. [PMID: 38424647 PMCID: PMC10903028 DOI: 10.1186/s40959-024-00204-6] [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] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Due to advancements in methods of cancer treatment, the population of people living with and beyond cancer is dramatically growing. The number of cancer survivors developing cardiovascular diseases and heart failure is also rising, due in part to the cardiotoxic nature of many cancer treatments. Guidelines are being increasingly released, emphasising the need for interdisciplinary action to address this gap in survivorship care. However, the extent to which interventions exist, incorporating the recommendations of cardio-oncology research, remains undetermined. OBJECTIVE The aim of this scoping review is to assess the nature, extent and remit of existing cancer care interventions and their integration of cardio-oncology principles. METHODS The review was conducted in accordance with the PRISMA Extension for Scoping Reviews Guidelines. Databases were independently searched for articles from 2010 to 2022, by two members of the research team. Data were charted and synthesised using the following criteria: (a) the focus of the intervention (b) the medium of delivery (c) the duration (d) the modalities included in the interventions (e) the research articles associated with each intervention (f) the type of studies conducted (g) key measures used (h) outcomes reported. RESULTS Interventions encompassed six key modalities: Psychological Support, Physical Activity, Nutrition, Patient Education, Lifestyle and Caregiver Support. The focus, medium of delivery and duration of interventions varied significantly. While a considerable number of study protocols and pilot studies exist documenting HSMIs, only 25% appear to have progressed beyond this stage of development. Of those that have, the present review did not identify any 'feasible' interventions that covered each of the six modalities, while being generalisable to all cancer survivors and incorporating the recommendations from cardio-oncology research. CONCLUSION Despite the substantial volume of research and evidence from the field of cardio-oncology, the findings of this scoping review suggest that the recommendations from guidelines have yet to be successfully translated from theory to practice. There is an opportunity, if not necessity, for cardiac rehabilitation to expand to meet the needs of those living with and beyond cancer.
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Affiliation(s)
- Anna Talty
- The Heart Manual Department, Astley Ainslie Hospital, Grange Loan, Edinburgh, Scotland, UK, EH9 2HL
| | - Roseanne Morris
- The Heart Manual Department, Astley Ainslie Hospital, Grange Loan, Edinburgh, Scotland, UK, EH9 2HL
| | - Carolyn Deighan
- The Heart Manual Department, Astley Ainslie Hospital, Grange Loan, Edinburgh, Scotland, UK, EH9 2HL.
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de Vries-Ten Have J, Winkels RM, Kampman E, Winkens LHH. Behaviour change techniques used in lifestyle interventions that aim to reduce cancer-related fatigue in cancer survivors: a systematic review. Int J Behav Nutr Phys Act 2023; 20:126. [PMID: 37833784 PMCID: PMC10576285 DOI: 10.1186/s12966-023-01524-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Lifestyle interventions that target dietary and/or physical activity behaviours may impact cancer-related fatigue in cancer survivors. Changing lifestyle may be especially difficult for cancer survivors suffering from cancer-related fatigue. To increase effectiveness of lifestyle interventions, behaviour change techniques (BCTs) can be applied. The aim of this review is to systematically describe which BCTs are applied in lifestyle interventions targeting cancer-related fatigue among cancer survivors who finished primary treatment. METHODS PubMed, Scopus, PsycINFO, Cochrane Library and Web of Science were searched to identify randomised controlled trials (RCTs) of dietary and/or physical activity interventions targeting cancer-related fatigue in cancer survivors. The BCT taxonomy was used to code the BCTs that were applied in those interventions. BCTs that were reported in at least 25% of effective interventions were indicated as 'promising BCT', but only retained this classification when these BCTs were present in less than 25% of ineffective interventions. RESULTS Twenty-nine RCTs were identified, of which 17 were effective in reducing cancer-related fatigue. The most frequently applied BCTs were Goal setting (behaviour), Instruction on how to perform the behaviour, Demonstration of the behaviour, Behavioural practice/rehearsal, and Credible Source. The BCT 'Generalisation of the target behaviour' was identified as promising. These results should be interpreted with caution as only three studies screened their participants on level of cancer-related fatigue and most studies focused only on physical activity. Furthermore, many studies did not include a measure for actual behaviour change and had no follow-up period after the intervention ended. CONCLUSIONS There is a need for studies that screen their participants on level of cancer-related fatigue and a need for studies that focus more on dietary behaviours as a possible intervention to reduce fatigue. Also, studies should include follow-up timepoints after the interventions ends to examine long-term behaviour change. Future lifestyle interventions should describe interventions in detail to allow for easier coding of BCTs, and report on actual behaviour change following the intervention. Interventions may apply the BCT 'Generalisation of the target behaviour' to incorporate lifestyle behaviours in daily life. This may increase the chance that interventions will effectively reduce cancer-related fatigue.
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Affiliation(s)
- Judith de Vries-Ten Have
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands.
| | - Renate M Winkels
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Laura H H Winkens
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands
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Rogers LQ, Pekmezi D, Schoenberger-Godwin YM, Fontaine KR, Ivankova NV, Kinsey AW, Hoenemeyer T, Martin MY, Pisu M, Farrell D, Wall J, Waugaman K, Oster RA, Kenzik K, Winters-Stone K, Demark-Wahnefried W. Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors. Digit Health 2023; 9:20552076231182805. [PMID: 37434730 PMCID: PMC10331096 DOI: 10.1177/20552076231182805] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/01/2023] [Indexed: 07/13/2023] Open
Abstract
Objective To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the AiM, Plan, and act on LIFestYles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations. Methods The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations. Results A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks. Conclusions Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.
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Affiliation(s)
- Laura Q. Rogers
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dori Pekmezi
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA, USA
| | - Yu-Mei Schoenberger-Godwin
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin R. Fontaine
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA, USA
| | - Nataliya V. Ivankova
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber W. Kinsey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Teri Hoenemeyer
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle Y. Martin
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Maria Pisu
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Kaitlyn Waugaman
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A. Oster
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kelly Kenzik
- Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Kerri Winters-Stone
- Division of Oncological Sciences, Oregon Health and Science University, Portland, OR, USA
| | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
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Irurita-Morales P, Soto-Ruiz N, San Martín-Rodríguez L, Escalada-Hernández P, García-Vivar C. Use of Telehealth Among Cancer Survivors: A Scoping Review. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0351] [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] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Leticia San Martín-Rodríguez
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Paula Escalada-Hernández
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Beenhakker L, Witteveen A, Wijlens KAE, Siemerink EJM, van der Lee ML, Bode C, Siesling S, Vollenbroek‐Hutten MMR. Patient preference attributes in eHealth interventions for cancer-related fatigue: A scoping review. Eur J Cancer Care (Engl) 2022; 31:e13754. [PMID: 36385440 PMCID: PMC9786794 DOI: 10.1111/ecc.13754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/11/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the most reported long-term effects breast cancer patients experience after diagnosis. Many interventions for CRF are effective, however, not for every individual. Therefore, intervention advice should be adjusted to patients' preferences and characteristics. Our aim was to develop an overview of eHealth interventions and their (preference sensitive) attributes. METHODS eHealth interventions were identified using a scoping review approach. Eligible studies included breast cancer patients and assessed CRF as outcome. Interventions were categorised as physical activity, mind-body, psychological, 'other' or 'combination'. Information was extracted on various (preference sensitive) attributes, like duration, intensity, peer support and costs. RESULTS Thirty-five interventions were included and divided over the intervention categories. (Preference sensitive) attributes varied both within and between these categories. Duration varied from 4 weeks to 6 months, intensity from daily to own pace. Peer support was present in seven interventions and costs were known for six. CONCLUSION eHealth interventions exist in various categories, additionally, there is much variation in (preference sensitive) attributes. This provides opportunities to implement our overview for personalised treatment recommendations for breast cancer patients struggling with CRF. Taking into account patients' preferences and characteristics suits the complexity of CRF and heterogeneity of patients.
