Advertisement

Supportive Care in Cancer

, Volume 25, Issue 6, pp 1953–1962 | Cite as

Get Healthy after Breast Cancer - examining the feasibility, acceptability and outcomes of referring breast cancer survivors to a general population telephone-delivered program targeting physical activity, healthy diet and weight loss

  • S. Lawler
  • G. Maher
  • M. Brennan
  • A. Goode
  • M. M. Reeves
  • E. Eakin
Original Article

Abstract

Purpose

This pilot study assessed the feasibility, acceptability and outcomes of referring breast cancer survivors to the ‘Get Healthy Service’ (GHS), a state health-funded 6-month telephone-delivered lifestyle program.

Methods

Pre-post study with eligible and consenting women following treatment for stages I–III breast cancer referred by nurses in a cancer treatment centre to the GHS. Feasibility was assessed via GHS uptake and completion; acceptability was assessed via patient satisfaction and nurse feedback. Changes in weight, physical activity, diet, quality of life (QoL) and fatigue from baseline to 6 months were examined.

Results

Fifty-three women (mean ± SD body mass index, 31.0 ± 5.5 kg/m2; age, 57.3 ± 10.0 years; 14.0 ± 7.1 months post-diagnosis; 43.4% born outside Australia, 49% high school or less education, 32.1% English as a second language) took up the GHS, with 62% completing the program. Almost all (92%) completers had high satisfaction ratings and breast nurses provided positive feedback. Findings from GHS completers (n = 33) show a statistically significant effect from baseline to 6 months for weight loss (mean ± SE; −2.4 ± 0.7 kg; p = 0.002) and total physical activity minutes per week (55 ± 18 min/week; p = 0.006). No significant changes in fruit or vegetable servings per day or takeaways and fast food frequency per week were observed. A significant improvement in mental QoL was observed (3.5 ± 1.6; p = 0.041), but not for physical QoL or fatigue.

Conclusion

GHS referral appeared feasible, acceptable and effective for a diverse group of women following completion of treatment for breast cancer, yet more remains to be done to fully integrate GHS screening and referral into usual care.

Keywords

Breast cancer Survivorship Telephone coaching Physical activity Exercise Diet 

Notes

Compliance with ethical standards

Funding

This project was funded by an Early Career Research grant from The University of Queensland. Eakin is supported by an Australian National Health and Medical Research Council Senior Research Fellowship. Reeves is supported by a Fellowship from the National Breast Cancer Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

520_2017_3599_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 26 kb)

