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  • Oxaliplatin br Cancer specific physical activity services ca

    2019-11-12


    Cancer-specific physical activity services can be costly and are often inaccessible. There is a call for scalable cost-effective remote interventions to support cancer survivors to become physically active.5 Cancer survivors across tumour sites and stages on the cancer continuum feel able and are interested in taking part in physical activities with a preference for home-based interventions6 delivered via mail, Internet and video.7 Cancer survivors want to become active on their own terms8 with flexibility around other commitments,6 and home-based interventions could help facilitate this.
    The efficacy of broad-reach interventions in changing lifestyle behaviours is supported by systematic review evi-dence; however, the results for physical activity exclusive of other lifestyle behaviours are mixed.5 Most offer one-to-one support either by phone, email or in-person,5 increasing intervention costs and limiting reach. A positive trend is re-ported in physical activity and quality of life in the few ex-amples of broad-reach interventions for cancer survivors without some Oxaliplatin of one-to-one support.9e13 Goode et al.5 call for the development and evaluation, including cost-effectiveness, of broad-reach interventions using newer technologies with integrated modalities. A combined approach using print and Internet modalities has been recommended.14
    Many interventions report a named theory, but few report on the application of theory to intervention development.5,15 This is a common problem in the reporting of behaviour change interventions more broadly. Less than 30% of public health and healthcare behaviour change interventions describe their content using theory and behaviour change techniques (BCTs) in enough detail for replication.16 The reporting of interventions should include detail of develop-ment, intervention components, related theoretical con-structs and the BCTs used.15,17
    Self-efficacy may be important in overcoming the barriers to physical activity faced by cancer survivors consistent with the general literature on health behaviour change.18 Previous studies give mention to the importance of self-efficacy but do not include aridity as an outcome measure or a predictor of change.11,12,19 Identifying as a physically active individual is also reported to be an indicator of physical activity in cancer survivors with those physically active before cancer diagnosis more likely to be so afterwards.20 
    A 2014 systematic review found no association between the time since diagnosis, treatment received or treatment status, tumour site, cancer stage or comorbidities with phys-ical activity adherence in cancer survivors.20 Clinical and de-mographic factors also do not predict improvement in health-related quality of life (HRQOL) in cancer survivors resulting from physical activity.21 In the general population, females and those of older age are less likely to adhere to physical activity;22 however, there is insufficient evidence to support this in cancer survivors.20
    This article describes the development and evaluation of a print-based intervention supported by Internet tools called the Move More Pack. This study aims to investigate the effect of the Move More Pack on the physical activity, self-efficacy and HRQOL of cancer survivors over 24 weeks. As the evidence supports the unequivocal role of physical activity in improving clinical and functional outcomes in cancer survivors,1 it is deemed unnecessary to assess additional outcomes.
    It is hypothesised that use of the Move More Pack will in-crease physical activity and the proportion of cancer survivors who are classified as active over 12 weeks, with changes maintained at 24 weeks. Furthermore, it is hypothesised that self-efficacy and prediagnosis levels of physical activity will predict improvements in physical activity. The economics of the Move More Pack are assessed by a cost-consequence analysis, an approach suggested to be appropriate for public health interventions.23