A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors

Abstract

PurposeLittle is known about how to improve and create sustainable lifestyle behaviors of cancer survivors. Interventions based on social cognitive theory (SCT) have shown promise. This review examined the effect of SCT-based physical activity and nutrition interventions that target cancer survivors and identified factors associated with their efficacy.MethodsA systematic search of seven databases identified randomized controlled trials that (i) targeted adult cancer survivors (any point from diagnosis); (ii) reported a primary outcome of physical activity, diet, or weight management; and (iii) included an SCT-based intervention targeting physical activity or diet. Qualitative synthesis and meta-analysis were conducted. Theoretical constructs and intervention characteristics were examined to identify factors associated with intervention efficacy.ResultsEighteen studies (reported in 33 publications) met review inclusion criteria. Meta-analysis (n = 12) revealed a significant intervention effect for physical activity (standardized mean difference (SMD) = 0.33; P < 0.01). Most studies (six out of eight) that targeted dietary change reported significant improvements in at least one aspect of diet quality. No SCT constructs were associated with intervention effects. There were no consistent trends relating to intervention delivery method or whether the intervention targeted single or multiple behaviors.ConclusionsSCT-based interventions demonstrate promise in improving physical activity and diet behavior in cancer survivors, using a range of intervention delivery modes. Further work is required to understand how and why these interventions offer promise for improving behavior.Implications for Cancer SurvivorsSCT-based interventions targeting diet or physical activity are safe and result in meaningful changes to diet and physical activity behavior that can result in health improvements.

Benefits and Barriers of Cancer Practitioners Discussing Physical Activity with their Cancer Patients

“…This may be achieved by hospitals developing improved PA resources and/or referral pathways to cancer-specific PA programs that are more accessible to patients. Collectively, these approaches may improve PA promotion by health professionals and result in improved outcomes for patients [14,19]. Cancer patients live with many sideeffects from treatments and disease Physical activity can alleviate many treatment and disease related side-effects…”

“…In light of research demonstrating the benefits of PA for cancer patients, it is clear that health professionals have a duty of care to more regularly discuss PA during their consultations. There is now considerable research that has examined the determinants of cancer patients' PA levels in an attempt to investigate possible ways to increase their PA [9,19,13,14]. Surprisingly, very little of this research has focused on the role of the health professional in supporting the PA behaviour of the patients [18,15].…”

“…Regardless of whose primary responsibility this is, a shared plan needs to be developed between the patient and relevant health professionals in regards to the primary and secondary goals of the PA program as well as developing strategies to overcome some of the barriers to regular PA participation. [19,20].…”

Effects of a self-managed home-based walking intervention on psychosocial health outcomes for breast cancer patients receiving chemotherapy: a randomised controlled trial

“…Patients were provided with an intervention booklet including (see 137 appendix) guidance and recommendations to ensure adherence to the intervention, tips and 138 encouragement outlining the benefits of walking, and a diary to keep a log of walking duration and 139 intensity. A number of physical activity interventions for cancer patients and cancer survivors have 140 been developed and evaluated using tenets of the (TPB) and have found that those receiving the TPB-141 based interventions generally reported positive changes in their attitude toward, and participation in 142 physical activity [30,31].Therefore, this theory was used to design the self-management strategies in 143 the home-based walking intervention booklet. A number of behavioural change techniques [32] based 144 on the theory were incorporated as part of the intervention to help cancer patients plan their physical 145 activity, set goals, self-monitor their progress and transform their intentions into actions [33].…”

“…However, these have been 94 directed by researchers or nursing staff. Therefore, building on the need for more self-managed 95 interventions, this study investigates the effectiveness of a 12 week self-managed, home-based 96 walking intervention designed upon principles of The Theory of Planned Behaviour [30,31]. The 97 randomised controlled trial investigates the impact of walking on the psychosocial well-being of 98 breast cancer patients receiving chemotherapy.…”