Background Physical activity can improve health and wellbeing after cancer and may reduce cancer recurrence and mortality. To achieve such long-term benefits cancer survivors must be habitually active. This review evaluates the effectiveness of interventions in supporting maintenance of physical activity behaviour change among adults diagnosed with cancer and explores which intervention components and contextual features are associated with effectiveness. Methods Relevant randomised controlled trials (RCTs) were identified by a search of Ovid Medline, Ovid Embase and PsychINFO. Trials including adults diagnosed with cancer, assessed an intervention targeting physical activity and reported physical activity behaviour at baseline and ≥ 3 months post-intervention were included. The behaviour change technique (BCT) taxonomy was used to identify intervention components and the Template for Intervention Description and Replication to capture contextual features. Random effect meta-analysis explored between and within group differences in physical activity behaviour. Standardised mean differences (SMD) describe effect size. Results Twenty seven RCTs were included, 19 were pooled in meta-analyses. Interventions were effective at changing long-term behaviour; SMD in moderate to vigorous physical activity (MVPA) between groups 0.25; 95% CI = 0.16–0.35. Within-group pre-post intervention analysis yielded a mean increase of 27.48 (95% CI = 11.48-43.49) mins/wk. of MVPA in control groups and 65.30 (95% CI = 45.59–85.01) mins/wk. of MVPA in intervention groups. Ineffective interventions tended to include older populations with existing physical limitations, had fewer contacts with participants, were less likely to include a supervised element or the BCTs of ‘action planning’, ‘graded tasks’ and ‘social support (unspecified)’. Included studies were biased towards inclusion of younger, female, well-educated and white populations who were already engaging in some physical activity. Conclusions Existing interventions are effective in achieving modest increases in physical activity at least 3 months post-intervention completion. Small improvements were also evident in control groups suggesting low-intensity interventions may be sufficient in promoting small changes in behaviour that last beyond intervention completion. However, study samples are not representative of typical cancer populations. Interventions should consider a stepped-care approach, providing more intensive support for older people with physical limitations and others less likely to engage in these interventions. Electronic supplementary material The online version of this article (10.1186/s12966-019-0787-4) contains supplementary material, which is available to authorized users.
BackgroundPhysical inactivity is a growing concern for society and is a risk factor for cardiovascular disease, obesity, and other chronic diseases.ObjectiveThis study aimed to determine the efficacy of the Accupedo-Pro Pedometer mobile phone app intervention, with the goal of increasing daily step counts in young adults.MethodsMobile phone users (n=58) between 17-26 years of age were randomized to one of two conditions (experimental and control). Both groups downloaded an app that recorded their daily step counts. Baseline data were recorded and followed-up at 5 weeks. Both groups were given a daily walking goal of 30 minutes, but the experimental group participants were told the equivalent goal in steps taken, via feedback from the app. The primary outcome was daily step count between baseline and follow-up.ResultsA significant time x group interaction effect was observed for daily step counts (P=.04). Both the experimental (P<.001) and control group (P=.03) demonstrated a significant increase in daily step counts, with the experimental group walking an additional 2000 steps per day.ConclusionsThe results of this study demonstrate that a mobile phone app can significantly increase physical activity in a young adult sample by setting specific goals, using self-monitoring, and feedback.
Objective: This review sought to summarize existing knowledge to inform the development of an online intervention that aims to improve quality of life after cancer treatment.Methods: To inform our intervention, we searched for studies relating to Web-based interventions designed to improve quality of life in adults who have completed primary treatment for breast, prostate, and colorectal cancer (as these are 3 of the most common cancers and impact a large number of cancer survivors). We included a variety of study designs (qualitative research, feasibility/pilot trials, randomized trials, and process evaluations) and extracted all available information regarding intervention characteristics, experiences, and outcomes. Data were synthesized as textual (qualitative) data and analyzed by using thematic analysis.Results: Fifty-seven full text articles were assessed for eligibility, and 16 papers describing 9 interventions were analyzed. Our findings suggest that cancer survivors value interventions that offer content specific to their changing needs and are delivered at the right stage of the cancer trajectory. Social networking features do not always provide added benefit, and behavior change techniques need to be implemented carefully to avoid potential negative consequences for some users. 14,15 ConclusionsReviews of heterogeneous, complex interventions frequently conclude that the evidence is "weak" or "mixed" 12,16 and often fail to address intervention usability and acceptability. 13 It is important to understand how an intervention works in and suits a given con- | METHODSTo inform decision making for intervention development purposes in a timely fashion, we followed rapid review methods [22][23][24][25] to identify studies of interest. We used thematic synthesis for analyzing the data, also drawing on approaches used in ICA. 19 We adhered to the AMSTAR: A Measurement Tool to Assess Reviews criteria 26 (see Appendix A for further details). | SearchInclusion and exclusion criteria are outlined in Inclusion Criteria Exclusion CriteriaParticipants Adults who have completed primary treatment for breast, prostate, and colorectal cancer (or interventions that included a variety of cancer types and focused on quality of life issues considered likely to be shared across all cancers)•Specific target groups that were not generalizable to breast, colorectal, or prostate cancer survivors (during primary treatment; pediatric samples, rare cancers, metastatic cancers, etc).•Studies where the focus was on needs associated with specific cancer types (e.g., a focus on specific needs associated with gynecological/head and neck cancers) •Interventions that took place during primary treatment Interventions Online, e-health, or Web-based interventions designed to improve QoL in adults who have completed primary treatment for cancer•Interventions delivered offline or analyses of online forum groups and interventions delivered solely via social media Web sites (e.g. Facebook)Comparators We did not include "comparison" (C...
For many participants in this study, the period that follows treatment for cancer did not represent a "teachable moment." A variety of complex and heterogeneous factors appeared to impact motivation and may limit cancer survivors from engaging with diet and PA changes.
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