Improving health-related quality of life in women with breast, blood, and gynaecological Cancer with an eHealth-enabled 12-week lifestyle intervention: the women’s wellness after Cancer program randomised controlled trial

Abstract

Background The residual effects of cancer and its treatment can profoundly affect women’s quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women’s Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment. Methods Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t0), 12 weeks (post-intervention, t1) and 24 weeks (to assess sustained behaviour change, t2). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36). Results Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less. Conclusions The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change. Trial registration The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 (ACTRN12614000800628).

Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…A total of 80% (24/30) of the studies [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49] involving 4822 participants used various scales to report the outcome of QOL. Of these 24 studies, 8 (33%) [19,26,27,37,39,40,42,43] focused on patients with breast cancer, and the other 16 (67%) included patients with multiple types of cancer (such as breast cancer, brain cancer, and prostate cancer).…”

“…Owing to the significant heterogeneity among the studies (P<.001; I 2 =77%), the results were pooled using a random-effects model. Overall, the mHealth app interventions significantly improved cancer-related QOL scores (SMD=0.39, 95% CI 0.27-0.51; P<.001; Figure 3 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). We conducted subgroup analyses according to intervention duration, type of cancer, intervention theory, treatment strategy, and intervention delivery format to investigate potential sources of heterogeneity.…”

“…We conducted subgroup analyses according to intervention duration, type of cancer, intervention theory, treatment strategy, and intervention delivery format to investigate potential sources of heterogeneity. Pooled results for the short-term (≤3 months) follow-up period suggested that mHealth app medical interventions were effective in improving QOL (SMD <3 months =0.41, 95% CI 0.26-0.57; P=.001; SMD 3 to 12 months =0.36, 95% CI 0.14-0.57; P=.001; Table 2 and Multimedia Appendix 3 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). When studies were grouped by type of cancer, the results showed that mHealth app interventions may improve cancer-related QOL scores across cancer types (SMD Breast cancer =0.42, 95% CI 0.21-0.63; P<.001; SMD Various cancers =0.38, 95% CI 0.23-0.53; P=.001; Table 2 and Multimedia Appendix 4 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42]…”

“…When studies were grouped by type of cancer, the results showed that mHealth app interventions may improve cancer-related QOL scores across cancer types (SMD Breast cancer =0.42, 95% CI 0.21-0.63; P<.001; SMD Various cancers =0.38, 95% CI 0.23-0.53; P=.001; Table 2 and Multimedia Appendix 4 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). Subgroup analyses of different intervention theories revealed low heterogeneity for cognitive behavioral theory (35%) and mindfulness-based theory (0%), implying that different intervention theories may be an important source of heterogeneity (Table 2 and Multimedia Appendix 5 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44]…”

“…Subgroup analyses of different intervention theories revealed low heterogeneity for cognitive behavioral theory (35%) and mindfulness-based theory (0%), implying that different intervention theories may be an important source of heterogeneity (Table 2 and Multimedia Appendix 5 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49]). Studies grouped by intervention delivery format revealed that these interventions significantly improved cancer-related QOL scores across different intervention delivery formats (SMD Interactive format =0.36, 95% CI 0.22-0.50; P<.001; SMD Didactic format =0.48, 95% CI 0.22-0.73; P<.001; Table 2 and Multimedia Appendix 6 [16,19,[25][26][27][28][29][30][33][34][35][37][38][39][40][41][42][43][44]…”