Healthy Living after Cancer: a dissemination and implementation study evaluating a telephone-delivered healthy lifestyle program for cancer survivors.

Elizabeth G Eakin,Ana D Goode,Marina M Reeves,Greg Sharplin,Polly Baldwin,Kathy Chapman,Lesley Millar,Lorna O’Brien,Katherine Lane,Janet E Hiller,Bogda Koczwara,Sandy Mckiernan,Gita D Mishra,Kate White,Frances Boyle,Kerry S Courneya,Kathryn H Schmitz,Afaf Girgis,Michael Jefford,Sandra C Hayes,Marion Haas ,Janette Vardy ,Christobel Saunders ,Anna Boltong ,Wendy Demark‐Wahnefried ,Erin Robson

doi:10.1186/s12885-015-2003-5

Abstract

BackgroundGiven evidence shows physical activity, a healthful diet and weight management can improve cancer outcomes and reduce chronic disease risk, the major cancer organisations and health authorities have endorsed related guidelines for cancer survivors. Despite these, and a growing evidence base on effective lifestyle interventions, there is limited uptake into survivorship care.Methods/DesignHealthy Living after Cancer (HLaC) is a national dissemination and implementation study that will evaluate the integration of an evidence-based lifestyle intervention for cancer survivors into an existing telephone cancer information and support service delivered by Australian state-based Cancer Councils. Eligible participants (adults having completed cancer treatment with curative intent) will receive 12 health coaching calls over 6 months from Cancer Council nurses/allied health professionals targeting national guidelines for physical activity, healthy eating and weight control. Using the RE-AIM evaluation framework, primary outcomes are service-level indicators of program reach, adoption, implementation/costs and maintenance, with secondary (effectiveness) outcomes of patient-reported anthropometric, behavioural and psychosocial variables collected at pre- and post-program completion. The total participant accrual target across four participating Cancer Councils is 900 over 3 years.DiscussionThe national scope of the project and broad inclusion of cancer survivors, alongside evaluation of service-level indicators, associated costs and patient-reported outcomes, will provide the necessary practice-based evidence needed to inform future allocation of resources to support healthy living among cancer survivors.Trial registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015)

Highlights

To mitigate these risks and improve the longer-term well-being of cancer survivors, national cancer organisations recommend that cancer survivors engage in regular physical activity, eat a healthy diet and keep their weight within a healthy range [8,9,10]
The Healthy Living after Cancer partnership Healthy Living after Cancer (HLaC) is a dissemination and implementation study that will evaluate the integration of an evidence-based lifestyle intervention for cancer survivors into an existing telephone cancer information and support service delivered by the Australian state-based Cancer Councils
The Cancer Councils offer a telephone “13 11 20 Cancer Information and Support Service” with coverage across Australia. This existing service delivery infrastructure, combined with the priority placed on survivorship support, and their position stand on nutrition and physical activity for cancer survivors [9], provide an optimal framework on which to scale-up, implement nationally and evaluate an evidence-based lifestyle intervention for cancer survivors

Summary

Discussion

This study represents the first scaled-up and nationallevel implementation and evaluation of an evidence-based lifestyle intervention for cancer survivors in collaboration with a peak cancer control and community facing partner. As such, it is consistent with calls for the conduct of practice-based and dissemination research that accelerates the transfer of cancer survivorship research into evidencebased cancer care [47,48,49]. From the outset, the study has engaged a group of cancer policy, practice and service delivery stakeholders, along with lifestyle and cancer survivorship experts and cancer clinicians This transdisciplinary collaboration provided guidance on study design, evaluation and intervention protocol adaptation and will oversee study implementation, culminating in consideration of and advocacy around study findings in relation to sustained funding for HLaC program delivery. All authors were involved in drafting and critically revising the manuscript and read and approved the final manuscript

Background

Methods/Design

Objectives

Findings

69. Canberra