Abstract
Spouses offer a primary source of support and may provide critical assistance for behavior change. A diet-exercise intervention previously found efficacious in improving cancer survivors’ lifestyle behaviors was adapted to utilize a couples-based approach. The aims were to test the feasibility of this couples-based (CB) intervention and compare its efficacy to the same program delivered to the survivor-only (SO). Twenty-two survivor-spouse couples completed baseline assessments and were randomized to the CB or SO interventions. The study surpassed feasibility benchmarks; 91% of survivors and 86% of spouses completed a 6-month follow-up. Survivors and spouses attended 94% and 91% of sessions, respectively. The SO survivors showed significant improvements on the 30-s chair stand and arm curl tests, weight, and fruit and vegetable (F and V) consumption. The CB survivors showed significant improvements on the 6-min walk and 2-min step tests, body weight, and fat and F and V consumption. Improvement in the 30-s chair stand and arm curl tests was significantly better for SO survivors. The SO spouses showed no significant changes in outcome measures, but the CB spouses showed significant improvements in moderate-to-strenuous physical activity, weight, and fat and F and V consumption. Weight loss was significantly greater in CB spouses compared to SO spouses. Findings demonstrate feasibility, warranting further investigation of CB approaches to promote lifestyle change among cancer survivors and spouses.
Highlights
Half a century ago, the nation’s War on Cancer was launched and has resulted in major increases in survival through improvements in early detection and treatment [1]
Few studies have incorporated spouses in behavioral interventions for cancer survivors, despite the importance of relationships between cancer survivors and their loved ones in survivorship and the potential to broaden the impact of positive behavior change [48]
The well-being of cancer survivors and their caregivers tend to covary over time throughout cancer treatment and survivorship, and the positive role modeling and social support for behavior change that may result from dyadic interventions can provide mutual benefits for both cancer survivors and their spouses in this context [27,49,50]
Summary
Half a century ago, the nation’s War on Cancer was launched and has resulted in major increases in survival through improvements in early detection and treatment [1]. There are over 17 million cancer survivors in the US alone, comprising roughly 4% of the population [2]. While many survivors have been definitively treated for cancer, they remain at risk for recurrence and are at an increased risk for second cancers, cardiovascular disease, and diabetes [3]. Many survivors experience lingering effects of cancer and its treatment, including fatigue, psychological distress, and accelerated functional decline [3,4]. The proposed study targets survivors of breast, prostate, and colorectal cancers because they are the largest segment of cancer survivors where survival rates currently exceed 90% [7]
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