Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review
Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery.
A structured search of PubMed, Embase, Web of Science, CINAHL, and CENTRAL (May 2013) was conducted. Included studies focused and reported on physical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50 % of intervention contacts by broad-reach modality and included a control group. Study design, intervention features, and behavioral/weight outcomes were extracted, tabulated, and summarized.
Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/27) targeted a single survivor group, namely breast cancer (n = 12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness.
This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyle interventions to cancer survivors. Future research should evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness.
Implications for Cancer Survivors
Broad-reach lifestyle interventions are effective, with further research needed to evaluate their generalizability and integration into cancer care.
KeywordsCancer survivors Diet Physical activity Weight loss Telephone Broad-reach
- 1.Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer, Lyon, France. 2013. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 17/06/2014.
- 10.World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington: AICR; 2007.Google Scholar
- 11.Blanchard CM, Courneya KS, Stein K, American Cancer Society’s SCS-II. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol. 2008;26(13):2198–204.CrossRefPubMedGoogle Scholar
- 20.Elena JW, Travis LB, Simonds NI, Ambrosone CB, Ballard-Barbash R, Bhatia S, et al. Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. J Natl Cancer Inst. 2013;105(2):85–94. doi:10.1093/jnci/djs473.PubMedCentralCrossRefPubMedGoogle Scholar
- 21.Phillips SM, Alfano CM, Perna FM, Glasgow RE. Accelerating translation of physical activity and cancer survivorship research into practice: recommendations for a more integrated and collaborative approach. Cancer Epidemiol Biomarkers Prev. 2014;23(5):687–99. doi:10.1158/1055-9965.EPI-13-1355.PubMedCentralCrossRefPubMedGoogle Scholar
- 32.Cohen J. Statistical power analysis for the behavioral sciences. New York: Academic Press; 1977.Google Scholar
- 37.Donnelly CM, Blaney JM, Lowe-Strong A, Rankin JP, Campbell A, McCrum-Gardner E, et al. A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Gynecol Oncol. 2011;122(3):618–24. doi:10.1016/j.ygyno.2011.05.029.CrossRefPubMedGoogle Scholar
- 38.Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade PD, Lynch BM, et al. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial. J Clin Oncol. 2013;31(18):2313–21. doi:10.1200/jco.2012.45.5873.CrossRefPubMedGoogle Scholar
- 40.Campbell MK, Carr C, DeVellis B, Switzer B, Biddle A, Amamoo MA, et al. A randomized trial of tailoring and motivational interviewing to promote fruit and vegetable consumption for cancer prevention and control. Ann Behav Med. 2009;38(2):71–85. doi:10.1007/s12160-009-9140-5.PubMedCentralCrossRefPubMedGoogle Scholar
- 45.Vallance JKH, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.1200/jco.2006.07.9988.CrossRefPubMedGoogle Scholar
- 49.Thorsen L, Skovlund E, Stromme SB, Hornslien K, Dahl AA, Fossa SD. Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol. 2005;23(10):2378–88. doi:10.1200/jco.2005.04.106.CrossRefPubMedGoogle Scholar
- 55.Ottenbacher AJ, Day RS, Taylor WC, Sharma SV, Sloane R, Snyder DC, et al. Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer. 2012;20(10):2483–9. doi:10.1007/s00520-011-1370-y.PubMedCentralCrossRefPubMedGoogle Scholar
- 57.Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer - The Women’s Healthy Eating and Living (WHEL) Randomized Trial. JAMA. 2007;298(3):289–98. doi:10.1001/jama.298.3.289.PubMedCentralCrossRefPubMedGoogle Scholar
- 59.Pierce JP, Faerber S, Wright FA, Rock CL, Newman V, Flatt SW, et al. A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) study. Control Clin Trials. 2002;23(6):728–56.CrossRefPubMedGoogle Scholar
- 61.Parsons JK, Newman V, Mohler JL, Pierce JP, Paskett E, Marshall J. The Men’s Eating and Living (MEAL) Study: a Cancer and Leukemia Group B pilot trial of dietary intervention for the treatment of prostate cancer. Urology. 2008;72(3):633-7.Google Scholar
- 62.Pinto BM, Rabin C, Papandonatos GD, Frierson GM, Trunzo JJ, Marcus BH. Maintenance of effects of a home-based physical activity program among breast cancer survivors. Support Care Cancer. 2008;33(2):235–254.Google Scholar
- 64.Griffith K, Wenzel J, Shang JJ, Thompson C, Stewart K, Mock V. Impact of a walking intervention on cardiorespiratory fitness, self-reported physical function, and pain in patients undergoing treatment for solid tumors. Cancer. 2009;115(20):4874–84. doi:10.1002/cncr.24551.PubMedCentralCrossRefPubMedGoogle Scholar
- 66.Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009;301(18):1883–91. doi:10.1001/jama.2009.643.PubMedCentralCrossRefPubMedGoogle Scholar
- 70.Ligibel JA, Meyerhardt J, Pierce JP, Najita J, Shockro L, Campbell N, et al. Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat. 2012. doi:10.1007/s10549-011-1882-7.Google Scholar
- 71.Hawkes AL, Pakenham KI, Courneya KS, Gollschewski S, Baade P, Gordon LG, et al. A randomised controlled trial of a tele-based lifestyle intervention for colorectal cancer survivors (‘CanChange’): study protocol. BMC Cancer. 2009;9:286. doi:10.1186/1471-2407-9-.PubMedCentralCrossRefPubMedGoogle Scholar
- 72.Hayes SC, Rye S, DiSipio T, Yates P, Bashford J, Pyke C, et al. Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer. Breast Cancer Res Treat. 2013;137(1):175–86. doi:10.1007/s10549-012-2331-y.CrossRefPubMedGoogle Scholar
- 77.Eakin E, Demark-Wahnefried W. Changing health behaviors after treatment. In: Holland JC, editor. Psycho-oncology. England: Oxford University Press; 2015.Google Scholar