Perceived barriers and facilitators to health behaviors in European childhood cancer survivors: A qualitative <scp>PanCareFollowUp</scp> study

Bouwman, Eline; Pluijm, Saskia M F; Stollman, Iridi; Araujo‐Soares, Vera; Blijlevens, Nicole M A; Follin, Cecilia; Winther, Jeanette Falck; Hjorth, Lars; Kepák, Tomáš; Kepakova, Katerina; Kremer, Leontien C. M.; Muraca, Monica; Pal, Helena van der; Schneider, Carina; Uyttebroeck, Anne; Vercruysse, Gertrui; Skinner, Roderick; Brown, Morven C.; Hermens, Rosella; Loonen, Jacqueline J.

doi:10.1002/cam4.5911

Cited by 6 publications

(3 citation statements)

References 36 publications

(103 reference statements)

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“…Twelve barriers and 19 facilitators associated with health behavior in general were identified in the included studies. Barriers identified in at least two studies were unmet information needs ( n = 2 29 , 30 ) and time constraints ( n = 2 29 , 30 ). Lifestyle advice and information ( n = 3 28 , 29 , 30 ) and having a health promotion conversation with a healthcare professional ( n = 2 28 , 30 ) were identified as facilitators in at least two studies.…”

Section: Resultsmentioning

confidence: 99%

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Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

de Beijer,

Bouwman,

Mulder

et al. 2024

Cancer Medicine

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BackgroundHealthy behaviors are paramount in preventing long‐term adverse health outcomes in childhood, adolescent, and young adult (CAYA) cancer survivors. We systematically reviewed and synthesized existing literature on barriers, facilitators, and other factors associated with health behaviors in this population.MethodsMEDLINE and PsycInfo were searched for qualitative and quantitative studies including survivors aged 16–50 years at study, a cancer diagnosis ≤25 years and ≥2 years post diagnosis. Health behaviors included physical activity, smoking, diet, alcohol consumption, sun exposure, and a combination of these behaviors (defined as health behaviors in general).ResultsBarriers, facilitators, and other factors reported in ≥2 two studies were considered relevant. Out of 4529 studies, 27 were included (n = 31,905 participants). Physical activity was the most frequently examined behavior (n = 12 studies), followed by smoking (n = 7), diet (n = 7), alcohol (n = 4), sun exposure (n = 4), and health behavior in general (n = 4). Relevant barriers to physical activity were fatigue, lack of motivation, time constraints, and current smoking. Relevant facilitators were perceived health benefits and motivation. Influence of the social environment and poor mental health were associated with more smoking, while increased energy was associated with less smoking. No relevant barriers and facilitators were identified for diet, alcohol consumption, and sun exposure. Barriers to healthy behavior in general were unmet information needs and time constraints whereas lifestyle advice, information, and discussions with a healthcare professional facilitated healthy behavior in general. Concerning other factors, women were more likely to be physically inactive, but less likely to drink alcohol and more likely to comply with sun protection recommendations than men. Higher education was associated with more physical activity, and lower education with more smoking.ConclusionThis knowledge can be used as a starting point to develop health behavior interventions, inform lifestyle coaches, and increase awareness among healthcare providers regarding which survivors are most at risk of unhealthy behaviors.

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Section: Resultsmentioning

confidence: 99%

“…Health promotion conversation with healthcare professional N = 2 [28,30] Being able to contact healthcare professional for lifestyle choices…”

Section: Barriers Facilitators Barriers Facilitators Barriers Facilit...mentioning

confidence: 99%

Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

de Beijer,

Bouwman,

Mulder

et al. 2024

Cancer Medicine

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“…This aligns with prior research highlighting a lack of health behaviour knowledge among HCPs affiliated with survivorship care clinics across Europe [ 59 ]. Furthermore, in another published paper, it has been indicated as a barrier for childhood cancer survivors to adopt or maintain healthy behaviours [ 60 ]. Therefore, additional training in health behaviours could benefit the lifestyle intervention.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and potential effectiveness of nurse-led video-coaching interventions for childhood, adolescent, and young adult cancer survivors: the REVIVER study

