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Randomized Controlled Trial
. 2016 Oct;10(5):883-97.
doi: 10.1007/s11764-016-0535-6. Epub 2016 Mar 17.

Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) intervention for cancer survivors: a randomized controlled trial

Iris M Kanera  1 , Catherine A W Bolman  2 , Roy A Willems  2 , Ilse Mesters  3 , Lilian Lechner  2
Affiliations
Randomized Controlled Trial

Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) intervention for cancer survivors: a randomized controlled trial

Iris M Kanera et al. J Cancer Surviv. 2016 Oct.

Abstract

Purpose: The web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) responds to the needs of cancer survivors and oncology care providers to improve the counseling related to self-management of lifestyle and psychosocial challenges. In present study, overall intervention effects and the effects of using specific components were evaluated on vegetable, fruit, whole grain bread, and fish consumption, physical activity (PA), and smoking behavior.

Methods: Cancer survivors from 21 Dutch hospitals were recruited for a randomized controlled trial (N = 432). Intervention effects after 6 months were evaluated using multilevel linear regression analysis (complete cases and intention-to-treat). By conducting moderation analyses, additional effects of following the behavior-related modules were explored. The false discovery rate correction was applied to account for multiple testing.

Results: After 6 months, 409 participants completed follow-up (dropout = 11.5 %). Indications were found that access to the intervention may result in increases of moderate PA and vegetable intake. The moderate PA increase was meaningful: 74.74 min p/w higher increase in the intervention condition. Effect sizes of moderate PA (d = .25) and vegetable (d = .37) consumption were comparable to prior effective interventions. Visiting behavior-related modules affected moderate PA, fruit, and fish consumption. However, after correction for multiple testing, significances expired. No significant intervention effect was found on smoking behavior due to low numbers of smokers.

Implications for cancer survivors: Although the effectiveness was only shown only to a limited extend, this study provided several indications that this theory-based, comprehensive, and personalized eHealth intervention provides valuable content to complement usual cancer aftercare.

Keywords: Cancer survivorship; Computer tailoring; Nutrition; Physical activity; Smoking; eHealth.

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Conflict of interest statement

Compliance with Ethical Standards This research project was funded by the Dutch Cancer Society (grant number NOU2011-5151). Conflict of interests All authors declare that they have no conflict of interest. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards. Ethics approval for this trial (Dutch Trial Register NTR3375) was obtained from The Medical Ethics Committee Zuyderland-Zuyd (NL41445.096.12, 12-T-115). Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Lifestyle recommendations for cancer survivors used in the KNW intervention. Adapted from “Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.” by WCRF/AICR, 2009, and “American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention. Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity” by Kushi et al., 2012. Not all of the recommendation of the WCRF/AICR and the American Cancer Society are displayed. 1 For persons aged 18–70 years
Fig. 2
Fig. 2
Flow diagram of the reach and attrition of the KNW intervention participants
See this image and copyright information in PMC

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