Utilizing an E-health intervention to promote health-related quality of life in women after cancer: The Australian women's wellness after cancer program

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Anderson, Debra
McGuire, Amanda
Porter-Steel, Janine
McCarthy, Alexandra
Seib, Charrlotte
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2018
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Santiago, Chile

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Introduction: Advances in medical technologies have improved many cancer survival rates (e.g., 5-year survival is 90% for breast cancer) and thus patients previously treated for cancer (or cancer survivors) represent a growing population. Despite this however, treatment-related health problems are common and are likely to significantly and negatively impact on quality of life. The project aimed to test the efficacy of 12-week ehealth multimodal lifestyle intervention to improve health-related quality of life (HRQoL) in Australian women previously treated for breast, gynaecological and blood cancers. Methods: The single-blinded multicentre randomized controlled trial recruited a total of 351 women within 24 months of completion of active cancer treatment. Women were randomly assigned to either a usual care or intervention group. The intervention, designed to enhance self-efficacy and promote positive lifestyle behaviours, comprised an interactive iBook and journal, web interface, and three virtual health coaching consultations by experienced cancer nurses. Data were collected on sociodemographic, lifestyle behaviours, and several health variables through structured online questionnaires at baseline (t0), 12 weeks (t1), and 24 weeks (t2). This paper used hierarchical models to examine within- and between- group changes (t0 – t2) in the main outcome variable of HRQoL (using the Short Form 36 or SF 36). Results: The average age of women in this study was 53 years (SD = 8). Over two-thirds of the sample were married (77%), many were Australian born (69%), and over half had completed a university degree (59%). Most Australian states were represented with around three-quarters of participants coming for Queensland, New South Wales, and Victoria. Linear mixed models showed significant within- and between- group increments in several SF 36 domains including Physical Functioning, Role Physical, Physical Component Scores (p<.05) while several other domains also showed significant improvements over time (Role Emotional, Social Function, Mental Component Score) though differences between groups were not noted. Conclusions: Despite generally good cancer survival rates, many women after cancer face a number of residual health problems which are amenable to interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related concerns and known chronic disease risk factors.

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International Journal of Behavioral Medicine

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25

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S1

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Psychology

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Public health

Biological psychology

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Psychology, Clinical

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Anderson, D; McGuire, A; Porter-Steel, J; McCarthy, A; Seib, C, Utilizing an E-health intervention to promote health-related quality of life in women after cancer: The Australian women's wellness after cancer program, Introduction: Advances in medical technologies have improved many cancer survival rates (e.g., 5-year survival is 90% for breast cancer) and thus patients previously treated for cancer (or cancer survivors) represent a growing population. Despite this however, treatment-related health problems are common and are likely to significantly and negatively impact on quality of life. The project aimed to test the efficacy of 12-week ehealth multimodal lifestyle intervention to improve health-related quality of life (HRQoL) in Australian women previously treated for breast, gynaecological and blood cancers. Methods: The single-blinded multicentre randomized controlled trial recruited a total of 351 women within 24 months of completion of active cancer treatment. Women were randomly assigned to either a usual care or intervention group. The intervention, designed to enhance self-efficacy and promote positive lifestyle behaviours, comprised an interactive iBook and journal, web interface, and three virtual health coaching consultations by experienced cancer nurses. Data were collected on sociodemographic, lifestyle behaviours, and several health variables through structured online questionnaires at baseline (t0), 12 weeks (t1), and 24 weeks (t2). This paper used hierarchical models to examine within- and between- group changes (t0 – t2) in the main outcome variable of HRQoL (using the Short Form 36 or SF 36). Results: The average age of women in this study was 53 years (SD = 8). Over two-thirds of the sample were married (77%), many were Australian born (69%), and over half had completed a university degree (59%). Most Australian states were represented with around three-quarters of participants coming for Queensland, New South Wales, and Victoria. Linear mixed models showed significant within- and between- group increments in several SF 36 domains including Physical Functioning, Role Physical, Physical Component Scores (p<.05) while several other domains also showed significant improvements over time (Role Emotional, Social Function, Mental Component Score) though differences between groups were not noted. Conclusions: Despite generally good cancer survival rates, many women after cancer face a number of residual health problems which are amenable to interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related concerns and known chronic disease risk factors., 2018, 25, pp. S152-S152