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Affiliation(s)
- Lian Beenhakker
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Annemieke Witteveen
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Kim A. E. Wijlens
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | | | - Marije L. van der Lee
- Scientific Research DepartmentHelen Dowling InstituteBilthovenThe Netherlands,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
| | - Christina Bode
- Department of Psychology, Health and TechnologyUniversity of TwenteEnschedeThe Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical CentreUniversity of TwenteEnschedeThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Miriam M. R. Vollenbroek‐Hutten
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands,Board of DirectorsMedisch Spectrum TwenteEnschedeThe Netherlands
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Collombon EHGM, Bolman CAW, Peels DA, de Bruijn GJ, de Groot RHM, Lechner L. Adding Mobile Elements to Online Physical Activity Interventions Targeted at Adults Aged 50 Years and Older: Protocol for a Systematic Design. JMIR Res Protoc 2022; 11:e31677. [PMID: 35819820 PMCID: PMC9328785 DOI: 10.2196/31677] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Physical activity (PA) can increase mental and physical health in adults aged 50 years and older. However, it has been shown that PA guidelines are often not met within this population. Therefore, our research group developed 2 computer-tailored intervention programs in the last decade to stimulate PA: Active Plus and I Move. Although these programs were proven effective, positive effects diminished over time and attrition rates were relatively high. To respond to this, we will integrate 3 interactive mobile elements into the existing programs: activity tracker, ecological momentary intervention program, and virtual coach app. OBJECTIVE The goal of the research is to define systematic and evidence-based steps for extending our online computer-based PA intervention programs with 3 interactive mobile elements. METHODS Components often included in other (eHealth) design models were identified as key components and served as a base for the definition of systematic steps: exploration of context, involvement of the target population, prototype and intervention testing, and implementation. Based on these key components, 10 systematic steps were defined. The initial step is a literature search, with the results serving as a base for development of the low-fidelity prototypes in step 2. The pilot phase comprises the 3rd to 6th steps and includes semistructured interviews, pilot tests, and adaptations of the prototypes with intensive involvement of the target population of adults aged 50 years and older, where particular attention will be paid to lower educated persons. The 7th step is an effect evaluation in the form of a randomized controlled trial. During the 8th step, the most effective intervention programs will be selected and reinforced. These reinforced intervention programs will be used during the design of an implementation plan in the 9th step and the subsequent field study in the 10th step. RESULTS The project will be executed from December 2019 to December 2023. During this period, the systematic approach presented will be practically executed according to the methodological procedures described. CONCLUSIONS Based on the 4 identified key components, we were able to design an evidence-based systematic design approach for separately adding 3 mobile elements to our existing online PA intervention programs. The 10 steps are presented as a useful approach to guide future eHealth design studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31677.
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Affiliation(s)
| | | | - Denise A Peels
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
| | - Gert-Jan de Bruijn
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands.,Department of Communication Science, University of Antwerp, Antwerp, Belgium
| | | | - Lilian Lechner
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
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van Deursen L, Versluis A, van der Vaart R, Standaar L, Struijs J, Chavannes N, Aardoom JJ. eHealth Interventions for Dutch Cancer Care: Systematic Review Using the Triple Aim Lens. JMIR Cancer 2022; 8:e37093. [PMID: 35699991 PMCID: PMC9240931 DOI: 10.2196/37093] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/04/2022] Open
Abstract
Background Globally, the burden of cancer on population health is growing. Recent trends such as increasing survival rates have resulted in a need to adapt cancer care to ensure a good care experience and manageable expenditures. eHealth is a promising way to increase the quality of cancer care and support patients and survivors. Objective The aim of this systematic review was 2-fold. First, we aimed to provide an overview of eHealth interventions and their characteristics for Dutch patients with and survivors of cancer. Second, we aimed to provide an overview of the empirical evidence regarding the impact of eHealth interventions in cancer care on population health, quality of care, and per capita costs (the Triple Aim domains). Methods The electronic databases Web of Science, PubMed, Cochrane, and Ovid PsycINFO were searched using 3 key search themes: eHealth interventions, cancer care, and the Netherlands. The identified interventions were classified according to predetermined criteria describing the intervention characteristics (eg, type, function, and target population). Their impact was subsequently examined using the Triple Aim framework. Results A total of 38 interventions were identified. Most of these were web portals or web applications functioning to inform and self-manage, and target psychosocial factors or problems. Few interventions have been tailored to age, disease severity, or gender. The results of this study indicate that eHealth interventions could positively affect sleep quality, fatigue, and physical activity of patients with and survivors of cancer. Inconclusive results were found regarding daily functioning and quality of life, psychological complaints, and psychological adjustment to the disease. Conclusions eHealth can improve outcomes in the Triple Aim domains, particularly in the population health and quality of care domains. Cancer-related pain and common symptoms of active treatment were not targeted in the included interventions and should receive more attention. Further research is needed to fully understand the impact of eHealth interventions in cancer care on participation, accessibility, and costs. The latter can be examined in economic evaluations by comparing eHealth interventions with care as usual.
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Affiliation(s)
- Liza van Deursen
- Department of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Anke Versluis
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Rosalie van der Vaart
- Department of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Lucille Standaar
- Department of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Department of Quality and Organization of Care, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Jeroen Struijs
- Department of Quality of Care and Health Economics, Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Health Campus The Hague, Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, Netherlands
| | - Niels Chavannes
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Jiska J Aardoom
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Coumans JM, Bolman CA, Oenema A, Lechner L. The effects of a web-based computer-tailored diet and physical activity intervention based on self-determination theory and motivational interviewing: A randomized controlled trial. Internet Interv 2022; 28:100537. [PMID: 35509808 PMCID: PMC9058957 DOI: 10.1016/j.invent.2022.100537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND According to self-determination theory (SDT), autonomous forms of motivation are more likely to result in sustained behavioral changes than controlled forms. Principles of motivational interviewing (MI) can be applied to facilitate more autonomous forms of motivation. This study investigated whether a combined diet and physical activity (PA) web-based computer-tailored intervention based on SDT and MI, called MyLifestyleCoach, was effective in promoting dietary and PA behaviors. METHODS A two-arm randomized controlled trial with 1142 Dutch adults was conducted. The intervention and control group completed questionnaires at baseline, 6, and 12 months from baseline. Only participants in the intervention condition had access to MyLifestyleCoach. The waiting list control condition had access to the intervention after completing the 12-month follow-up questionnaire. A modified food frequency questionnaire was used to measure dietary behaviors (fruit, vegetables, fish, and unhealthy snacks). The Dutch Short Questionnaire to ASsess Health was used to measure the weekly minutes of moderate-to-vigorous PA (MVPA). Usage data, which is operationalized as completed sessions in this study, was objectively assessed by log data. We conducted two-step linear mixed effect models. In the first step, a model consisting of condition, time, potentially confounding variables and a random intercept for participants was tested. In the second step, an interaction term was added to investigate the intervention's (time × condition) and usage (time × opening session and time × completed sessions) effects over time for the dietary and PA outcomes. RESULTS The findings showed no differences between the groups for all four dietary behaviors and the weekly minutes of MVPA at any of the time points. In-depth analyses showed that participants who followed the opening session of the intervention, in which they received personalized feedback on their behaviors, had a stronger increase in fruit consumption at 6 months and 12 months than participants who did not follow the interventions' opening session. Lastly, participants who followed more sessions in the diet module had a stronger increase in fruit and vegetable consumption at 6 months, and a stronger decrease in the consumption frequency of unhealthy snacks at 12 months post-baseline. CONCLUSION Overall, the intervention was not effective in changing dietary and PA behavior. However, moderation analyses suggest that the intervention is effective in changing dietary behavior for those participants who used the intervention more intensively. Further research should focus on improving intervention use.
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Affiliation(s)
- Juul M.J. Coumans
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands,Corresponding author at: Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Valkenburgerweg 177, 6419 AT Heerlen, the Netherlands.
| | - Catherine A.W. Bolman
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
| | - Anke Oenema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Lilian Lechner
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
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9
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Coumans JMJ, Lechner L, Bolman CAW, Oenema A. Clustering of motivational constructs based on self-determination theory for diet and physical activity and their associations with behaviour: a cross-sectional study. J Nutr Sci 2022; 11. [PMID: 35399551 PMCID: PMC8943567 DOI: 10.1017/jns.2022.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 02/03/2023] Open
Abstract
The present study explored whether motivational constructs for diet and physical activity (PA) cluster and how these motivational constructs relate to dietary and PA behaviour. Data of 1142 participants were used from a randomised controlled trial examining the effects of a web-based diet and PA promotion intervention based on self-determination theory and motivational interviewing. Motivation was assessed using the Treatment Self-Regulation Questionnaire and Behavioural Regulation in Exercise Questionnaire. The dietary outcomes were measured using an adapted Food Frequency Questionnaire. PA was assessed using the Short QUestionnaire to ASsess Health. Spearman rank-order correlations showed large correlation coefficients (rs ≥ 0⋅63) between similar motivational constructs between the two lifestyle domains, except for intrinsic motivation where a medium correlation coefficient was found (rs = 0⋅41). Furthermore, the exploratory factor analysis illustrated that more self-determined forms of motivation seem to be more domain-specific. In contrast, non-self-determined forms of motivation seem to be domain-independent. Last, regression analyses demonstrated that intrinsic motivation towards PA was the only motivational construct significantly positively associated with all PA sub-behaviours (standardised regression coefficients ranging from 0⋅17 to 0⋅28, all P < 0⋅0125). Intrinsic motivation to eat healthily was significantly positively associated with fruits, vegetables and fish intake (standardised regression coefficients ranging from 0⋅11 to 0⋅16, all P < 0⋅0125), but not with unhealthy snacks. Insight of this exploratory study is useful for understanding the interrelationships of motivational induced behaviours, the development of interventions targeting multiple behaviours, and the construction of questionnaires.
