Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial

Abstract

BackgroundThe number of cancer survivors is growing. Negative physical and psychosocial consequences of cancer treatment can occur during survivorship. Following healthy lifestyle recommendations is beneficial to increase quality of life and to reduce the risk of cancer recurrence and comorbidities. To meet individual needs, web-based interventions can supply a large population of cancer survivors with easily accessible and personalized information. Evidence concerning the long-term effects of web-based cancer aftercare interventions on lifestyle outcomes is limited. The present study evaluates the 12-month effects of a fully automated web-based cancer aftercare intervention. We investigated whether the previously determined 6-month effects on moderate physical activity and vegetable intake were maintained over 12 months. Possible moderator effects of using specific intervention modules, gender, age, and education were also explored.MethodA two-armed randomized controlled trial was conducted using online self-report questionnaires among survivors of various types of cancer (N = 462). The intervention group had access to the online intervention for 6 months, and the control group received access after 12-months. Multilevel linear regression analyses (complete cases and intention-to-treat) were conducted to explore 12- month effects.ResultsA significant intervention effect after 12 months was found for moderate physical activity (complete cases: B = 128.475, p = .010, d = .35; intention-to-treat: B = 129.473, p = .011). Age was the only significant moderator (p = .010), with the intervention being effective among participants aged younger than 57 years (B = 256.549, p = .000, d = .59). No significant intervention effect remained for vegetable consumption after 12 months (complete cases: B = 5.860, p = .121; intention–to-treat: B = 5.560, p = .132).ConclusionThe online cancer after care intervention is effective in increasing and maintaining moderate physical activity in the long term among early cancer survivors younger than 57 years. Short-term increases in vegetable consumption were not sustained in the long term. These findings indicate the value and potential of eHealth interventions for cancer survivors. Based on the study results, web-based self-management interventions could be recommended for younger cancer survivors (<57 years of age) as a possible method to increase physical activity.Trial registrationDutch Trial Register NTR3375. Registered 29 March 2012.

A Lifestyle Intervention via Email in Minority Breast Cancer Survivors: Randomized Parallel-Group Feasibility Study (Preprint)

“…Additionally, similar results were not observed in our intent-to-treat analysis. To our knowledge, only three Web-based intervention studies among cancer survivors have intervened on dietary intake [24,29,32], with two showing improvements [29,33]. It could be that 3-months was not sufficient to produce changes in dietary intake in our sample.…”

“…It could be that 3-months was not sufficient to produce changes in dietary intake in our sample. Recently Kanera et al [33] demonstrated an improvement in dietary intake at 12-months, an diet effect was not significant at the 6-month assessment [32]. More research is needed to determine what frequency and regularity of Web visits needed to produce changes in dietary behaviors.…”

“…Web-based approaches offer a potential to overcome both provider and participant (cost, time, and distance) barriers [21]. More recently, there has been an increase in advocacy for Web-based interventions among cancer survivors [22,23], as well as interventions designed for cancer survivors [24][25][26][27][28][29][30][31], with several demonstrating improvements in lifestyle behaviors [28,29,[31][32][33][34].…”

Effect of Promotional Initiatives on Visits to a Dedicated Website for Physical Activity and Non-Communicable Disease in Luxembourg: An Event Study

“…Promising results are observed also for patients with NCDs. Indeed, Internet-based interventions are effective at increasing physical activity in patients with cardiovascular disease or cancer (especially the youngest patients) (18, 19). In addition to research in e-health interventions, several websites, including practical and theoretical information regarding the primary, secondary, and tertiary prevention of NCDs, have been developed in different European countries: in Sweden, in France, in Wales, in Germany, in Switzerland, and in the UK.…”

Application of Elaborated Intrusion Theory to the Measurement and Enhancement of Motivation in Type 2 Diabetes

“…In some instances, the addition of web-based treatment to usual care enhances clinical outcomes (Polzien, 2006). There is evidence for both short-term and long-term behaviour change following implementation of web supports that include health behaviour reminders (Naughton et al, 2014), health education (Kanera et al, 2017), and tailored decision-making (Friederichs et al, 2015). Greatest effects are observed when these elements are combined .…”