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

Elizabeth G. Eakin, Marina M. Reeves, Ana D. Goode, Elisabeth A.H. Winkler, Janette L. Vardy, Frances Boyle, Marion R. Haas, Janet E. Hiller, Gita D. Mishra, Michael Jefford, Bogda Koczwara, Christobel M. Saunders, Kathy Chapman, Liz Hing, Anna G. Boltong, Katherine Lane, Polly Baldwin, Lesley Millar, Sandy McKiernan, Wendy Demark-WahnefriedKerry S. Courneya, Jennifer Job, Natasha Reid, Erin Robson, Nicole Moretto, Louisa Gordon, Sandra C. Hayes

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Healthy 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. Methods: In 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. Results: Four 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. Conclusions: This 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 registration: Australian and New Zealand Clinical Trials Registry (ANZCTR)-ACTRN12615000882527 (registered on 24/08/2015).

Original languageEnglish
Article number963
Number of pages13
JournalBMC Cancer
Volume20
Issue number1
DOIs
Publication statusPublished - 6 Oct 2020

Keywords

  • Cancer survivors
  • Dissemination and implementation study
  • Healthy weight
  • Lifestyle intervention
  • Nutrition
  • Physical activity

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