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10
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Yeary KHK, Clark N, Saad-Harfouche F, Erwin D, Kuliszewski MG, Li Q, McCann SE, Yu H, Lincourt C, Zoellner J, Tang L. Cruciferous Vegetable Intervention to Prevent Cancer Recurrence in Non-Muscle Invasive Bladder Cancer Survivors: Development using a Systematic Process (Preprint). JMIR Cancer 2021; 8:e32291. [PMID: 35166681 PMCID: PMC8889476 DOI: 10.2196/32291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/30/2021] [Accepted: 01/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Bladder cancer is one of the top 10 most common cancers in the United States. Most bladder cancers (70%-80%) are diagnosed at early stages as non–muscle-invasive bladder cancer (NMIBC), which can be removed surgically. However, 50% to 80% of NMIBC cases recur within 5 years, and 15% to 30% progress with poor survival. Current treatments are limited and expensive. A wealth of preclinical and epidemiological evidence suggests that dietary isothiocyanates in cruciferous vegetables (Cruciferae) could be a novel, noninvasive, and cost-effective strategy to control NMIBC recurrence and progression. Objective The aim of this study is to develop a scalable dietary intervention that increases isothiocyanate exposure through Cruciferae intake in NMIBC survivors. Methods We worked with a community advisory board (N=8) to identify relevant factors, evidence-based behavior change techniques, and behavioral theory constructs used to increase Cruciferae intake in NMIBC survivors; use the PEN-3 Model focused on incorporating cultural factors salient to the group’s shared experiences to review the intervention components (eg, the saliency of behavioral messages); administer the revised intervention to community partners for their feedback; and refine the intervention. Results We developed a multicomponent intervention for NMIBC survivors consisting of a magazine, tracking book, live telephone call script, and interactive voice messages. Entitled POW-R Health: Power to Redefine Your Health, the intervention incorporated findings from our adaptation process to ensure saliency to NMIBC survivors. Conclusions This is the first evidence-based, theoretically grounded dietary intervention developed to reduce bladder cancer recurrence in NMIBC survivors using a systematic process for community adaptation. This study provides a model for others who aim to develop behavioral, community-relevant interventions for cancer prevention and control with the overall goal of wide-scale implementation and dissemination.
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Affiliation(s)
- Karen H Kim Yeary
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Nikia Clark
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Frances Saad-Harfouche
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Deborah Erwin
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Margaret Gates Kuliszewski
- New York State Cancer Registry, New York State Department of Health, Albany, NY, United States
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY, United States
| | - Qiang Li
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Department of Pharmacology & Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Susan E McCann
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Han Yu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Catherine Lincourt
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jamie Zoellner
- Department of Public Health Science, University of Virginia, Charlottesville, VA, United States
| | - Li Tang
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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van der Hout A, van Uden-Kraan C, Holtmaat K, Jansen F, Lissenberg-Witte B, Nieuwenhuijzen G, Hardillo J, Baatenburg de Jong R, Tiren-Verbeet N, Sommeijer D, de Heer K, Schaar C, Sedee R, Bosscha K, van den Brekel M, Petersen J, Westerman M, Honings J, Takes R, Houtenbos I, van den Broek W, de Bree R, Jansen P, Eerenstein S, Leemans C, Zijlstra J, Cuijpers P, van de Poll-Franse L, Verdonck-de Leeuw I. Reasons for not reaching or using web-based self-management applications, and the use and evaluation of Oncokompas among cancer survivors, in the context of a randomised controlled trial. Internet Interv 2021; 25:100429. [PMID: 34401388 PMCID: PMC8350584 DOI: 10.1016/j.invent.2021.100429] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/22/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The web-based self-management application Oncokompas was developed to support cancer survivors to monitor health-related quality of life and symptoms (Measure) and to provide tailored information (Learn) and supportive care options (Act). In a previously reported randomised controlled trial (RCT), 68% of 655 recruited survivors were eligible, and of those 45% participated in the RCT. Among participants of the RCT that were randomised to the intervention group, 52% used Oncokompas as intended. The aim of this study was to explore reasons for not participating in the RCT, and reasons for not using Oncokompas among non-users, and the use and evaluation of Oncokompas among users. METHODS Reasons for not participating were assessed with a study-specific questionnaire among 243 survivors who declined participation. Usage was investigated among 320 participants randomised to the intervention group of the RCT via system data and a study-specific questionnaire that was assessed during the 1 week follow-up (T1) assessment. RESULTS Main reasons for not participating were not interested in participation in scientific research (40%) and not interested in scientific research and Oncokompas (28%). Main reasons for not being interested in Oncokompas were wanting to leave the period of being ill behind (29%), no symptom burden (23%), or lacking internet skills (18%). Out of the 320 participants in the intervention group 167 (52%) used Oncokompas as intended. Among 72 non-users, main reasons for not using Oncokompas were no symptom burden (32%) or lack of time (26%). Among 248 survivors that activated their account, satisfaction and user-friendliness were rated with a 7 (scale 0-10). Within 3 (IQR 1-4) sessions, users selected 32 (IQR 6-37) topics. Main reasons for not using healthcare options in Act were that the information in Learn was already sufficient (44%) or no supportive care needs (32%). DISCUSSION Main reasons for not reaching or using Oncokompas were no symptom burden, no supportive care needs, or lack of time. Users selected many cancer-generic and tumour-specific topics to address, indicating added value of the wide range of available topics.
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Affiliation(s)
- A. van der Hout
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - C.F. van Uden-Kraan
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - K. Holtmaat
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
| | - F. Jansen
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - B.I. Lissenberg-Witte
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
| | | | - J.A. Hardillo
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Centre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R.J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Centre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - N.L. Tiren-Verbeet
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D.W. Sommeijer
- Department of Internal Medicine, Flevoziekenhuis, Almere, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands
| | - K. de Heer
- Department of Internal Medicine, Flevoziekenhuis, Almere, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - C.G. Schaar
- Department of Internal Medicine, Gelre ziekenhuis, Apeldoorn, the Netherlands
| | - R.J.E. Sedee
- Department of Otolaryngology, Head and Neck Surgery, Haaglanden MC, The Hague, the Netherlands
| | - K. Bosscha
- Department of Surgery, Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands
| | - M.W.M. van den Brekel
- Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - J.F. Petersen
- Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - M. Westerman
- Department of Hematology, Northwest Clinics, Alkmaar, the Netherlands
| | - J. Honings
- Department of Otorhinolaryngology – Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R.P. Takes
- Department of Otorhinolaryngology – Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - I. Houtenbos
- Department of Hematology, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | | | - R. de Bree
- Department of Head and Neck Surgical Oncology, Utrecht University Medical Center, Utrecht, the Netherlands
| | - P. Jansen
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - S.E.J. Eerenstein
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - C.R. Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
| | - J.M. Zijlstra
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Amsterdam, the Netherlands
| | - P. Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - L.V. van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation, Eindhoven, the Netherlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, the Netherlands
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - I.M. Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology – Head and Neck Surgery, Amsterdam, the Netherlands
- Corresponding author at: Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
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Finlay A, Evans H, Vincent A, Wittert G, Vandelanotte C, Short CE. Optimising Web-Based Computer-Tailored Physical Activity Interventions for Prostate Cancer Survivors: A Randomised Controlled Trial Examining the Impact of Website Architecture on User Engagement. Int J Environ Res Public Health 2020; 17:ijerph17217920. [PMID: 33126692 PMCID: PMC7662822 DOI: 10.3390/ijerph17217920] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/17/2020] [Accepted: 10/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Web-based computer-tailored interventions can assist prostate cancer survivors to become more physically active by providing personally relevant behaviour change support. This study aimed to explore how changing the website architecture (free choice vs. tunnelled) impacted engagement within a physical activity computer-tailored intervention targeting prostate cancer survivors. METHODS On a 2:2:1 ratio, 71 Australian prostate cancer survivors with local or locally advanced disease (mean age: 66.6 years ± 9.66) were randomised into either a free-choice (N = 27), tunnelled (N = 27) or minimal intervention control arm (N =17). The primary outcome was differences in usage of the physical activity self-monitoring and feedback modules between the two intervention arms. Differences in usage of other website components between the two intervention groups were explored as secondary outcomes. Further, secondary outcomes involving comparisons between all study groups (including the control) included usability, personal relevance, and behaviour change. RESULTS The average number of physical activity self-monitoring and feedback modules accessed was higher in the tunnelled arm (M 2.6 SD 1.3) compared to the free-choice arm (M 1.5 SD 1.4), p = 0.01. However, free-choice participants were significantly more likely to have engaged with the social support (p = 0.008) and habit formation (p = 0.003) 'once-off' modules compared to the standard tunnelled arm. There were no other between-group differences found for any other study outcomes. CONCLUSION This study indicated that website architecture influences behavioural engagement. Further research is needed to examine the impact of differential usage on mechanisms of action and behaviour change.
