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

Authors
  • Eakin, Elizabeth G.1, 2
  • Reeves, Marina M.1
  • Goode, Ana D.1
  • Winkler, Elisabeth A. H.1
  • Vardy, Janette L.3
  • Boyle, Frances3, 4
  • Haas, Marion R.5
  • Hiller, Janet E.6
  • Mishra, Gita D.1
  • Jefford, Michael7, 8
  • Koczwara, Bogda9
  • Saunders, Christobel M.10
  • Chapman, Kathy3, 11
  • Hing, Liz12
  • Boltong, Anna G.8, 13
  • Lane, Katherine14
  • Baldwin, Polly15
  • Millar, Lesley10
  • McKiernan, Sandy16
  • Demark-Wahnefried, Wendy17
  • And 7 more
  • 1 The University of Queensland, Brisbane, QLD, Australia , Brisbane (Australia)
  • 2 The University of Queensland, Herston Road, Herston, QLD, 4006, Australia , Herston (Australia)
  • 3 University of Sydney, Sydney, NSW, Australia , Sydney (Australia)
  • 4 Mater Hospital, Sydney, NSW, Australia , Sydney (Australia)
  • 5 University of Technology Sydney, Sydney, NSW, Australia , Sydney (Australia)
  • 6 Swinburne University of Technology, Melbourne, VIC, Australia , Melbourne (Australia)
  • 7 Peter MacCallum Cancer Centre, Melbourne, VIC, Australia , Melbourne (Australia)
  • 8 University of Melbourne, Carlton, VIC, Australia , Carlton (Australia)
  • 9 Flinders University, Adelaide, SA, Australia , Adelaide (Australia)
  • 10 University of Western Australia, Perth, WA, Australia , Perth (Australia)
  • 11 University of Newcastle, Newcastle, NSW, Australia , Newcastle (Australia)
  • 12 Cancer Council New South Wales, Woolloomooloo, Australia , Woolloomooloo (Australia)
  • 13 Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia , Parkville (Australia)
  • 14 Cancer Council Victoria, Melbourne, VIC, Australia , Melbourne (Australia)
  • 15 Cancer Council South Australia, Adelaide, SA, Australia , Adelaide (Australia)
  • 16 Cancer Council Western Australia, Perth, WA, Australia , Perth (Australia)
  • 17 University of Alabama at Birmingham, Birmingham, USA , Birmingham (United States)
  • 18 University of Alberta, Edmonton, Canada , Edmonton (Canada)
  • 19 QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia , Brisbane (Australia)
  • 20 Griffith University, Menzies Health Institute Queensland, Brisbane, QLD, Australia , Brisbane (Australia)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 06, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12885-020-07454-4
Source
Springer Nature
Keywords
License
Green

Abstract

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).

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