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

BMC Cancer

Liz Hing¹  Polly Baldwin²  Katherine Lane³  Sandy McKiernan⁴  Bogda Koczwara⁵  Sandra C. Hayes⁶  Michael Jefford⁷  Louisa Gordon⁸  Janet E. Hiller⁹  Marina M. Reeves^1,10  Erin Robson^1,10  Jennifer Job^1,10  Ana D. Goode^1,10  Elisabeth A. H. Winkler^1,10  Gita D. Mishra^1,10  Natasha Reid^1,10  Nicole Moretto^1,11  Elizabeth G. Eakin^1,12  Wendy Demark-Wahnefried^1,13  Kerry S. Courneya^1,14  Anna G. Boltong^1,15  Janette L. Vardy^1,16  Frances Boyle^1,17  Kathy Chapman^1,18  Marion R. Haas^1,19  Christobel M. Saunders^2,20  Lesley Millar^2,20 

[1] Cancer Council New South Wales, Woolloomooloo, Australia;Cancer Council South Australia, Adelaide, SA, Australia;Cancer Council Victoria, Melbourne, VIC, Australia;Cancer Council Western Australia, Perth, WA, Australia;Flinders University, Adelaide, SA, Australia;Griffith University, Menzies Health Institute Queensland, Brisbane, QLD, Australia;Peter MacCallum Cancer Centre, Melbourne, VIC, Australia;University of Melbourne, Carlton, VIC, Australia;QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia;Swinburne University of Technology, Melbourne, VIC, Australia;The University of Queensland, Brisbane, QLD, Australia;The University of Queensland, Brisbane, QLD, Australia;QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia;The University of Queensland, Brisbane, QLD, Australia;School of Public Health, Faculty of Medicine, The University of Queensland, Herston Road, 4006, Herston, QLD, Australia;University of Alabama at Birmingham, Birmingham, USA;University of Alberta, Edmonton, Canada;University of Melbourne, Carlton, VIC, Australia;Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia;University of Sydney, Sydney, NSW, Australia;University of Sydney, Sydney, NSW, Australia;Mater Hospital, Sydney, NSW, Australia;University of Sydney, Sydney, NSW, Australia;University of Newcastle, Newcastle, NSW, Australia;University of Technology Sydney, Sydney, NSW, Australia;University of Western Australia, Perth, WA, Australia;

关键词: Lifestyle intervention;    Cancer survivors;    Dissemination and implementation study;    Physical activity;    Nutrition;    Healthy weight;   

DOI  :  10.1186/s12885-020-07454-4

来源: Springer

【 摘 要 】

BackgroundHealthy 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.MethodsIn 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.ResultsFour 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.ConclusionsThis 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 registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015).

【 授权许可】

CC BY