Surviving and Thriving With Cancer Using a Web-Based Health Behavior Change Intervention: Randomized Controlled Trial

Abstract

BackgroundGiven the substantial improvements in cancer screening and cancer treatment in the United States, millions of adult cancer survivors live for years following their initial cancer diagnosis and treatment. However, latent side effects can occur and some symptoms can be alleviated or managed effectively via changes in lifestyle behaviors.ObjectiveThe purpose of this study was to test the effectiveness of a six-week Web-based multiple health behavior change program for adult survivors.MethodsParticipants (n=352) were recruited from oncology clinics, a tumor registry, as well as through online mechanisms, such as Facebook and the Association of Cancer Online Resources (ACOR). Cancer survivors were eligible if they had completed their primary cancer treatment from 4 weeks to 5 years before enrollment. Participants were randomly assigned to the Web-based program or a delayed-treatment control condition.ResultsIn total, 303 survivors completed the follow-up survey (six months after completion of the baseline survey) and participants in the Web-based intervention condition had significantly greater reductions in insomnia and greater increases in minutes per week of vigorous exercise and stretching compared to controls. There were no significant changes in fruit and vegetable consumption or other outcomes.ConclusionsThe Web-based intervention impacted insomnia and exercise; however, a majority of the sample met or exceeded national recommendations for health behaviors and were not suffering from depression or fatigue at baseline. Thus, the survivors were very healthy and well-adjusted upon entry and their ability to make substantial health behavior changes may have been limited. Future work is discussed, with emphasis placed on ways in which Web-based interventions can be more specifically analyzed for benefit, such as in regard to social networking.Trial RegistrationClinicaltrials.gov NCT00962494; http://www.clinicaltrials.gov/ct2/show/NCT00962494 (Archived by WebCite at http://www.webcitation.org/6NIv8Dc6Q).

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

“…However, greater improvements in moderate to vigorous physical activity were observed here. Prior studies have observed improvements in moderate to vigorous physical activity that ranged from 18-minutes [24] to 103-minutes [30], whereas we observed a 250-minutes increase in our complete-case and 147-minute increase in our intent-totreat analyses. Despite the large improvements we observed, the effect size comparing conditions were small in magnitude.…”

“…Our feasibility data were favorable, but attrition rates were high. The study's attrition rate was comparable to previous web-based intervention studies [48][49][50], but higher than others [24,26,[29][30][31]34]. We believe that functionality challenges contributed to high attrition rates.…”

“…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.…”

“…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].…”

A Personalized Physical Activity Program With Activity Trackers and a Mobile Phone App for Patients With Metastatic Breast Cancer: Protocol for a Single-Arm Feasibility Trial (Preprint)

“…A study performed in overweight and obese endometrial and breast cancer patients observed a significant reduction in anthropometric measurements after a onemonth intervention with a specific mobile application [33]. Another study including 303 women with cancer reported a reduction in insomnia, an increase in levels of vigorous physical activity and stretching after a six-week web health program [34]. The positive effects of a mobile health and pedometer on physical fitness, physical activity and quality of life of patients with breast cancer have been recently described [35].…”