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Affiliation(s)
- Amy Finlay
- The Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide 5000, SA, Australia; (A.F.); (H.E.); (A.V.); (G.W.)
| | - Holly Evans
- The Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide 5000, SA, Australia; (A.F.); (H.E.); (A.V.); (G.W.)
| | - Andrew Vincent
- The Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide 5000, SA, Australia; (A.F.); (H.E.); (A.V.); (G.W.)
| | - Gary Wittert
- The Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide 5000, SA, Australia; (A.F.); (H.E.); (A.V.); (G.W.)
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton 4701, QLD, Australia;
| | - Camille E Short
- The Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide 5000, SA, Australia; (A.F.); (H.E.); (A.V.); (G.W.)
- The Melbourne School of Psychological Sciences and Melbourne School of Health Science (Jointly Appointed), The University of Melbourne, Parkville 3010, VIC, Australia
- Correspondence: ; Tel.: +61-3-8344-1192
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13
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Hwang NK, Jung YJ, Park JS. Information and Communications Technology-Based Telehealth Approach for Occupational Therapy Interventions for Cancer Survivors: A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8040355. [PMID: 32977651 PMCID: PMC7712965 DOI: 10.3390/healthcare8040355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients’ health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind–body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul 02062, Korea;
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division DongSeo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
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14
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Coumans JMJ, Bolman CAW, Oenema A, Lechner L. Predictors of Self-Determined Module Choice in a Web-Based Computer-Tailored Diet and Physical Activity Intervention: Secondary Analysis of Data From a Randomized Controlled Trial. J Med Internet Res 2020; 22:e15024. [PMID: 32706659 PMCID: PMC7413275 DOI: 10.2196/15024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/19/2019] [Revised: 01/13/2020] [Accepted: 03/11/2020] [Indexed: 12/24/2022] Open
Abstract
Background Tailoring an online intervention to participant preferences (eg, by giving participants a choice which modules to follow) may increase engagement in the intervention, motivation for behavioral change, and possibly intervention effects. So far, little is known about what characteristics predict these module choices. Filling this knowledge gap is useful for optimizing program engagement. Objective We investigated participant choice for a dietary and/or physical activity (PA) promotion module in our web-based computer-tailored intervention based on self-determination theory (SDT) and motivational interviewing (MI). Furthermore, we investigated which demographic characteristics, current behavior, psychosocial constructs and constructs from SDT and MI, and program-related variables such as advice on which module to follow were associated with these choices. Methods Observational data were used from the randomized controlled trial MyLifestyleCoach of participants who were randomized into the intervention condition, completed the baseline questionnaire, and made a module choice in the opening session of the intervention. Here, they received advice on their own dietary and PA behavior. At the session’s end, they chose which lifestyle modules they would like to follow (both, diet, PA, or no module). Measurements included demographic information; self-reported diet and PA; and several psychosocial, SDT, and MI constructs. In total, data from 619 Dutch adults (59.6% women; mean age was 51.9 [SD 13.5] years) were analyzed. A stepwise multinomial logistic regression analysis was conducted to investigate which characteristics are related to module choice; the diet module served as reference category as almost everyone was advised to follow this module. Results Of this sample, 54.8% (339/619) chose to do both the diet and PA module, 25.4% (157/619) chose to follow the diet module, 17.8% (110/619) preferred to follow no module, and 2.1% (13/619) chose to do the PA module only. Furthermore, it was found that older people, those who consumed more fruit, and those who scored lower on importance to change their current diet were more likely to choose no module compared to the diet module. People who had more motivation to change their current PA and those who received strong advice compared with slight advice to follow the diet module were more likely to choose both modules compared with the diet module only. Conclusions The results show that more than half of the sample was interested in following both the diet and PA module in this online lifestyle intervention. Several characteristics were found to be related to module choice. A future challenge is to examine how this knowledge can be used to improve future interventions, such as tailoring (messages or content) on specific groups or examining where and how MI could be used to motivate people to make a certain module choice. Trial Registration Netherlands Trial Register NL7333; https://www.trialregister.nl/trial/7333
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Affiliation(s)
- Juul M J Coumans
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Catherine A W Bolman
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Anke Oenema
- Department of Health Promotion, Caphri, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Lilian Lechner
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
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15
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Coumans JMJ, Bolman CAW, Friederichs SAH, Oenema A, Lechner L. Development and Testing of a Personalized Web-Based Diet and Physical Activity Intervention Based on Motivational Interviewing and the Self-Determination Theory: Protocol for the MyLifestyleCoach Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e14491. [PMID: 32014841 PMCID: PMC7055747 DOI: 10.2196/14491] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/19/2019] [Accepted: 09/07/2019] [Indexed: 12/17/2022] Open
Abstract
Background Unhealthy dietary patterns and insufficient physical activity (PA) are associated with negative health outcomes, such as cardiovascular diseases, type 2 diabetes, cancer, overweight, and obesity. This makes the promotion of healthy dietary and PA behaviors a public health priority. Objective This paper describes the development, design, and evaluation protocol of a Web-based computer-tailored (CT) dietary and PA promotion intervention, MyLifestyleCoach. A Web-based format was chosen for its accessibility and large-scale reach and low-cost potential. To achieve effective and persistent behavioral change, this innovative intervention is tailored to individual characteristics and is based on the self-determination theory and motivational interviewing (MI). Methods The 6 steps of the intervention mapping protocol were used to systematically develop MyLifestyleCoach based on the existing effective CT PA promotion intervention I Move. The MyLifestyleCoach intervention consists of 2 modules: I Move, which is aimed at promoting PA, and I Eat, which is aimed at promoting healthy eating. Development of the I Eat module was informed by the previously developed I Move. Both modules were integrated to form the comprehensive MyLifestyleCoach program. Furthermore, I Move was slightly adapted, for example, the new Dutch PA guidelines were implemented. A randomized controlled trial consisting of an intervention condition and waiting list control group will be used to evaluate the effectiveness of the intervention on diet and PA. Results Self-reported measures take place at baseline, 6 months, and 12 months after baseline. Enrollment started in October 2018 and will be completed in June 2020. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2020. Conclusions MyLifestyleCoach is one of the first interventions to translate and apply self-determination theory and techniques from MI in Web-based computer tailoring for an intervention targeting PA and dietary behavior. Intervention mapping served as a blueprint for the development of this intervention. We will evaluate whether this approach is also successful in promoting eating healthier and increasing PA using an randomized controlled trial by comparing the intervention to a waiting list control condition. The results will provide an insight into the short- and long-term efficacy and will result in recommendations for the implementation and promotion of healthy eating and PA among adults in the Netherlands. Trial Registration Dutch Trial Register NL7333; https://www.trialregister.nl/trial/7333 International Registered Report Identifier (IRRID) DERR1-10.2196/14491
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Affiliation(s)
- Juul M J Coumans
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Catherine A W Bolman
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Stijn A H Friederichs
- Department of Clinical Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Anke Oenema
- Department of Health Promotion, Caphri, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Lilian Lechner
- Department of Health Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
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16
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Greidanus MA, de Boer AGEM, Tiedtke CM, Frings-Dresen MHW, de Rijk AE, Tamminga SJ. Supporting employers to enhance the return to work of cancer survivors: development of a web-based intervention (MiLES intervention). J Cancer Surviv 2020; 14:200-210. [PMID: 31938966 PMCID: PMC7182637 DOI: 10.1007/s11764-019-00844-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
Purpose The purpose of this study was to develop an intervention targeting employers, with the aim of enhancing cancer survivors’ return to work (RTW). Methods Intervention Mapping was used to combine information gathered from several procedures involving numerous stakeholders, for example, employers, cancer survivors, oncological occupational physicians, and e-health experts. Results Employers indicated that they require tailored support during four RTW phases: (1) disclosure, (2) treatment, (3) RTW planning, and (4) actual RTW. The most important employer actions were identified for each RTW phase, for instance, “communicate,” “support practically,” and “assess work ability,” and thereafter formulated as the performance objectives of the intervention. The trans-theoretical model of change was used as a theoretical framework, and several methodologies were employed to induce the desired behavior change, for example modeling, tailoring, and active learning. Subsequently, a web-based intervention with interactive videos, conversation checklists, links to reliable external sources, and succinct, tailored tips and information was developed and adjusted on the basis of pre-tests with different stakeholders. Conclusions The intervention was developed with input from employers and all relevant stakeholders in the RTW of cancer survivors. The systematic, step-wise development resulted in a succinct and easily accessible intervention targeting the most important employer actions during all RTW phases. As such, the intervention corresponds with employers’ needs and preferences in practice. Implications for cancer survivors By providing employers with support, the intervention could well be the missing link in efforts to optimize the work participation of cancer survivors. Electronic supplementary material The online version of this article (10.1007/s11764-019-00844-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C M Tiedtke
- Department of Public Health and Primary Care, Centre for Environment & Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Mujcic A, Blankers M, Bommelé J, Boon B, Berman AH, Verdonck‐de Leeuw IM, van Laar M, Engels R. The effectiveness of distance‐based interventions for smoking cessation and alcohol moderation among cancer survivors: A meta‐analysis. Psychooncology 2020; 29:49-60. [PMID: 31663182 PMCID: PMC8246955 DOI: 10.1002/pon.5261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/30/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only. METHODS A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated. RESULTS A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P = .007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P < .0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, -0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, -0.08 to 0.31, P = .24). CONCLUSIONS Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors.
