Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors

Abstract

Objective To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the Ai M, Plan, and act on LIFest Yles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations. Methods The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations. Results A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks. Conclusions Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.

Using Mixed Methods Research to Optimize Healthy Lifestyle Intervention Adaptation for Web-Based Delivery: A Pragmatic Approach

“…AMPLIFY adaptation process was conducted in three phases spanning six years: (1) formative assessment and intervention development; (2) beta-testing and refinement; and (3) efficacy testing and process evaluation (Rogers et al, 2023). Multiple forms of quantitative and qualitative data were collected, analyzed, and integrated using concurrent and sequential timing to inform the adaptation processes in all phases, thus forming a complex (Creswell & Plano Clark, 2018) or scaffolded (Fetters, 2020) longitudinal mixed methods design intersected with an overall AM-PLIFY intervention design (Plano Clark & Ivankova, 2016) (Figure 1).…”

“…AMPLIFY was developed by adapting traditional modalities (i.e., face-to-face and print materials) of two previously tested diet and exercise interventions BEAT Cancer and RENEW (Morey et al, 2009;Rogers et al, 2015) both of which were found efficacious, to a web-based delivery. This work was performed under a program grant funded by the National Cancer Institute in 2018 (P01CA229997; Pekmezi et al, 2022;Rogers et al, 2023). AMPLIFY provides healthy eating and exercise behavior change support to promote weight loss, improvements in diet quality, and adherence to physical activity.…”

“…The exercise module focuses on the types, duration, and intensity of physical activity recommended for middleaged and older cancer survivors. The combined module incorporates both the diet and exercise interventions into a single, seamlessly merged program delivering diet and exercise simultaneously (Rogers et al, 2023). AMPLIFY national sample included 603 cancer survivors older than 49 years of age with a body mass index (BMI) of 25 to 50, who were randomized across the three intervention modules.…”

“…The purpose of this phase was to pilot test (beta-test) the adapted AMPLIFY program and generate "just-in-time" data to refine the program content, organization, and presentation using a concurrent Quantitative + Qualitative mixed methods design. Beta-testing was implemented in three phases: after 1 month, after 2-6 months, and after 7-12 months of using AMPLIFY website during which 14 cancer survivors completed weekly session evaluation surveys and participated in "think aloud" semi-structured individual interviews (Anderson et al, 2024;Rogers et al, 2023). Session evaluation surveys included Likert-type questions related to comprehension, relevance and importance of the information in each session and suggested improvements.…”

“…Examining the intervention underlying theory or evidence base and how it relates to program activities to maintain the original intervention fidelity is critical for an effective initiation of the adaption process. Since the AMPLIFY intervention was adapted from two social cognitive theory (SCT)-based exercise and diet behavior change interventions, SCT was selected to guide the AMPLIFY adaptation (Rogers et al, 2023). SCT promotes developing self-efficacy, overcoming barriers, and outcome expectations for a positive behavior change (Bandura et al, 1999), which aligns with AMPLIFY's purpose of providing encouragement with healthy eating and exercise to cancer survivors.…”