Abstract
BackgroundThe number of cancer survivors is growing. Negative physical and psychosocial consequences of cancer treatment can occur during survivorship. Following healthy lifestyle recommendations is beneficial to increase quality of life and to reduce the risk of cancer recurrence and comorbidities. To meet individual needs, web-based interventions can supply a large population of cancer survivors with easily accessible and personalized information. Evidence concerning the long-term effects of web-based cancer aftercare interventions on lifestyle outcomes is limited. The present study evaluates the 12-month effects of a fully automated web-based cancer aftercare intervention. We investigated whether the previously determined 6-month effects on moderate physical activity and vegetable intake were maintained over 12 months. Possible moderator effects of using specific intervention modules, gender, age, and education were also explored.MethodA two-armed randomized controlled trial was conducted using online self-report questionnaires among survivors of various types of cancer (N = 462). The intervention group had access to the online intervention for 6 months, and the control group received access after 12-months. Multilevel linear regression analyses (complete cases and intention-to-treat) were conducted to explore 12- month effects.ResultsA significant intervention effect after 12 months was found for moderate physical activity (complete cases: B = 128.475, p = .010, d = .35; intention-to-treat: B = 129.473, p = .011). Age was the only significant moderator (p = .010), with the intervention being effective among participants aged younger than 57 years (B = 256.549, p = .000, d = .59). No significant intervention effect remained for vegetable consumption after 12 months (complete cases: B = 5.860, p = .121; intention–to-treat: B = 5.560, p = .132).ConclusionThe online cancer after care intervention is effective in increasing and maintaining moderate physical activity in the long term among early cancer survivors younger than 57 years. Short-term increases in vegetable consumption were not sustained in the long term. These findings indicate the value and potential of eHealth interventions for cancer survivors. Based on the study results, web-based self-management interventions could be recommended for younger cancer survivors (<57 years of age) as a possible method to increase physical activity.Trial registrationDutch Trial Register NTR3375. Registered 29 March 2012.
Highlights
The number of cancer survivors is growing
The aim of the present study is to examine the longterm (12-month) effects of the web-based Kanker Nazorg Wijzer (KNW) on moderate physical activity (PA) and vegetable consumption, in order to evaluate whether the KNW outcomes on moderate PA and vegetable intake that were found 6 months after the baseline measurement were maintained in the long term
For the analyses of moderate PA, 11 respondents were excluded due to outliers (>6720 min p/w PA) at either baseline, 6-month or 12-month follow-up, which is in accordance with the SQUASH scorings manual, resulting in a baseline dataset of N = 451 for analyses [67]
Summary
The number of cancer survivors is growing. Negative physical and psychosocial consequences of cancer treatment can occur during survivorship. Following healthy lifestyle recommendations is beneficial to increase quality of life and to reduce the risk of cancer recurrence and comorbidities. Evidence concerning the long-term effects of web-based cancer aftercare interventions on lifestyle outcomes is limited. As a consequence of primary cancer treatment, cancer survivors’ quality of life (QoL) can be reduced by physical and psychosocial health problems, such as pain, fatigue, anxiety, depression, and work-related issues [3, 4]. A growing body of evidence has shown that cancer survivors’ QoL can be improved by adopting and maintaining a healthy lifestyle [7,8,9,10,11,12,13,14]. Despite the beneficial effects of recommended PA and healthy diet, the great majority of cancer survivors fail to meet the lifestyle recommendations [22,23,24,25]
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