Background: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients. Patients and methods: One hundred and sixty-two patients with a range of cancers were recruited. QOL and fatigue were measured by Functional Assessment of Cancer Therapy—General and Functional Assessment of Cancer Therapy—Fatigue, respectively, and mood status by Profile of Mood State. The inflammatory marker serum C-reactive protein (CRP) was monitored serially. Results: Regression analysis indicated that the MQ group significantly improved overall QOL ( t 144 = −5.761, P < 0.001), fatigue ( t 153 = −5.621, P < 0.001), mood disturbance ( t 122 =2.346, P = 0.021) and inflammation (CRP) ( t 99 = 2.042, P < 0.044) compared with usual care after controlling for baseline variables. Conclusions: This study indicates that MQ can improve cancer patients’ overall QOL and mood status and reduce specific side-effects of treatment. It may also produce physical benefits in the long term through reduced inflammation.

This study evaluated the efficacy of a theory of planned behaviour (TPB) based intervention to increase fruit and vegetable consumption. The extent to which fruit and vegetable consumption and change in intake could be explained by the TPB was also examined.Participants were randomly assigned to two levels of intervention frequency matched for intervention content (low frequency n = 92, high frequency n = 102). Participants received TPB-based email messages designed to increase fruit and vegetable consumption, messages targeted attitude, subjective norm and perceived behavioural control (PBC). Baseline and post-intervention measures of TPB variables and behaviour were collected. Across the entire study cohort, fruit and vegetable consumption increased by 0.83 servings/day between baseline and follow-up. Intention, attitude, subjective norm and PBC also increased (p<.05).The TPB successfully modelled fruit and vegetable consumption at both time points but not behaviour change. The increase of fruit and vegetable consumption is a promising preliminary finding for those primarily interested in increasing fruit and vegetable consumption. However, those interested in theory development may have concerns about the use of this model to explain behaviour change in this context. More high quality experimental tests of the theory are needed to confirm this result.Keywords: theory of planned behaviour; fruit and vegetable consumption; behaviour change Like attitude and subjective norm, PBC is thought to influence behaviour through its influence on intention. It is also thought to have a direct influence on behaviour over and above its influence on intention. The extent to which PBC has a direct influence on behaviour is often thought to reflect an individual's actual behavioural control over the target behaviour (Fishbein & Ajzen, 2010). Given the difficulty in directly assessing actual behaviour control for most health related behaviours, PBC is used as a proxy for actual behaviour control the majority of TPB based studies (Armitage & Conner, 2001;Fishbein & Ajzen, 2010;Godin & Kok, 1996).A large number of studies provide support for the utility of the model in the prediction of behaviour (Armitage & Conner, 2001;Godin & Kok, 1996). In the context of fruit and vegetable intake, the model has been reported to account for an average of 41% of the variance in intention and 45% of the variance in behaviour (Guillaumie, Godin, & Vézina-Im, 2010). In their meta-analytic review of psychosocial predictors of fruit and vegetable intake, Guillaumie, Godin, and Vézina-Im argued that the TPB is the most strongly supported model of intention and behaviour (Guillaumie, et al., 2010), and therefore there is sound justification for the use of the model in interventions designed to increase intake of fruit and vegetables (Guillaumie, et al., 2010). TPB and behaviour changeAlthough the predictive utility of the TPB model has been well established, there are relatively few studies which manipulate the cognitions specified in the mod...

Rationale: Seasonal influenza vaccination rates are below the recommended targets, contributing to significant preventable harms. Protection Motivation Theory (PMT), a widely applied model of motivation to respond to threats, may provide some insights into strategies to increase the rate of vaccine uptake. However, previous research has omitted some of the proposed predictors of intention when applying this model to vaccination. Objective: The aim of the study is to assess the utility of the PMT in predicting intention to obtain the seasonal influenza vaccine. This study will be the first to examine the role of all six PMT constructs in predicting intention to receive the seasonal influenza vaccine. Method: A cross-sectional study of 547 US residents was conducted using Amazon MTurk. Results: All constructs show significant bivariate correlations in the direction expected from the prior literature. However, examination of the theory within a linear regression model found that perceived costs of vaccinating (response costs) did not uniquely account for variance in intention. All other components, perceived severity of and susceptibility to influenza, the perceived benefits of not vaccinating (maladaptive response rewards), the self-efficacy to vaccinate, and the perceived efficacy of vaccinating in preventing influenza (response efficacy) were unique predictors of intention. Overall, the PMT accounted for 62% of the variance in intention to vaccinate. Conclusions: The study is the first to investigate influenza vaccination using all six theorised predictors of intention from the PMT. The findings highlight the importance of the simultaneous inclusion of all components of the model in assessing their potential utility as targets for intervention. Importantly, the results identify under-utilised constructs in the promotion of vaccine uptake, such as maladaptive response rewards, which should be considered targets for future intervention.

Background. The Institute of Medicine recommends that survivorship care plans (SCPs) be included in cancer survivorship care. Our meta-analysis compares patient-reported outcomes between SCP and no SCP (control) conditions for cancer survivors. Our systematic review examines the feasibility of implementing SCPs from survivors' and health care professionals' perspectives and the impact of SCPs on health care professionals' knowledge and survivorship care provision. Methods. We searched seven online databases (inception to April 22, 2018) for articles assessing SCP feasibility and health care professional outcomes. Randomized controlled trials comparing patient-reported outcomes for SCP recipients versus controls were eligible for the meta-analysis. We performed random-effects meta-analyses using pooled standardized mean differences for each patient-reported outcome.Results. Eight articles were eligible for the meta-analysis (n = 1,286 survivors) and 50 for the systematic review (n = 18,949 survivors; n = 3,739 health care professionals). There were no significant differences between SCP recipients and controls at 6 months postintervention on selfreported cancer and survivorship knowledge, physical functioning, satisfaction with information provision, or selfefficacy or at 12 months on anxiety, cancer-specific distress, depression, or satisfaction with follow-up care. SCPs appear to be acceptable and potentially improve survivors' adherence to medical recommendations and health care professionals' knowledge of survivorship care and late effects. Conclusion. SCPs appear feasible but do not improve survivors' patient-reported outcomes. Research should ascertain whether this is due to SCP ineffectiveness, implementation issues, or inappropriate research design of comparative effectiveness studies. The Oncologist 2020;25:e351-e372 Implications for Practice: Several organizations recommend that cancer survivors receive a survivorship care plan (SCP) after their cancer treatment; however, the impact of SCPs on cancer survivors and health care professionals is unclear. This systematic review suggests that although SCPs appear to be feasible and may improve health care professionals' knowledge of late effects and survivorship care, there is no evidence that SCPs affect cancer survivors' patient-reported outcomes. In order to justify the ongoing implementation of SCPs, additional research should evaluate SCP implementation and the research design of comparative effectiveness studies. Discussion may also be needed regarding the possibility that SCPs are fundamentally ineffective.