Creating a teachable moment in community pharmacy for men with prostate cancer: A qualitative study of lifestyle changes

Abstract

Objective It is well established that exercise and lifestyle behaviours improve men's health outcomes from prostate cancer. With 3.8 million men living with the disease worldwide, the challenge is creating accessible intervention approaches that lead to sustainable lifestyle changes. We carried out a phase II feasibility study of a lifestyle intervention delivered by nine community pharmacies in the United Kingdom to inform a larger efficacy study. Qualitative interviews explored how men experienced the intervention, and these data are presented here. Methods Community pharmacies delivered a multicomponent lifestyle intervention to 116 men with prostate cancer. The intervention included a health, strength, and fitness assessment, immediate feedback, lifestyle prescription with telephone support, and reassessment 12 weeks later. Three months after receiving the intervention, 33 participants took part in semistructured telephone interviews. Results Our framework analysis identified how a teachable moment can be created by a community pharmacy intervention. There was evidence of this when men's self‐perception was challenged and coupled to a positive interaction with a pharmacist. Our findings highlight the social context of behaviour change with men identifying how their lifestyle choices were negotiated within their household. There was a ripple effect as lifestyle behaviours made a positive impact on friends and family. Conclusions The teachable moment is not a serendipitous opportunity but can be created by an intervention. Our study adds insight into how community pharmacists can support cancer survivors to make positive lifestyle behaviour changes and suggests a role for doing rather than just telling.

Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review

“…Men with prostate cancer in these studies also sometimes reported that they required help from others to be motivated, that ongoing social support in planning and engaging with PA is a facilitator, that they needed physical concerns to be addressed during PA engagement, that their PA programme needed to be individualised, and that they valued objective feedback as a motivator . These are all areas that, according to the reviewed studies, can come under the remit of the exercise physiotherapist/specialist.…”

“…Many of the included qualitative studies were of good quality, fulfilling most JBI appraisal criteria, bar that which is commonly not reported (eg, statements locating the researchers culturally/theoretically) (see Appendix S1). Methodological issues amongst the other studies and issues relating to congruity of research question, methods, and interpretation were not representing participants voices adequately, Some appraisal criteria were unfulfilled by default because of an apparent lack of detail in reporting, a common occurrence being reports not addressing the influence of the researcher on the research (and vice versa) .…”

“…Men with prostate cancer in these studies also sometimes reported that they required help from others to be motivated, 49,56 that ongoing social support in planning and engaging with PA is a facilitator, 50,55 that they needed physical concerns to be addressed during PA engagement, 49,50,52 that their PA programme needed to be individualised, 19 and that they valued objective feedback as a motivator. [48][49][50]55,56 These are all areas that, according to the reviewed studies, can come under the remit of the exercise physiotherapist/specialist. Given that the data reviewed here suggest that different professionals in the patient's care team may be particularly well situated to address certain aspects of the patient's social cognition, co-ordination of the care team in this regard appears to be sensible to maximise facilitation of exercise.…”

“…Methodological issues amongst the other studies and issues relating to congruity of research question, methods, and interpretation 50,51,54,61 were not representing participants voices adequately, 19,57 Some appraisal criteria were unfulfilled by default because of an apparent lack of detail in reporting, a common occurrence being reports not addressing the influence of the researcher on the research (and vice versa). 48,50,[52][53][54]56 The consistent application of COREQ criteria 72 for qualitative reporting may benefit this area of study.…”

Exercise Counselling To Promote Exercise Behaviour Change In Individuals With Prostate Cancer

“…13,[30][31][32]35,36 However, research shows that individuals with prostate cancer have a high willingness to be active and that a window of opportunity for behaviour change or "teachable moment" may exist. 28,[37][38][39][40] Considering that the majority of individuals with prostate cancer do not currently achieve the recommended weekly exercise levels, new efficacious approaches supporting exercise adoption and adherence are needed.…”