References

  1. 1.
    Youlden DR, Cramb SM, Dunn NAM, Muller JM, Pyke CM, Baade PD (2012) The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol 36(3):237–248CrossRefPubMedGoogle Scholar
  2. 2.
    Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA (2016) American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 34(6):611–635. doi: 10.1200/JCO.2015.64.3809 CrossRefPubMedGoogle Scholar
  3. 3.
    Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62(4):243–274CrossRefPubMedGoogle Scholar
  4. 4.
    Zhao G, Li C, Okoro CA, Li J, Wen XJ, White A, Balluz LS (2013) Trends in modifiable lifestyle-related risk factors following diagnosis in breast cancer survivors. J Cancer Surviv 7(4):563–569. doi: 10.1007/s11764-013-0295-5 CrossRefPubMedGoogle Scholar
  5. 5.
    Berry N, Miller M, Woodman R, Coveney J, Booth S, Dollman J, Mackenzie C, Koczwara B (2014) Differences in chronic conditions and lifestyle behaviour between people with a history of cancer and matched controls. Med J Aust 201(2):96–100CrossRefPubMedGoogle Scholar
  6. 6.
    Harrison SA, Hayes SC, Newman B (2010) Age-related differences in exercise and quality of life among breast cancer survivors. Med Sci Sports Exerc 42(1):67–74. doi: 10.1249/MSS.0b013e3181b0f2cb CrossRefPubMedGoogle Scholar
  7. 7.
    Jiralerspong S, Kim ES, Dong W, Feng L, Hortobagyi GN, Giordano SH (2013) Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol 24(10):2506–2514. doi: 10.1093/annonc/mdt224 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Protani M, Coory M, Martin J (2010) Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123(3):627–635. doi: 10.1007/s10549-010-0990-0 CrossRefPubMedGoogle Scholar
  9. 9.
    Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, Navarro Rosenblatt D, Thune I, Vieira R, Norat T (2014) Body mass index and survival in women with breast cancer—systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 25(10):1901–1914. doi: 10.1093/annonc/mdu042 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Friedenreich CM, Neilson HK, Farris M, Courneya KS (2016) Physical activity and cancer outcomes: a precision medicine approach. Clin Cancer Res 22(19):4766–4775. doi: 10.1158/1078-0432.CCR-16-0067 CrossRefPubMedGoogle Scholar
  11. 11.
    Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF, American College of Cardiology/American Heart Association Task Force on Practice G, Obesity S (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force On Practice Guidelines and The Obesity Society. Circulation 129(25 Suppl 2):S102–S138. doi: 10.1161/01.cir.0000437739.71477.ee CrossRefPubMedGoogle Scholar
  12. 12.
    Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT (2011) Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomark Prev 20(1):123–133. doi: 10.1158/1055-9965.EPI-10-0988 CrossRefGoogle Scholar
  13. 13.
    Ferrer RA, Huedo-Medina TB, Johnson BT, Ryan S, Pescatello LS (2011) Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Ann Behav Med 41(1):32–47. doi: 10.1007/s12160-010-9225-1 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Reeves MM, Terranova CO, Eakin EG, Demark-Wahnefried W (2014) Weight loss intervention trials in women with breast cancer: a systematic review. Obes Rev 15(9):749–768. doi: 10.1111/obr.12190 CrossRefPubMedGoogle Scholar
  15. 15.
    Zhu G, Zhang X, Wang Y, Xiong H, Zhao Y, Sun F (2016) Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trials. OncoTargets and therapy 9:2153–2168. doi: 10.2147/OTT.S97864 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Goode AD, Lawler SP, Brakenridge CL, Reeves MM, Eakin EG (2015) Telephone, print, and web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review. J Cancer Surviv 9(4):660–682. doi: 10.1007/s11764-015-0442-2 CrossRefPubMedGoogle Scholar
  17. 17.
    Alfano CM, Bluethmann SM, Tesauro G, Perna F, Agurs-Collins T, Elena JW, Ross SA, O'Connell M, Bowles HR, Greenberg D, Nebeling L (2016) NCI funding trends and priorities in physical activity and energy balance research among cancer survivors. J Natl Cancer Inst 108(1). doi: 10.1093/jnci/djv285
  18. 18.
    Anderson AS, Macleod M, Mutrie N, Sugden J, Dobson H, Treweek S, O'Carroll RE, Thompson A, Kirk A, Brennan G, Wyke S (2014) Breast cancer risk reduction—is it feasible to initiate a randomised controlled trial of a lifestyle intervention programme (ActWell) within a national breast screening programme? Int J Behav Nutr Phys Act 11:156. doi: 10.1186/s12966-014-0156-2 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Lawler S, Spathonis KM, Masters J, Adams J, Eakin E (2011) Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women. Support Care Cancer 19(12):1975–1982CrossRefPubMedGoogle Scholar
  20. 20.
    O’Hara BJ, Bauman AE, Eakin EG, King L, Haas M, Allman-Farinelli M, Owen N, Cardona-Morell M, Farrell L, Milat AJ, Phongsavan P (2013) Evaluation framework for translational research: case study of Australia’s Get Healthy Information and Coaching Service®. Health Promot Pract 14(3):380–389CrossRefPubMedGoogle Scholar
  21. 21.
    Eakin EG, Lawler SP, Vandelanotte C, Owen N (2007) Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med 32(5):419–434CrossRefPubMedGoogle Scholar
  22. 22.
    Goode AD, Reeves MM, Eakin EG (2012) Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med 42(1):81–88. doi: 10.1016/j.amepre.2011.08.025 CrossRefPubMedGoogle Scholar
  23. 23.
    Graves N, Barnett AG, Halton KA, Veerman JL, Winkler E, Owen N, Reeves MM, Marshall A, Eakin E (2009) Cost-effectiveness of a telephone-delivered intervention for physical activity and diet. PLoS One 4(9):e7135. doi: 10.1371/journal.pone.0007135 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    O’Hara BJ, Phongsavan P, McGill B, Maxwell M, Ahmed N, Raheb S, Bauman AE (2014) The NSW Get Healthy Information and Coaching Service: the first five years. (trans: Sydney. NMoHPRCUo)Google Scholar
