BMC Cancer (Oct 2020)

Translating research into practice: outcomes from the Healthy Living after Cancer partnership project

  • Elizabeth G. Eakin,
  • Marina M. Reeves,
  • Ana D. Goode,
  • Elisabeth A. H. Winkler,
  • Janette L. Vardy,
  • Frances Boyle,
  • Marion R. Haas,
  • Janet E. Hiller,
  • Gita D. Mishra,
  • Michael Jefford,
  • Bogda Koczwara,
  • Christobel M. Saunders,
  • Kathy Chapman,
  • Liz Hing,
  • Anna G. Boltong,
  • Katherine Lane,
  • Polly Baldwin,
  • Lesley Millar,
  • Sandy McKiernan,
  • Wendy Demark-Wahnefried,
  • Kerry S. Courneya,
  • Jennifer Job,
  • Natasha Reid,
  • Erin Robson,
  • Nicole Moretto,
  • Louisa Gordon,
  • Sandra C. Hayes

DOI
https://doi.org/10.1186/s12885-020-07454-4
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 13

Abstract

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Abstract Background Healthy Living after Cancer (HLaC) was a national dissemination and implementation study of an evidence-based lifestyle intervention for cancer survivors. The program was imbedded into existing telephone cancer information and support services delivered by Australian state-based Cancer Councils (CC). We report here the reach, effectiveness, adoption, implementation, and maintenance of the program. Methods In this phase IV study (single-group, pre-post design) participants - survivors of any type of cancer, following treatment with curative intent - received up to 12 nurse/allied health professional-led telephone health coaching calls over 6 months. Intervention delivery was grounded in motivational interviewing, with emphasis on evidence-based behaviour change strategies. Using the RE-AIM evaluation framework, primary outcomes were reach, indicators of program adoption, implementation, costs and maintenance. Secondary (effectiveness) outcomes were participant-reported anthropometric, behavioural and psychosocial variables including: weight; physical activity; dietary intake; quality-of-life; treatment side-effects; distress; and fear of cancer recurrence and participant satisfaction. Changes were evaluated using linear mixed models, including terms for timepoint (0/6 months), strata (Cancer Council), and timepoint x strata. Results Four of 5 CCs approached participated in the study. In total, 1183 cancer survivors were referred (mostly via calls to the Cancer Council telephone information service). Of these, 90.4% were eligible and 88.7% (n = 791) of those eligible consented to participate. Retention rate was 63.4%. Participants were mostly female (88%), aged 57 years and were overweight (BMI = 28.8 ± 6.5 kg/m2). Improvements in all participant-reported outcomes (standardised effect sizes of 0.1 to 0.6) were observed (p < 0.001). The program delivery costs were on average AU$427 (US$296) per referred cancer survivor. Conclusions This telephone-delivered lifestyle intervention, which was feasibly implemented by Cancer Councils, led to meaningful and statistically significant improvements in cancer survivors’ health and quality-of-life at a relatively low cost. Trial registration Australian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015).

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