scholarly journals Effectiveness of a Mobile Health Behavior Change Intervention for Cancer Survivors with Overweight/Obesity: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Jane C Walsh ◽  
Janice Richmond ◽  
Jenny McSharry ◽  
AnnMarie Groarke ◽  
Liam Glynn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Cancer Survivors ◽  
Goal Setting ◽  
Intervention Group ◽  
Health Behavior Change ◽  
Behavior Change Intervention ◽  
Intervention Condition

BACKGROUND Cancer survivorship in Ireland is increasing in both frequency and longevity. However, a significant proportion of cancer survivors do not reach recommended physical activity levels and have overweight. This has health implications both physical and psychological, including increased risk of subsequent and secondary cancers. Mobile health (mHealth) interventions demonstrate potential for positive health behavior change, but there is little evidence for the efficacy of mobile technology to improve health outcomes in cancer survivors with overweight/obesity. OBJECTIVE This study sought to investigate whether a personalized mHealth behavior change intervention improved physical and psychological health outcomes in cancer survivors with overweight/obesity. METHODS A sample of 123 cancer survivors (body mass index ≥25 kg/m2) was randomly assigned to the standard care control (n=61) or intervention (n=62) condition. Group allocation was unblinded. The intervention group attended a 4-hour tailored lifestyle information and education session with physiotherapists, a dietician, and clinical psychologist to support self-management of health behavior. Over the following 12 weeks, participants engaged in personalized goal-setting to incrementally increase physical activity (with feedback and review of goals through short message service text messaging contact with the research team). Objective measures of physical activity were collected using a Fitbit accelerometer. Data on anthropometric, functional exercise capacity, dietary behavior, and psychological measures were collected at face-to-face assessments in a single hospital site at baseline (T0), 12 weeks (T1; intervention end), and 24 weeks (T2; follow-up). RESULTS Rates of attrition were 21% for the control condition and 14% for the intervention condition. Using intent-to-treat analysis significant reductions in body mass index (BMI) (F(2,242) = 4.149, p = .017, ηp2= .033) and waist circumference (F(2,242) = 3.342, p = .037, np2 = .027) were seen in the intervention group. Over the 24-week study BMI was reduced by 0.52 in the intervention condition, relative to a non-significant reduction of 0.11 in the control arm. Waist circumference reduced by 3.02cm in the intervention relative to 1.82cm in the control condition. High levels of attainment for step count goals were observed with significantly higher levels of physical activity recorded for participants in the intervention group post-intervention (t(105) =2.60, p=.011) and at follow-up (t(105) =2.43, p=.017), accounting for up to 1999 additional steps per day. CONCLUSIONS The results demonstrate that for cancer survivors with a BMI ≥ 25 lifestyle education and personalized goal-setting using mobile technology can yield significant change on clinically relevant health indicators. Further research is needed to elucidate to mechanisms for behavior change and explore the capacity for mHealth interventions to improve broader health and wellbeing outcomes in the growing population of cancer survivors. CLINICALTRIAL ISRCTN-18676721 https://doi.org/10.1186/ISRCTN18676721 INTERNATIONAL REGISTERED REPORT RR2-10.2196/13214

scholarly journals Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors

2016 ◽  
Vol 12 (3) ◽  
pp. 184-199 ◽  
Author(s):  
Steve Amireault ◽  
Angela J. Fong ◽  
Catherine M. Sabiston
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Cancer Survivors ◽  
Healthy Eating ◽  
Health Behavior Change ◽  
Cochrane Library ◽  
Multiple Health Behavior Change ◽  
The Impact ◽  
Multiple Health

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.

scholarly journals Effects of a Telephone-Delivered Multiple Health Behavior Change Intervention (CanChange) on Health and Behavioral Outcomes in Survivors of Colorectal Cancer: A Randomized Controlled Trial

