Abstract
BackgroundLifestyle factors, including diet and physical activity, are associated with prostate cancer progression and mortality. However, it is unclear how men would like lifestyle information to be delivered following primary treatment. This study aimed to identify men’s preferences for receiving lifestyle information.MethodsWe conducted a cross-sectional pilot best-worst discrete choice experiment which was nested within a feasibility randomised controlled trial. Our aim was to explore men’s preferences of receiving diet and physical activity advice following surgery for localised prostate cancer. Thirty-eight men with a mean age of 65 years completed best-worst scenarios based on four attributes: (1) how information is provided; (2) where information is provided; (3) who provides information; and (4) the indirect cost of receiving information. Data was analysed using conditional logistic regression. Men’s willingness to pay (WTP) for aspects of the service was calculated using an out-of-pocket cost attribute.ResultsThe combined best-worst analysis suggested that men preferred information through one-to-one discussion β = 1.07, CI = 0.88 to 1.26) and not by email (β = − 1.02, CI = − 1.23 to − 0.80). They preferred information provided by specialist nurses followed by dietitians (β = 0.76, CI = 0.63 to 0.90 and − 0.16, CI = − 0.27 to − 0.05 respectively) then general nurses (β = − 0.60, CI = − 0.73 to − 0.48). Three groups were identified based on their preferences. The largest group preferred information through individual face-to-face or group discussions (β = 1.35, CI = 1.05 to 1.63 and 0.70, CI = 0.38 to 1.03 respectively). The second group wanted information via one-to-one discussions or telephone calls (β = 1.89, CI = 1.41 to 2.37 and 1.03, CI = 0.58 to 1.48 respectively), and did not want information at community centres (β = − 0.50, CI = − 0.88 to − 0.13). The final group preferred individual face-to-face discussions (β = 0.45, CI = 0.03 to 0.88) but had a lower WTP value (£17).ConclusionsMen mostly valued personalised methods of receiving diet and physical activity information over impersonal methods. The out-of-pocket value of receiving lifestyle information was important to some men. These findings could help inform future interventions using tailored dietary and physical activity advice given to men by clinicians following treatment for prostate cancer, such as mode of delivery, context, and person delivering the intervention. Future studies should consider using discrete choice experiments to examine information delivery to cancer survivor populations.
Highlights
Lifestyle factors, including diet and physical activity, are associated with prostate cancer progression and mortality
Weight gain over 8-years prior to diagnosis was associated with an increased risk of advanced prostate cancer in men with a body mass index (BMI) ≥ 25kg/m2 at age 21 who never smoked [4]
Wright and colleagues [22] used the same Best-Worst Discrete Choice Experiments (BWDCE) questionnaire to quantify the preferences for lifestyle information delivery in 179 men and women adult survivors of colorectal cancer, who had completed treatment
Summary
Lifestyle factors, including diet and physical activity, are associated with prostate cancer progression and mortality. It is unclear how men would like lifestyle information to be delivered following primary treatment. Prostate cancer is the second most common cancer in men worldwide, accounting for 15% of all male-related cancer diagnoses [1] It is the fifth most common cause of cancer death worldwide in men, with more than 300, 000 deaths per year [2]. Evidence from longitudinal studies suggests that lifestyle factors, such as being overweight or obese, having an unhealthy diet, and little physical exercise can increase a man’s risk of prostate cancer progression. Over 51,500 men who performed ≥ 3 h of vigorous exercise per week had a 61% lower risk of prostate cancer mortality compared to men who performed < 1 h per week over a 10-year follow-up period [6]
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