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Affiliation(s)
- Ajla Mujcic
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| | - Matthijs Blankers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Department of Research, Arkin Mental Health CareAmsterdamThe Netherlands
- Amsterdam UMC, Location AMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Bommelé
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Brigitte Boon
- Academy Het Dorp Department Scientific Research, Siza Arnhem, The NetherlandsArnhemThe Netherlands
- Department Scientific ResearchSizaArnhemThe Netherlands
| | - Anne H. Berman
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden
- Stockholm Center for Dependency DisordersStockholm Health Care Services, Stockholm RegionStockholmSweden
- Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center AmsterdamAmsterdamThe Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam Public HealthAmsterdamThe Netherlands
| | - Margriet van Laar
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Rutger Engels
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
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18
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Abstract
PURPOSE OF REVIEW The number of cancer survivors is growing due to population ageing, earlier detection and more effective therapies. Routinely collected data (RCD), generally cancer registry data, has been used to investigate survivors' needs and outcomes. We reviewed uses of RCD since 2017, identifying novel findings and research directions. RECENT FINDINGS Survival is improving internationally but continues to vary between subgroups. Longitudinal survivor surveys suggest malignancy-specific temporal patterns in unmet needs and health-related quality-of-life (HRQoL). Unmet needs are a risk factor for future depression and depression predicts poorer HRQoL in all domains. Emerging evidence suggests links between posttraumatic stress and poor HRQoL and posttraumatic growth and improved HRQoL. Evidence for a link between cancer-related financial hardship and poor HRQoL is accumulating. Surveys and linkage studies continue to show poorer work outcomes in survivors. Among survivors of childhood and young adult cancers, large linkage studies demonstrate significant risk of late effects, including hospitalization, pregnancy and labour complications, and cardiac death. SUMMARY RCD plays a significant role in understanding survivors' needs and outcomes. New approaches which overlay different types of data - including detailed clinical and treatment data, biomarker data and nonhealth administrative data - have the potential to generate considerable new knowledge.
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Moore G, Wilding H, Gray K, Castle D. Participatory Methods to Engage Health Service Users in the Development of Electronic Health Resources: Systematic Review. J Particip Med 2019; 11:e11474. [PMID: 33055069 PMCID: PMC7434099 DOI: 10.2196/11474] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/29/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023] Open
Abstract
Background When health service providers (HSP) plan to develop electronic health (eHealth) resources for health service users (HSU), the latter’s involvement is essential. Typically, however, HSP, HSU, and technology developers engaged to produce the resources lack expertise in participatory design methodologies suited to the eHealth context. Furthermore, it can be difficult to identify an established method to use, or determine how to work stepwise through any particular process. Objective We sought to summarize the evidence about participatory methods and frameworks used to engage HSU in the development of eHealth resources from the beginning of the design process. Methods We searched for studies reporting participatory processes in initial development of eHealth resources from 2006 to 2016 in 9 bibliographic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Emcare, Cochrane Library, Web of Science, ACM Guide to Computing Literature, and IEEE Xplore. From 15,117 records initially screened on title and abstract for relevance to eHealth and early participatory design, 603 studies were assessed for eligibility on full text. The remaining 90 studies were rated by 2 reviewers using the Mixed Methods Appraisal Tool Version 2011 (Pluye et al; MMAT) and analyzed with respect to health area, purpose, technology type, and country of study. The 30 studies scoring 90% or higher on MMAT were included in a detailed qualitative synthesis. Results Of the 90 MMAT-rated studies, the highest reported (1) health areas were cancer and mental disorders, (2) eHealth technologies were websites and mobile apps, (3) targeted populations were youth and women, and (4) countries of study were the United States, the United Kingdom, and the Netherlands. Of the top 30 studies the highest reported participatory frameworks were User-Centered Design, Participatory Action Research Framework, and the Center for eHealth Research and Disease Management (CeHRes) Roadmap, and the highest reported model underpinning development and engagement was Social Cognitive Theory. Of the 30 studies, 4 reported on all the 5 stages of the CeHRes Roadmap. Conclusions The top 30 studies yielded 24 participatory frameworks. Many studies referred to using participatory design methods without reference to a framework. The application of a structured framework such as the CeHRes Roadmap and a model such as Social Cognitive Theory creates a foundation for a well-designed eHealth initiative that ensures clarity and enables replication across participatory design projects. The framework and model need to be clearly articulated and address issues that include resource availability, responsiveness to change, and the criteria for good practice. This review creates an information resource for future eHealth developers, to guide the design of their eHealth resource with a framework that can support further evaluation and development. Trial Registration PROSPERO CRD42017053838; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=53838
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Affiliation(s)
- Gaye Moore
- Mental Health Executive Services, St Vincent's Hospital, Melbourne, Fitzroy, Australia.,Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Helen Wilding
- Mental Health Executive Services, St Vincent's Hospital, Melbourne, Fitzroy, Australia.,Library Service, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Kathleen Gray
- Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Australia
| | - David Castle
- Mental Health Executive Services, St Vincent's Hospital, Melbourne, Fitzroy, Australia.,Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
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20
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Schepisi G, De Padova S, De Lisi D, Casadei C, Meggiolaro E, Ruffilli F, Rosti G, Lolli C, Ravaglia G, Conteduca V, Farolfi A, Grassi L, De Giorgi U. Psychosocial Issues in Long-Term Survivors of Testicular Cancer. Front Endocrinol (Lausanne) 2019; 10:113. [PMID: 30858829 PMCID: PMC6397854 DOI: 10.3389/fendo.2019.00113] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/07/2019] [Indexed: 01/20/2023] Open
Abstract
Testicular cancer is the most frequent tumor in young males aged 15-39 years. As cure rates are currently around 90%, the prevalence of survivors is increasing. However, a disease-free condition does not necessarily correspond to a life free of physical and psychosocial health problems. The aim of this review was to explore psychosocial morbidity among testicular cancer survivors. A literature search was conducted in three electronic databases (PubMed, Medline, and Embase). The results of the search on cancer survivors were then combined with those of the search on psychosocial concerns and work performance. Eighty-four publications met the inclusion criteria. Physical, psychological, work-related problems and changing perspectives about work and life in general influenced life and career decisions among testicular cancer survivors. Individual health, sexual relationships and work problems, affect several important aspects of survival and significantly influence the QoL of long-term survivors.