2013 ◽  
Vol 31 (18) ◽  
pp. 2313-2321 ◽  
Author(s):  
Anna L. Hawkes ◽  
Suzanne K. Chambers ◽  
Kenneth I. Pakenham ◽  
Tania A. Patrao ◽  
Peter D. Baade ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Body Mass Index ◽  
Health Behavior ◽  
Behavior Change ◽  
Cancer Survivors ◽  
Body Mass ◽  
Dietary Habits ◽  
Health Behavior Change ◽  
Colorectal Cancer Survivors

Purpose Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. Methods In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form–36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m2], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. Results At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (−0.9 kg/m2; P = .001), energy from total fat (−7.0%; P = .006), and energy from saturated fat (−2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. Conclusion The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.

scholarly journals Therapeutic Alliance Between Dietitians and Patients With Head and Neck Cancer: The Effect of Training in a Health Behavior Change Intervention

2018 ◽  
Vol 53 (8) ◽  
pp. 756-768
Author(s):  
Rebecca Murray ◽  
Amanda Baker ◽  
Sean Halpin ◽  
Ben Britton ◽  
Kristen McCarter ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Health Behavior ◽  
Behavior Change ◽  
Therapeutic Alliance ◽  
Motivational Interviewing ◽  
Head And Neck ◽  
Neck Cancer ◽  
Health Behavior Change ◽  
Behavior Change Intervention ◽  
Interviewing Techniques

Abstract Background The relationship between a clinician and their client—the “therapeutic alliance” is a robust predictor of outcome in healthcare settings; yet, few interventions to improve alliance have been tested. Motivational interviewing is a client-centered approach that embodies many principles and strategies consistent with a strong therapeutic alliance. Purpose To examine whether alliance is enhanced by training dietitians to deliver a motivational interviewing informed health behavior change intervention (“Eating as Treatment”; EAT) as part of routine consultations with patients with head and neck cancer. The predictive ability of motivational interviewing techniques was also assessed. Methods A secondary analysis of the EAT stepped-wedge cluster-randomized controlled trial was conducted. Patients with head and neck cancer undergoing radiotherapy (n = 307) were treated by radiotherapy dietitians (n = 29) during the control (Treatment as Usual) or intervention (EAT) phase. Alliance was rated during the first and final weeks of radiotherapy, and again 4 and 12 weeks post-radiotherapy. Dietetic sessions were audiotaped. Week one sessions were objectively rated for dietitians’ use of motivational interviewing techniques. Results Generalized linear-mixed effects regressions found no effect of EAT on dietitian-rated alliance (p = .237). After excluding outliers, patient-rated alliance was 0.29 points lower after EAT training (p = .016). Post hoc analyses revealed lower patient ratings on perceived support and dietitian confidence. Hierarchical multiple regressions found that no specific motivational interviewing techniques predicted patient-rated alliance. Dietitian acknowledgment of patient challenges was related to dietitian-rated alliance (β =.15, p =.035). Conclusions Patient and dietitian ratings of alliance were high after EAT training, but not significantly improved. Further research is needed to better understand the differential impact of intervention training and delivery on patient and clinician ratings of therapeutic alliance. Clinical Trial information Trial registration number ACTRN12613000320752

scholarly journals Goal Setting and Action Planning for Health Behavior Change

2017 ◽  
Vol 13 (6) ◽  
pp. 615-618 ◽  
Author(s):  
Ryan R. Bailey
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Goal Setting ◽  
Action Planning ◽  
Health Behavior Change ◽  
Actual Behavior ◽  
Mastery Goals ◽  
Avoidance Goals ◽  
Goal Characteristics ◽  
Selection Of

Health behavior change is challenging for most individuals, but there are many strategies that individuals can use to facilitate their behavior change efforts. Goal setting is one such strategy that assists individuals to identify specific behaviors to change and how to go about doing so. For many, however, simply setting a goal seldom leads to actual behavior change. For some, identifying an appropriate goal is difficult, while for others, putting goals into action is the roadblock. Two strategies may be of assistance for setting and achieving goals. First, consideration of key goal characteristics (eg, approach vs avoidance goals, performance vs mastery goals, level of difficulty) may result in selection of more appropriate and feasible goals. Second, action planning can help individuals put goals into action. Clinicians can help patients utilize these strategies to set and achieve goals for health behavior change.

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