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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.

BackgroundPhysical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients’ preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors.MethodsProstate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (N = 249), or a usual-care waiting-list control group (N = 229). OncoActive participants received a pedometer and computer-tailored PA advice, both Web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days ≥30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined.ResultsThree months after baseline OncoActive participants significantly increased their self-reported PA (PA days: d = 0.46; MVPA: d = 0.23). Physical functioning (d = 0.23) and fatigue (d = − 0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days: d = 0.51; MVPA: d = 0.37) and ActiGraph MVPA (d = 0.27) increased significantly, and ActiGraph days (d = 0.16) increased borderline significantly (p = .05; d = 0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d = 0.14), fatigue (d = − 0.23) and depression (d = − 0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants’ PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women.ConclusionsThe OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects.Trial registrationThe study was registered in the Dutch Trial Register (NTR4296) on October 17 2018.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0734-9) contains supplementary material, which is available to authorized users.

PurposeThe 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.MethodsCancer 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.ResultsAfter 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 SurvivorsAlthough 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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