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Affiliation(s)
- Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
- *Correspondence: Giuseppe Schepisi
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Delia De Lisi
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giovanni Rosti
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Cristian Lolli
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giorgia Ravaglia
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Luigi Grassi
- Hospital Psychiatry Unit, Department of Biomedical and Specialty Surgical Sciences, Integrated Department of Mental Health and Addictive Behavior, Institute of Psychiatry, St. Anna University Hospital and NHS Community Health Trusts, University of Ferrara, Ferrara, Italy
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
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21
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Friesen-Storms JH, Bours GJ, Snijders IC, van der Weijden T, Jie KSG, Beurskens AJ. A conversation approach based on shared goal-setting and shared decision-making for nurses in cancer aftercare: A developmental study. Eur J Oncol Nurs 2018; 35:107-116. [PMID: 30057077 DOI: 10.1016/j.ejon.2018.06.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 06/02/2018] [Accepted: 06/11/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. METHODS We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. RESULTS The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. EVALUATION The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. CONCLUSION The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.
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Affiliation(s)
- Jolanda Hhm Friesen-Storms
- Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands; Maastricht University, CAPHRI Care and Public Health Research Institute, Department of Family Medicine, Maastricht, The Netherlands.
| | - Gerrie Jjw Bours
- Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands; Maastricht University, CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
| | | | - Trudy van der Weijden
- Maastricht University, CAPHRI Care and Public Health Research Institute, Department of Family Medicine, Maastricht, The Netherlands
| | - Kon-Siong G Jie
- Zuyderland Medical Center Sittard-Geleen, Heerlen, The Netherlands; Research Centre for Integrative Patient Centred Health Care, Zuyd Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Anna Jhm Beurskens
- Research Centre for Autonomy and Participation for Persons with a Chronic Illness, Zuyd Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands; Maastricht University, CAPHRI Care and Public Health Research Institute, Department of Family Medicine, Maastricht, The Netherlands
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22
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Koutoukidis DA, Lopes S, Atkins L, Croker H, Knobf MT, Lanceley A, Beeken RJ. Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the shape-up following cancer treatment program. BMC Public Health 2018; 18:415. [PMID: 29587699 PMCID: PMC5869761 DOI: 10.1186/s12889-018-5329-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 03/16/2018] [Indexed: 11/25/2022] Open
Abstract
Background About 80% of endometrial cancer survivors (ECS) are overweight or obese and have sedentary behaviors. Lifestyle behavior interventions are promising for improving dietary and physical activity behaviors, but the constructs associated with their effectiveness are often inadequately reported. The aim of this study was to systematically adapt an evidence-based behavior change program to improve healthy lifestyle behaviors in ECS. Methods Following a review of the literature, focus groups and interviews were conducted with ECS (n = 16). An intervention mapping protocol was used for the program adaptation, which consisted of six steps: a needs assessment, formulation of matrices of change objectives, selection of theoretical methods and practical applications, program production, adoption and implementation planning, and evaluation planning. Social Cognitive Theory and Control Theory guided the adaptation of the intervention. Results The process consisted of eight 90-min group sessions focusing on shaping outcome expectations, knowledge, self-efficacy, and goals about healthy eating and physical activity. The adapted performance objectives included establishment of regular eating, balanced diet, and portion sizes, reduction in sedentary behaviors, increase in lifestyle and organized activities, formulation of a discrepancy-reducing feedback loop for all above behaviors, and trigger management. Information on managing fatigue and bowel issues unique to ECS were added. Conclusions Systematic intervention mapping provided a framework to design a cancer survivor-centered lifestyle intervention. ECS welcomed the intervention and provided essential feedback for its adaptation. The program has been evaluated through a randomized controlled trial. Electronic supplementary material The online version of this article (10.1186/s12889-018-5329-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dimitrios A Koutoukidis
- Institute for Women's Health, University College London, London, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sonia Lopes
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lou Atkins
- Centre for Behaviour Change, University College London, London, UK
| | - Helen Croker
- Department of Behavioural Science and Health, University College London, London, UK
| | - M Tish Knobf
- School of Nursing, Yale University, New Haven, CT, USA
| | - Anne Lanceley
- Institute for Women's Health, University College London, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK. .,Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
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23
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Lozano-Lozano M, Galiano-Castillo N, Martín-Martín L, Pace-Bedetti N, Fernández-Lao C, Arroyo-Morales M, Cantarero-Villanueva I. Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study. JMIR Mhealth Uhealth 2018; 6:e67. [PMID: 29588273 PMCID: PMC5893887 DOI: 10.2196/mhealth.9669] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 12/16/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The majority of breast cancer survivors do not meet recommendations in terms of diet and physical activity. To address this problem, we developed a mobile health (mHealth) app for assessing and monitoring healthy lifestyles in breast cancer survivors, called the Energy Balance on Cancer (BENECA) mHealth system. The BENECA mHealth system is a novel and interactive mHealth app, which allows breast cancer survivors to engage themselves in their energy balance monitoring. BENECA was designed to facilitate adherence to healthy lifestyles in an easy and intuitive way. OBJECTIVE The objective of the study was to assess the concurrent validity and test-retest reliability between the BENECA mHealth system and the gold standard assessment methods for diet and physical activity. METHODS A reliability study was conducted with 20 breast cancer survivors. In the study, tri-axial accelerometers (ActiGraphGT3X+) were used as gold standard for 8 consecutive days, in addition to 2, 24-hour dietary recalls, 4 dietary records, and sociodemographic questionnaires. Two-way random effect intraclass correlation coefficients, a linear regression-analysis, and a Passing-Bablok regression were calculated. RESULTS The reliability estimates were very high for all variables (alpha≥.90). The lowest reliability was found in fruit and vegetable intakes (alpha=.94). The reliability between the accelerometer and the dietary assessment instruments against the BENECA system was very high (intraclass correlation coefficient=.90). We found a mean match rate of 93.51% between instruments and a mean phantom rate of 3.35%. The Passing-Bablok regression analysis did not show considerable bias in fat percentage, portions of fruits and vegetables, or minutes of moderate to vigorous physical activity. CONCLUSIONS The BENECA mHealth app could be a new tool to measure energy balance in breast cancer survivors in a reliable and simple way. Our results support the use of this technology to not only to encourage changes in breast cancer survivors' lifestyles, but also to remotely monitor energy balance. TRIAL REGISTRATION ClinicalTrials.gov NCT02817724; https://clinicaltrials.gov/ct2/show/NCT02817724 (Archived by WebCite at http://www.webcitation.org/6xVY1buCc).
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
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24
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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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25
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Lamort-Bouché M, Sarnin P, Kok G, Rouat S, Péron J, Letrilliart L, Fassier JB. Interventions developed with the Intervention Mapping protocol in the field of cancer: A systematic review. Psychooncology 2018; 27:1138-1149. [PMID: 29247578 DOI: 10.1002/pon.4611] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 07/07/2017] [Revised: 10/27/2017] [Accepted: 12/04/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The Intervention Mapping (IM) protocol provides a structured framework to develop, implement, and evaluate complex interventions. The main objective of this review was to identify and describe the content of the interventions developed in the field of cancer with the IM protocol. Secondary objectives were to assess their fidelity to the IM protocol and to review their theoretical frameworks. METHODS Medline, Web of Science, PsycINFO, PASCAL, FRANCIS, and BDSP databases were searched. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by 2 reviewers blinded to each other. RESULTS Sixteen studies were identified, and these reported 15 interventions. The objectives were to increase cancer screening participation (n = 7), early consultation (n = 1), and aftercare/quality of life among cancer survivors (n = 7). Six reported a complete participatory planning group, and 7 described a complete logic model of the problem. Ten studies described a complete logic model of change. The main theoretical frameworks used were the theory of planned behaviour (n = 8), the transtheoretical model (n = 6), the health belief model (n = 6), and the social cognitive theory (n = 6). The environment was rarely integrated in the interventions (n = 4). Five interventions were reported as effective. CONCLUSIONS Culturally relevant interventions were developed with the IM protocol that were effective to increase cancer screening and reduce social disparities, particularly when they were developed through a participative approach and integrated the environment. Stakeholders' involvement and the role of the environment were heterogeneously integrated in the interventions.