  25. 25.
    NSW Health Western Sydney Local Health District (2013) Western Sydney Local Health District—about us. http://www.wslhd.health.nsw.gov.au/About-Us. Accessed 26 Aug 2016
  26. 26.
    Australian Institute of Health and Welfare (2003) The Active Australia Survey: a guide and manual for implementation, analysis and reporting. Australian Institute of Health and Welfare, CanberraGoogle Scholar
  27. 27.
    Reeves MM, Winkler EAH, Eakin EG (2015) Fat and Fibre Behaviour Questionnaire: reliability, relative validity and responsiveness to change in Australian adults with type 2 diabetes and/or hypertension. Nutrition & Dietetics. doi: 10.1111/1747-0080.12160 Google Scholar
  28. 28.
    Coyne T, Ibiebele TI, McNaughton S, Rutishauser IHE, O'Dea K, Hodge AM, McClintock C, Findlay MG, Lee A (2005) Evaluation of brief dietary questions to estimate vegetable and fruit consumption using serum carotenoids and red-cell folate. Public Health Nutr 8(3):298–308CrossRefPubMedGoogle Scholar
  29. 29.
    Rutishauser IHE, Webb K, Abraham B, Allsopp R (2001) Evaluation of short dietary questions from the 1995 National Nutrition Survey. Australian Government Department of Health and Ageing, CanberraGoogle Scholar
  30. 30.
    Sanson-Fisher RW, Perkins JJ (1998) Adaptation and validation of the SF-36 Health Survey for use in Australia. J Clin Epidemiol 51(11):961–967CrossRefPubMedGoogle Scholar
  31. 31.
    Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manag 13(2):63–74CrossRefGoogle Scholar
  32. 32.
    Australian Bureau of Statistics (2009) Household income and income distribution, Australia, 2007–2008. CanberraGoogle Scholar
  33. 33.
    O'Hara BJ, Phongsavan P, Venugopal K, Eakin EG, Eggins D, Caterson H, King L, Allman-Farinelli M, Haas M, Bauman AE (2012) Effectiveness of Australia’s Get Healthy Information and Coaching Service®: translational research with population wide impact. Prev Med 55(4):292–298. doi: 10.1016/j.ypmed.2012.07.022 CrossRefPubMedGoogle Scholar
  34. 34.
    Goode A, Reeves M, Owen N, Eakin E (2013) Results from the dissemination of an evidence-based telephone-delivered intervention for healthy lifestyle and weight loss: the Optimal Health Program. Translational Behavioral Medicine 3(4):340–350. doi: 10.1007/s13142-013-0210-7 CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Whelan ME, Goode AD, Eakin EG, Veerman JL, Winkler EAH, Hickman IJ, Reeves MM (2016) Feasibility, effectiveness and cost-effectiveness of a telephone-based weight loss program delivered via a hospital outpatient setting. Translational Behavioral Medicine 6(3):386–395. doi: 10.1007/s13142-015-0337-9 CrossRefPubMedGoogle Scholar
  36. 36.
    O'Hara BJ, Phongsavan P, Eakin EG, Develin E, Smith J, Greenaway M, Bauman AE (2013) Effectiveness of Australia’s Get Healthy Information and Coaching Service®: maintenance of anthropometric and behavioural changes after program completion. BMC Public Health 13:175CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    O’Hara BJ, Phongsavan P, Venugopal K, Bauman AE (2011) Characteristics of participants in Australia’s Get Healthy telephone-based lifestyle information and coaching service: reaching disadvantaged communities and those most at need. Health Educ Res 26(6):1097–1106. doi: 10.1093/her/cyr091 CrossRefPubMedGoogle Scholar
  38. 38.
    Goode A, Lawler S, Brakenridge C, Reeves M, Eakin E (2015) Telephone, print and web-based interventions for physical activity, diet and weight control among cancer survivors: a systematic review. Journal of Cancer Survivorship Research and Practice 9(4):660–682CrossRefPubMedGoogle Scholar
  39. 39.
    Brennan ME, Butow P, Spillane AJ, Boyle FM (2010) Survivorship care after breast cancer: follow-up practices of Australian health professionals and attitudes to a survivorship care plan. Asia Pac J Clin Oncol 6(2):116–125. doi: 10.1111/j.1743-7563.2010.01286.x CrossRefPubMedGoogle Scholar
  40. 40.
    Viswanathan M, Halpern M, Swinson Evans T, Birken SA, Mayer DK, Basch E (2014) Models of cancer survivorship care. Agency for Healthcare Research and Quality Rockville, MDGoogle Scholar
  41. 41.
    Brennan ME, Butow P, Marven M, Spillane AJ, Boyle FM (2011) Survivorship care after breast cancer treatment—experiences and preferences of Australian women. Breast 20(3):271–277. doi: 10.1016/j.breast.2010.12.006 CrossRefPubMedGoogle Scholar
  42. 42.
    Mishra GD, Hockey R, Dobson AJ (2014) A comparison of SF-36 summary measures of physical and mental health for women across the life course. Qual Life Res 23(5):1515–1521. doi: 10.1007/s11136-013-0586-3 CrossRefPubMedGoogle Scholar
  43. 43.
    Goodwin PJ, Segal RJ, Vallis M, Ligibel JA, Pond GR, Robidoux A, Blackburn GL, Findlay B, Gralow JR, Mukherjee S, Levine M, Pritchard KI (2014) Randomized trial of a telephone-based weight loss intervention in postmenopausal women with breast cancer receiving letrozole: the LISA Trial. J Clin Oncol 32(21):2231–2239. doi: 10.1200/JCO.2013.53.1517 CrossRefPubMedGoogle Scholar
  44. 44.
    Fong DYT, Ho JWC, Hui BPH, Lee AM, Macfarlane DJ, Leung SSK, Cerin E, Chan WYY, Leung IPF, Lam SHS, Taylor AJ, Cheng K-k (2012) Physical activity for cancer survivors: meta-analysis of randomised controlled trials. The BMJ 344:e70. doi: 10.1136/bmj.e70 CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    World Cancer Research Fund, American Institute for Cancer Research (2010) Breast cancer 2010 report. Food, nutrition, physical activity, and the prevention of breast cancer. Continuous update project: keeping the science current. American Institute for Cancer Research, Washington DCGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Cancer Prevention Research Centre, School of Public HealthThe University of QueenslandBrisbaneAustralia
  2. 2.Westmead Breast Cancer InstituteSydneyAustralia

Personalised recommendations