Bouwman,

Stollman,

Wilbers

et al. 2024

BMC Cancer

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Background Childhood, adolescent, and young adult (CAYA) cancer survivors, at risk for late effects, including cancer-related fatigue, cardiovascular issues, and psychosocial challenges, may benefit from interventions stimulating behaviour adjustments. Three nurse-led eHealth interventions (REVIVER) delivered via video calls and elaborating on person-centred care, cognitive behaviour therapy and/or motivational interviewing were developed. These interventions target: 1) fatigue management, 2) healthier lifestyle behaviours, and 3) self-efficacy and self-management. This study aimed to assess the feasibility and potential effectiveness of the REVIVER interventions for CAYA cancer survivors and healthcare professionals. Methods In a single-group mixed methods design, CAYA cancer survivors aged 16–54, more than five years post-treatment, were enrolled. Feasibility, assessed via Bowen's outcomes for feasibility studies, included acceptability, practicality, integration and implementation, demand and adherence. Qualitative data from semi-structured interviews and a focus group interview with survivors and healthcare professionals supplemented the evaluation. Paired sample t-tests assessed changes in self-reported quality of life, fatigue, lifestyle, self-management, and self-efficacy at baseline (T0), post-intervention (T1), and 6-month follow-up (T2). Results The interventions and video consults were generally acceptable, practical, and successfully integrated and implemented. Success factors included the nurse consultant (i.e., communication, approach, and attitude) and the personalised approach. Barriers included sustainability concerns, technical issues, and short intervention duration. Regarding demand, 71.4%, 65.4%, and 100% of eligible CAYA cancer survivors engaged in the fatigue (N = 15), lifestyle (N = 17) and empowerment (N = 3) intervention, respectively, with 5, 5 and 2 participants interviewed, correspondingly. Low interest (demand) in the empowerment intervention (N = 3) and dropout rates of one-third for both fatigue and empowerment interventions were noted (adherence). Improvements in quality of life, fatigue (fatigue intervention), lifestyle (lifestyle intervention), self-efficacy, and self-management were evident among survivors who completed the fatigue and lifestyle interventions, with medium and large effect sizes observed immediately after the intervention and six months post-intervention. Conclusions Our study demonstrates the feasibility of nurse-led video coaching (REVIVER interventions) despite lower demand for the empowerment intervention and lower adherence to the fatigue and empowerment interventions. The medium and high effect sizes found for those who completed the interventions hold potential clinical significance for future studies investigating the effectiveness of the REVIVER interventions.

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Perceived barriers and facilitators to health behaviors in European childhood cancer survivors: A qualitative PanCareFollowUp study

et al. 2023

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The last four decades have seen great improvements in childhood cancer survival with 5-year survival rates increasing from 30% in 1970 to more than 80% at present. Currently, there are over 300,000 and 400,000 childhood cancer survivors living in Europe and the United States, respectively. 1-4 However, an unfortunate consequence of cancer treatment is that a majority of survivors are predisposed to an elevated life-long risk of developing health-related late effects. [5][6][7] Previous research has shown that health behaviors may have an impact upon a range of late effects. [8][9][10][11] For example, several studies have found associations between physical activity and a better cardiometabolic profile in adult survivors of childhood cancer. [8][9][10]12 In addition, a study by Tonorezos et al. showed that adherence to a Mediterranean diet pattern with high fruit and vegetable

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Perceived barriers and facilitators to health behaviors in European childhood cancer survivors: A qualitative PanCareFollowUp study

Cited by 6 publications

References 36 publications

Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

Feasibility and potential effectiveness of nurse-led video-coaching interventions for childhood, adolescent, and young adult cancer survivors: the REVIVER study

Perceived barriers and facilitators to health behaviors in European childhood cancer survivors: A qualitative PanCareFollowUp study

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