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Affiliation(s)
- Marion Lamort-Bouché
- UMRESTTE UMR T 9405, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Collège Universitaire de Médecine Générale, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Sarnin
- Groupe de Recherche en Psychologie Sociale (GREPS-EA 4163), Univ Lyon, Université Lumière Lyon 2, Lyon, France
| | - Gerjo Kok
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Sabrina Rouat
- Groupe de Recherche en Psychologie Sociale (GREPS-EA 4163), Univ Lyon, Université Lumière Lyon 2, Lyon, France
| | - Julien Péron
- Laboratoire de Biométrie et Biologie Evolutive LBBE-UMR 5558, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Service d'Oncologie Médicale, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Pierre-Bénite, France
| | - Laurent Letrilliart
- Collège Universitaire de Médecine Générale, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Health Services and Performance Research (HESPER-EA 7425), Univ Lyon, Université Claude Bernard Lyon 1, Université Lyon 2, Lyon, France
| | - Jean-Baptiste Fassier
- UMRESTTE UMR T 9405, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Service de Médecine et Santé au Travail, Hospices Civils de Lyon, Lyon, France
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26
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NOBAKHT Z, RASSAFIANI M, HOSSEINI SA. A Web-Based Caring Training for Caregivers of Children with Cerebral Palsy: Development and Evaluation. Iran J Child Neurol 2018; 12:65-84. [PMID: 30279710 PMCID: PMC6160627] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/15/2017] [Accepted: 09/23/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Caregivers of children with cerebral palsy (CP) have to spend a long time to take care of their children. We aimed to develop a user-friendly web-based intervention for training parents of children with CP and evaluate the process of development using modified CeHRes roadmap. MATERIALS & METHODS The study was conducted from September 2016 to September 2017 in Tehran, Iran. We did it in four main steps including determining the needs of users, content development, design, operational development and evaluation. RESULTS The website for caregiver training provided nine general topics and had the possibility that the caregivers could determine their educational priorities. Moreover, the users could share their experiences with other users and could ask questions from an expert. Ten caregivers completed a usability questionnaire after four weeks of use. The average score of 70.5 out of 100 was shown among caregivers. The average score of all statements was above three on a Likert scale between 1 and 5. CONCLUSION The website has the possibilities including registering caregivers of children with CP, the possibility to confirm registration with an SMS and the possibility to determine the caregiver educational priorities. It has the usability for training caregivers of children with CP.
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Affiliation(s)
- Zahra NOBAKHT
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi RASSAFIANI
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | - Seyed Ali HOSSEINI
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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27
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Corbett T, Singh K, Payne L, Bradbury K, Foster C, Watson E, Richardson A, Little P, Yardley L. Understanding acceptability of and engagement with Web-based interventions aiming to improve quality of life in cancer survivors: A synthesis of current research. Psychooncology 2017; 27:22-33. [DOI: 10.1002/pon.4566] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/30/2017] [Accepted: 10/04/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Teresa Corbett
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP); University of Southampton; Southampton UK
| | - Karmpaul Singh
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP); University of Southampton; Southampton UK
| | - Liz Payne
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP); University of Southampton; Southampton UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP); University of Southampton; Southampton UK
| | - Claire Foster
- Faculty of Health Sciences; University of Southampton; Southampton UK
| | - Eila Watson
- Department of Applied Health and Professional Development, Faculty of Health and Life Sciences; Oxford Brookes University; Oxford UK
| | - Alison Richardson
- Faculty of Health Sciences, University Hospital Southampton NHS Foundation Trust; University of Southampton; Southampton UK
| | - Paul Little
- Primary Care and Population Sciences; Aldermoor Health Centre, Aldermoor Close; Southampton UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology (CCCAHP); University of Southampton; Southampton UK
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
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Seiler A, Klaas V, Tröster G, Fagundes CP. eHealth and mHealth interventions in the treatment of fatigued cancer survivors: A systematic review and meta-analysis. Psychooncology 2017; 26:1239-1253. [PMID: 28665554 DOI: 10.1002/pon.4489] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [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: 01/31/2017] [Revised: 05/30/2017] [Accepted: 06/26/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To (1) evaluate existing eHealth/mHealth interventions developed to help manage cancer-related fatigue (CRF); and (2) summarize the best available evidence on their effectiveness. METHODS A comprehensive literature search of PubMed, MEDLINE, EMBASE, and the Cochrane Library up to November 2016 was conducted. Study outcomes were extracted, tabulated, and summarized. Random effects meta-analyses were conducted for the primary outcome (fatigue), and the secondary outcomes quality of life and depression, yielding pooled effect sizes (r), and 95% confidence intervals (CI). RESULTS For eHealth interventions, our search of published papers identified 9 completed studies and 6 protocols for funded projects underway. No studies were identified for mHealth interventions that met our inclusion criteria. A meta-analysis of the 9 completed eHealth studies revealed a statistically significant beneficial effect of eHealth interventions on CRF (r = .27, 95% CI [.1109 - .4218], P < 0.01). Therapist-guided eHealth interventions were more efficacious then self-guided interventions (r = .58, 95% CI: [.3136 - .5985, P < 0.001). Small to moderate therapeutic effects were also observed for HRQoL (r = .17, 95% CI [.0384 - .3085], P < 0.05) and depression (r = .24, 95% CI [.1431 - .3334], P < 0.001). CONCLUSIONS eHealth interventions appear to be effective for managing fatigue in cancer survivors with CRF. Continuous development of eHealth interventions for the treatment of CRF in cancer survivors and their testing in long-term, large-scale efficacy outcome studies is encouraged. The degree to which mHealth interventions can change CRF in cancer survivors need to be assessed systematically and empirically.
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Affiliation(s)
- Annina Seiler
- Department of Psychology, Rice University, Houston, TX, USA
| | - Vanessa Klaas
- Wearable Computing Laboratory, Department of Information Technology and Electrical Engineering, ETH Zurich, Zürich, Switzerland
| | - Gerhard Tröster
- Wearable Computing Laboratory, Department of Information Technology and Electrical Engineering, ETH Zurich, Zürich, Switzerland
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Houston, TX, USA.,Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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29
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Willems RA, Mesters I, Lechner L, Kanera IM, Bolman CAW. Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial. J Cancer Surviv 2017; 11:691-703. [PMID: 28698999 DOI: 10.1007/s11764-017-0625-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 08/01/2016] [Accepted: 06/15/2017] [Indexed: 12/16/2022]
Abstract
Purpose The web-based computer-tailored Kanker Nazorg Wijzer (Cancer Aftercare Guide) supports cancer survivors with psychosocial issues during cancer recovery. The current study investigates whether the 6-month effects in increasing emotional and social functioning and reducing depression and fatigue hold at 12 months from baseline. Moreover, it explores whether patient characteristics moderate the 6- and 12-month intervention effectiveness. Methods Cancer survivors from 21 Dutch hospitals (November 2013–June 2014) were randomized to an intervention (n = 231) or a wait-list control group (n = 231). Intervention effects on emotional and social functioning (EORTC QLQ-C30), depression (HADS), and fatigue (CIS) were evaluated through multilevel linear regression analyses. Results At 12 months from baseline, the intervention group no longer differed from the control group in emotional and social functioning, depression, and fatigue. Moderator analyses indicated that, at 6 months, the intervention was effective in improving social functioning for men (d = 0.34), reducing fatigue for participants ≤56 years (d = 0.44), and reducing depression for participants who received chemotherapy (d = 0.36). At 12 months, participants with a medium educational level reported higher social functioning (d = 0.19), while participants with a low educational level reported lower social functioning (d = 0.22) than participants with a similar educational level in the control group. Conclusions The intervention gave cancer patients a head start to psychological recovery after the end of cancer treatment. The control group caught up in the long run. Implications for cancer survivors The Cancer Aftercare Guide expedited recovery after cancer treatment. Being a low intensity, easy accessible, and relatively low cost intervention, it could serve as a relevant step in recovery and stepped care. Electronic supplementary material The online version of this article (doi:10.1007/s11764-017-0625-0) contains supplementary material, which is available to authorized users.
