Supportive Care in Cancer

, Volume 27, Issue 4, pp 1299–1308 | Cite as

Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction intervention: a qualitative study

  • Darryl SomayajiEmail author
  • Amanda C. Blok
  • Laura L. Hayman
  • Yolanda Colson
  • Michael Jaklisch
  • Mary E. Cooley
Original Article



Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction intervention.


Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics.


Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors.


Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.


Lung cancer Health goals Multiple health behavior change Coaching Health-related quality of life Lifestyle risk reduction 



The authors would like to thank Karen M. Emmons, PhD, for guidance and use of HD intervention materials and Raphael Bueno MD for guidance in implementing the study.


This study was financially supported by the Lung Cancer Research Foundation (MEC), National Institutes of Health, U54 CA156732 (DS), R25T CA172009 (ACB).

Compliance with ethical standards

Conflict of interest

Authors Somayaji, Blok, Hayman, Colson, and Jaklisch have no conflicts of interest to disclose. Dr. Cooley reports grant support from the Lung Cancer Research Foundation. Dr. Cooley has control of all primary data and agrees to allow the journal to review their data if requested.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University at BuffaloBuffaloUSA
  2. 2.Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial HospitalUnited States Department of Veterans AffairsBedfordUSA
  3. 3.Graduate School of Nursing and Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonUSA
  5. 5.Division of Thoracic SurgeryBrigham and Women’s HospitalBostonUSA
  6. 6.Dana-Farber Cancer InstituteBostonUSA

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