Increasing physical activity levels following treatment for cervical cancer: an intervention mapping approach

Abstract

Purpose The purpose of this study was to utilise the intervention mapping (IM) protocol as a framework with which to develop an intervention underpinned by relevant behaviour change theory to promote physical activity (PA) following treatment for cervical cancer. Methods The six steps of the IM protocol were followed. A qualitative semi-structured interview study and a rapid review of the literature were conducted along with the development of a logic model of the problem and a logic model of change to inform intervention development. Results An intervention was developed which aims to increase PA levels following treatment for cervical cancer, tailored to address key findings from the IM needs assessment. These include embedding behavioural and social strategies that help participants to overcome perceived barriers to PA participation; goal setting strategies to gradually increase PA levels with a view of reaching relevant PA guidelines for cancer survivors and feedback to encourage self-assessment of well-being and PA capability. Conclusion This study maps the development of a novel PA intervention for those who have been treated for cervical cancer. The use of a systematic development framework was necessary as little insight exists regarding PA preferences after treatment for cervical cancer. Implications for Cancer Survivors PA behaviour is associated with positive physical and psychological health outcomes for cancer survivors. Optimising targeted promotion of PA behaviour following treatment for cervical cancer may result in an enhanced survivorship experience through increased PA behaviour and improved quality of life (QOL).

Cervical Cancer Prevention and Treatment Needs among Hispanic Women Living on the US-Mexico Border

“…Many interviewees brought up the long-term effects of different treatment modalities on physical and mental health and overall quality of life (QoL), including struggling with pain and menopausal symptoms. These results line up with a substantial literature demonstrating the adverse consequences of some of the most common treatments for cervical cancer, suggesting that many times medical professionals and cervical cancer patients may make treatment decisions based on short-term chances of success rather than considering long-term QoL outcomes (Hossain et al, 2015; Khalil et al, 2015; Lau et al, 2013; Millet, Moss, et al, 2022; Pfaendler et al, 2015). Despite being a mainstay in cervical cancer treatment, radiotherapy in particular poses the greatest risk of long-term bladder, bowel, sexual, menopausal, and psychosocial dysfunction; surgery and chemotherapy have mixed associations with high incidence of complications (Carter et al, 2013; Khalil et al, 2015; Mirabeau-Beale & Viswanathan, 2014; Mujahadatuljannah, 2019; Osann et al, 2014; Pfaendler et al, 2015).…”

“…Some of the women experienced a lack of support and interpersonal conflict with their spouses specifically that complicated their marriage relationship and their ability to deal with their cancer. Vermeer et al (2016), Shinan-Altman et al (2022), Millet, Moss, et al (2022) and Levkovich et al (2022) indicate that although many survivors of cervical cancer want their spouse to be both emotionally supportive and involved in their care, many patients and their partners experience psychosexual healthcare needs for information and care that often go unmet as well as communication difficulties and emotional issues such as distancing from one’s spouse, guilt, grief, and loneliness. They suggest that psychosexual support should go beyond physical sexual functioning and instrumental care and should consider couple-oriented education and interventions that help partners provide extra resources, sexual distress, relationship satisfaction, and partner perspective/posttraumatic symptoms in addition to simply providing practical information about sexuality after cervical cancer in a culturally competent manner.…”

“…Despite the challenges these women faced and the obstacles they had to overcome during and long after their treatment, they also demonstrated an incredible resilience and a concept that has been defined as post-traumatic growth (Millet, Moss, et al, 2022; Zhou et al, 2021). Research has characterized posttraumatic growth in survivors of gynecological cancers as a renewed appreciation for life, personal strength and empowerment, transformative cognitive shift, and spiritual change (Levkovich et al, 2022; Millet, Moss, et al, 2022). For example, spiritual well-being and keeping faith in God were found to be an important aspect of self-care for the women who participated in this study.…”

ACCEPTANCE: protocol for a feasibility study of a multicomponent physical activity intervention following treatment for cervical cancer

“…Hence, the aerobic PA recommendations were deemed an appropriate target for women treated for cervical cancer. 29 Additionally, the criterion to include women who are at least 6 months post treatment was also a decision informed by the need’s assessment, with the time between 3 and 9 months post treatment being identified as critical for intervention and for positive change. 49 A limitation is that the protocol does not incorporate strength training, and therefore does not reflect the current PA guidelines for after cancer.…”

“…Insights and feedback gathered from one to one and group discussions with PPI members enabled development of the research question, assessment of the potential burden on participants and informed the intervention content to ensure that intervention materials were user friendly ( table 1 ). 29 Continuation of PPI involvement will inform the intervention delivery and dissemination of results to the wider community as appropriate.…”