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30
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Heiniger LE, Smith AB, Olver I, Grimison P, Klein B, Wootten A, Abbott JAM, Price MA, McJannett M, Tran B, Stockler MR, Gurney H, Butow PN. e-TC: Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28544085 DOI: 10.1111/ecc.12698] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 01/27/2023]
Abstract
e-TC is an online intervention designed to address common psychosocial concerns of testicular cancer survivors. It aims to reduce anxiety, depression and fear of cancer recurrence by providing evidence-based information and psychological intervention. This paper details the development and pilot testing of e-TC. During pilot testing, 25 men (with varying psychological profiles) who had completed treatment for testicular cancer, 6 months to 5 years ago (which had not recurred), used e-TC over a 10-week period and provided quantitative and qualitative feedback on the feasibility and acceptability of the programme. Six men also completed a qualitative interview to provide detailed feedback on their experiences using e-TC. Fourteen men (56%) completed at least 80% of the programme. Participants reported a high level of satisfaction with the programme. Men's limited time was a barrier to programme use and completion, and participants suggested that men with a more recent diagnosis and a higher level of distress may be more likely to engage with the programme. e-TC appears to be a feasible and acceptable online intervention for survivors of testicular cancer. Findings from this study are currently being used to refine e-TC and guide the design of a larger efficacy study.
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Affiliation(s)
- L E Heiniger
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - A B Smith
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Oncology Education and Research Translation (CONCERT), The Ingham Institute for Applied Medical Research & University of New South Wales, Liverpool, NSW, Australia
| | - I Olver
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Cancer Council Australia, Sydney, NSW, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - P Grimison
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - B Klein
- Centre for Biopsychosocial and eHealth Research and Innovation, Federation University, Ballarat, Vic., Australia.,National Institute for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - A Wootten
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Epworth Prostate Centre, Epworth, Vic., Australia
| | - J-A M Abbott
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Vic., Australia
| | - M A Price
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - M McJannett
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - B Tran
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - M R Stockler
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Concord Hospital, Concord, NSW, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - H Gurney
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - P N Butow
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Murphy MJ, Newby JM, Butow P, Kirsten L, Allison K, Loughnan S, Price MA, Shaw J, Shepherd H, Smith J, Andrews G. iCanADAPT Early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual. BMC Cancer 2017; 17:193. [PMID: 28298187 PMCID: PMC5353884 DOI: 10.1186/s12885-017-3182-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 01/25/2017] [Accepted: 03/08/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This RCT with two parallel arms will evaluate the efficacy of an internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for the treatment of clinical depression and/or anxiety in early stage cancer survivors. METHODS/DESIGN Early stage cancer survivors will be recruited via the research arm of a not-for-profit clinical research unit and randomised to an intervention (iCBT) group or a 'treatment as usual' (TAU) control group. The minimum sample size for each group is 45 people (assuming effect size > 0.6, power of 80%, and alpha at .05), but 10% more will be recruited to account for attrition. A solitary or cumulative diagnosis(es) of Major Depressive Episode (current), Generalised Anxiety Disorder, Illness Anxiety Disorder, Panic Disorder, Agoraphobia, and/or Adjustment disorder will be determined using modules from the Anxiety Disorders Interview Schedule for DSM-5. Depression and anxiety levels with be measured via the total score of the Hospital Anxiety and Depression scale (HADS-T), the primary outcome measure. Secondary measures will include the Kessler 10 to measure general distress, the Fear of Cancer Recurrence Inventory (FCRI) to measure the specific fear of cancer recurrence and the Functional Assessment of Cancer Therapy, General Version 4 (FACT-G) for self-report of physical, social, emotional and functional well-being. iCBT participants will complete the measures before lessons 1 and 5, at post-treatment and at 3-month follow-up. The TAU group will complete similar measures at weeks 1, 8 and 16 of the waiting period. Program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in depressive and anxious symptoms over time and changes in FCRI and FACT-G QOL in separate analysis. DISCUSSION This is the first RCT looking at iCBT specifically for clinical depression and/or anxiety in a cancer population. Findings will help to direct the role of iCBT in streamlined psycho-social care pathways. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12616000231448, registered 19th February 2016 ( www.anzctr.org.au ). This trial protocol is in compliance with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines.
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Affiliation(s)
- M. J. Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent’s Hospital, Level 4, O’Brien Centre, St Vincent’s Hospital, 394 Victoria Street, Sydney, NSW 2010 Australia
| | - J. M. Newby
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent’s Hospital, Level 4, O’Brien Centre, St Vincent’s Hospital, 394 Victoria Street, Sydney, NSW 2010 Australia
- School of Psychology, Faculty of Science, UNSW Australia, Mathews Building, Kensington, NSW 2052 Australia
| | - P. Butow
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - L. Kirsten
- Nepean Cancer Care Centre, Sydney West Cancer Network, Kingswood, NSW 2747 Australia
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - K. Allison
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - S. Loughnan
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent’s Hospital, Level 4, O’Brien Centre, St Vincent’s Hospital, 394 Victoria Street, Sydney, NSW 2010 Australia
| | - M. A. Price
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - J. Shaw
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - H. Shepherd
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - J. Smith
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006 Australia
| | - G. Andrews
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent’s Hospital, Level 4, O’Brien Centre, St Vincent’s Hospital, 394 Victoria Street, Sydney, NSW 2010 Australia
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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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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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Duijts S, Dalton SO, Lundh MH, Horsboel TA, Johansen C. Cancer survivors and return to work: current knowledge and future research. Psychooncology 2016; 26:715-717. [PMID: 27478074 DOI: 10.1002/pon.4235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Saskia Duijts
- VU University Medical Center, Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands
| | | | - Marie Høyer Lundh
- Metropolitan University College, Department of Nursing, Copenhagen, Denmark.,Uppsala University, Department of Public Health and Caring Sciences, Uppsala, Sweden
| | | | - Christoffer Johansen
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark.,Rigshospitalet, Department of Oncology, Copenhagen, Denmark
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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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Abstract
BACKGROUND The proportion of people living with and surviving cancer is growing. This has led to increased awareness of the importance of quality of life, including sexual function, in those affected by cancer. Sexual dysfunction is a potential long-term complication of many cancer treatments. This includes treatments that have a direct impact on the pelvic area and genitals, and also treatments that have a more generalised (systemic) impact on sexual function.This is an update of the original Cochrane review published in Issue 4, 2007, on interventions for treating sexual dysfunction following treatments for cancer for men and women. Since publication in 2007, there has been an increase in the number of trials for both men and women and this current review critiques only those for women. A review in press will present those for men. OBJECTIVES To evaluate the effectiveness of interventions for treating sexual dysfunction in women following treatments for cancer. To assess adverse events associated with interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 9), MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Dissertation Abstracts and the NHS Research Register. The searches were originally run in January 2007 and we updated these to September 2015. SELECTION CRITERIA We included randomised controlled trials (RCTs) that assessed the effectiveness of a treatment for sexual dysfunction. The trial participants were women who had developed sexual dysfunction as a consequence of a cancer treatment. We sought evaluations of interventions that were pharmaceutical, mechanical, psychotherapeutic, complementary or that involved physical exercise. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data and assessed trial quality. We considered meta-analysis for trials with comparable key characteristics. MAIN RESULTS Since the original version of this review we have identified 11 new studies in women. The one study identified in the earlier version of this review was excluded in this update as it did not meet our narrower inclusion criteria to include only interventions for the treatment, not prevention, of sexual dysfunction.In total 1509 female participants were randomised across 11 trials. All trials explored interventions following treatment either for gynaecological or breast cancer. Eight trials evaluated a psychotherapeutic or psycho-educational intervention. Two trials evaluated a pharmaceutical intervention and one pelvic floor exercises. All involved heterosexual women. Eight studies were at a high risk of bias as they involved a sample of fewer than 50 participants per trial arm. The trials varied not only in intervention content but in outcome measurements, thereby restricting combined analysis. In the trials evaluating a psychotherapeutic intervention the effect on sexual dysfunction was mixed; in three trials benefit was found for some measures of sexual function and in five trials no benefit was found. Evidence from the other three trials, two on different pharmaceutical applications and one on exercise, differed and was limited by small sample sizes. Only the trial of a pH-balanced vaginal gel found significant improvements in sexual function. The trials of pharmaceutical interventions measured harm: neither reported any. Only one psychological intervention trial reported that no harm occurred because of the intervention; the other trials of psychological support did not measure harm. AUTHORS' CONCLUSIONS Since the last version of this review, the new studies do not provide clear information on the impact of interventions for sexual dysfunction following treatments for cancer in women. The sexual dysfunction interventions in this review are not representative of the range that is available for women, or of the wider range of cancers in which treatments are known to increase the risk of sexual problems. Further evaluations are needed.
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Affiliation(s)
- Bridget Candy
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London, UK, W1T 7NF
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